Your essential update on health for the week.

HSJ Catch Up

This weekly email gives HSJ subscribers a vital update on the biggest stories in health. If you have been out of the office or otherwise just too busy to keep up, HSJ Catch Up will ensure you are still in the know.

Inaccurate, infrequently made, disjointed and incomplete

The prime minister’s recent announcement of capital funding focussed on new buildings and facilities, but funding for IT infrastructure is required just as urgently.

One trust in dire need of an upgrade is Blackpool Teaching Hospitals Foundation Trust, where the poor quality of patient notes and information sharing has been cited in at least five inquests since 2016.

In a case three years ago, an assistant coroner for Blackpool and Fylde warned the provider about patient records that were “inaccurate, infrequently made, disjointed and incomplete”, which she said was impacting on the care being given.

Strapped for cash

The CQC has recently investigated Leicester Royal Infirmary’s maternity wards, having been prompted to do so after three serious incidents.

Inspectors found a lack of consultants in the maternity assessment unit and assessments of women being delayed because staff had to juggle managing telephones and patient care.

These findings might be particularly galling for the trust, considering its capital bid for reconfiguring the services has been turned down repeatedly by the government.

Subculture shock

Being a clinical leader in the NHS is fraught with challenges, but new research from the General Medical Council has suggested the biggest challenge of all could come from your own team of doctors.

The medical regulator has produced a report defining five clinical subcultures that could be harmful if they are allowed to develop within a team.

Among them, the “diva” is highlighted as one that is most difficult to change if the “chief actor remains in situ”. However, addressing this is probably easier said than done in many cases, as this person is often powerful and, as pointed out by HSJ readers, rather good at their job.

A muted national emergency

Across the country, it is thought around 2,500 people rely on intravenous nutritional feed because they can no longer digest normal food. 

HSJ has reported serious delays to the supply of IV feed for hundreds of patients which has led to some, including children, being admitted to hospital to receive IV fluids after their feed bags were not delivered.

The situation is now so serious the NHS has declared a national emergency incident and is considering importing feeds from other countries.

Taking fire seriously

After the Grenfell fire in 2017, there was a burst of activity to make sure NHS trusts got their fire safety compliance in order. As HSJ revealed shortly after that tragic incident, several trusts had a lot of work to do.

Since then, parts of the NHS have been making efforts to bring their buildings up to standard, but worryingly this – in some cases – appears to be easier said than done. Improving fire safety costs money, and the lack of capital funding available for trusts to spend has been documented frequently by HSJ.

But it’s not just getting the money which can be the problem. In Cornwall, a dispute over much-needed fire safety works has resulted in the county’s mental health and community trust refusing to pay bills or rent for areas that require upgrading by landlord NHS Property Services.

Years of bumpy roads

After two years of uncertainty, the merger of Luton and Dunstable Hospital FT and Bedford Hospital Trust looks set to go ahead following the confirmation of badly needed capital funding from government last week.

It has been a bumpy road since the merger proposals were first unveiled in 2017, with ongoing doubts the trusts would secure the capital funding required for the collaboration to go ahead.

Last week, the trusts received the news they had been waiting for – that Luton and Dunstable had been allocated a portion of funding from government. The £99.5m will enable Luton and Dunstable to build a new acute services block and pave the way towards Luton and Bedford becoming a single trust.

Still fragile

Brighton and Sussex University Hospitals Trust has had a difficult journey over the past two years, having been subjected to a lot of regulatory intervention over poor care concerns and inadequate governance and management.

On both quality and finance, BSUH had showed signs of improvement under the leadership of Dame Marianne Griffiths. First, the trust exited financial special measures in July last year and then got the CQC seal of approval in January this year with a rare jump from an “inadequate” to a “good” overall rating. The trust was also taken out of quality special measures in January.

But a new undertakings document, published by NHS Improvement, reveals the trust’s continuing poor performance across a whole gamut of metrics, including accident and emergency, referral to treatment, 62-day cancer and diagnostics. 

Public sector bodies are usually loath to take each other to court, but that has not prevented a legal dispute between a well-regarded NHS foundation trust and the government’s tax collector.

In June, Northumbria Healthcare FT won a judicial review against Her Majesty’s Revenue and Customs over £14m of VAT claims which the trust argued it was entitled to reclaim.

The money relates to the trust’s innovative car scheme, NHS Fleet Solutions, which is used by many public sector organisations.

But HMRC decided to appeal the outcome and was granted permission to do so by the High Court.