Your essential update on health for the week.

HSJ Catch Up

This weekly email gives HSJ subscribers a vital update on the biggest stories from the last week 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.

Holes in the data

Disquiet has been growing in the centre for some time about trusts talking to tech companies about data sharing.

One concern is that trusts are giving away patient data too cheaply but another – growing – concern is these deals might interfere with grander national data-sharing plans.

The government views current (and, more importantly, future) national NHS patient data sets as a valuable economic tool to be leveraged to support research and industry. Holes in the data make it less valuable.

That is why a letter has been sent out to trusts ordering them not to enter exclusive deals to share data with one tech company.

The detail of the deal

On the face of it, the procurement of a new IT system by Guy’s and St Thomas’ Foundation Trust is a standard, albeit large, purchase – £175m over 10 years for such a large trust is not out of the ordinary.

What makes it more noteworthy is the successful contractor must include an option to join up two other trusts.

Which ones? Why, neighbour/rival King’s College Hospital FT and embattled specialist Royal Brompton and Harefield FT.

Toxic stuff

Rivalries and competition between leaders can be healthy, but, in the NHS, it can also have terrible consequences.

In Lancashire, a wide-ranging review of the urgent mental healthcare pathways has heavily criticised the poor relationships between key organisations, which deteriorated so much that some health and care leaders were said to “take pleasure” from problems experienced by their peers.

The reviewers found these poor relationships and a wider blame culture had “a direct impact on front line service delivery” and may have contributed to service users attempting suicide.

This is toxic stuff which has been allowed to go on for too long.

Mind the gap

According to Department of Health and Social Care analysis seen by HSJ, even with the very best efforts to boost international recruitment, the NHS will still be short of nearly 19,000 nurses by 2023-24.

And that 19,000 estimate is if “optimal delivery” of international recruitment efforts is pulled off. As Health Education England’s director of global engagement Ged Byrne has told HSJ in an exclusive interview, there are financial barriers getting in the way of some trusts investing in international recruitment.

Professor Byrne also addressed the process of international recruitment. He stressed HEE is trying to create greater transparency in the process to improve the “conversion rates” of interested potential recruits who actually end up working in the NHS.

Dropped monikers

It would seem good business practice, not to mention the patient safety implications, to have a (very) good reason for terminating a contract to provide clinical services early and at short notice.

Unfortunately, when provider Concordia Specialist Care Services “ceased delivering” a dermatology services contract in Essex, including some work for cancer patients, two months early, the company provided no official reason for doing so and just five days’ notice.

But this is not the only unusual detail of this story.

The provider’s parent company was called Concordia Health Holdings LLP until 17 May. Then its name, as listed on the Companies House website, changed to Omnes Healthcare Holdings LLP.

No name change can, however, hide or change its financial performance as reported in its most recent accounts, for the 18 months leading up to March 2018. These not only stated its liabilities exceeded its assets but raised doubts over the company’s ability to continue as a going concern.

Third strike

The Care Quality Commission has exercised its fundamental standards powers for the third time since they were introduced following the Mid Staffordshire care scandal.

The safety and quality regulator has announced it is prosecuting Avon and Wiltshire Mental Health Partnership Trust for allegedly failing to provide safe care to one of its patients. The prosecution relates to an incident where a patient sustained serious injuries falling from the roof of the trust’s Applewood ward in 2016. 

Temporary disruption

Digital service Push Doctor has emerged as one of the major players in the race to provide GP video consultations to the NHS, but it has had its teething problems.

In January last year, it attracted the ire of a local NHS organisation for using the address of a walk-in centre while advertising its private GP video consultation service. Its first CQC inspection, carried out in 2017, found Push Doctor was not providing a safe service. Last year, another CQC report noted that, despite some improvements, parts of the service were still not safe.

Now, according to a statement on the company’s website, it is temporarily suspending its services for all patients under 18. 

In a statement, the company said: “The crucial change that is being implemented is that you will be required to enable the sharing of your child’s medical records with their GP before your child is able to consult on Push Doctor.”

However, there is no indication in the statement as to what specifically prompted the suspension.

A familiar tale

The failings highlighted by the death of the young Averil Hart back in 2012 will sadly be a familiar tale.

Ms Hart was a young woman, 19 years old, who had suffered from anorexia nervosa for a number of years. She tragically died following a catalogue of failings from the four NHS organisations who cared for her. A 2017 Parliamentary health service ombudsman report into her death found every organisation missed opportunities to recognise her deteriorating condition.

But the failings from Averil’s death may have been more widespread than initially thought, as HSJ this week revealed the senior coroner for Cambridgeshire, David Hemings, is now looking into four other deaths he claimed were “inextricably” linked to that of Ms Hart.