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.
What the Queen’s Speech means for healthcare
The briefing on Thursday’s Queen’s Speech — giving a bit of detail behind her short spoken statement — drew heavily, in places, on the Conservative’s election manifesto.
Much questioned promises feature, including that 40 new hospitals will be funded and built over the next 10 years and the NHS will have 50,000 more nurses, while the pledge that the “price for NHS drugs is not on the table” was also repeated.
The document itself gave few surprises. It included: increases to the surcharge that immigrants pay towards the NHS; enshrining in law the NHS multiyear funding settlement; introducing fast-track reduced-fee visas for NHS doctors, nurses and allied health professionals; and providing hospital parking for those in greatest need.
The long wait
An audit of London trusts has shone a light on an issue which is widely accepted but for which we have little national evidence — mental health waits in accident and emergency departments.
The study of mental health patients across 25 A&Es in August found a pretty staggering 15 per cent waited more than 12 hours, while 55 per cent were not seen within the four-hour target.
Wednesday was “NHS day” for the new government, which is trying to use its post-election-win honeymoon to get a tranche of announcements and briefings out of the traps.
For national NHS officials, it will have gone down as a win, getting ministers — most notably the purse-holders at the Treasury — to sign off on nursing student grants just three working days after the election result, and ahead of the 15 January university application deadline.
In a speech on Wednesday morning, health and social care secretary Matt Hancock made the nursing grant announcement and threw in a few other pointers for this new term.
On tech, a new programme was born, called — adopting the health policy jargon of the day — the “digital aspirant programme”. This appears to be a signalling that “many more hospitals” need to get major IT upgrades, moving on from the focus of recent years on “exemplars” — and, therefore, effectively a bid to get substantial capital funding (and the associated revenue funding which would be needed) into these widespread tech investments.
Not a moment too soon
The high level of assaults on health and social care workers has prompted the Health and Safety Executive to step in. The watchdog has inspected 20 health and care providers on how they manage risks to their staff from violence and aggression, as well as musculoskeletal disorders.
And not a moment too soon. Three staff members have been killed by patients in the last five years. They include two people who were stabbed while working at mental health hospitals — one NHS-run — and another who was beaten with a fire extinguisher at a charity-run hostel, again by a mental health patient.
Non-fatal incidents in health and social care attributed to violence are also three times as high as all industries between 2015 and 2018, according to the HSE.
The age-old problem of provider deficits
Although they are now overshadowed by staggeringly poor A&E performance figures, NHS provider deficits are a problem that won’t go away.
The official mid-year performance figures for the sector showed little improvement to previous years, and analysis by HSJ suggests they will continue to get worse.
Several of the country’s largest trusts have been reviewing their forecasts during the third quarter of the year, including: University Hospital Southampton Foundation Trust; Barts Health Trust; and London North West University Healthcare Trust.
Oxford University Hospitals FT has already admitted it will miss its underlying control total by £17m.
Three strikes for Brighton
Coroners’ powers to issue prevention of future death reports often result in embarrassing publicity for trusts and other organisations on the receiving end of them — but do they result in meaningful change for patients?
Veronica Hamilton-Deeley, the senior coroner for Brighton and Hove, might say “not often enough” after issuing a third report focussing on patient transfers at Brighton and Sussex University Hospitals Trust.
In the most recent case, 88-year-old Jean Waghorn was moved three times in just over 48 hours. The first time was to make sure the patient could access specialist care at the Royal Sussex County Hospital, but then she was moved twice more for reasons Ms Hamilton-Deeley viewed as “not appropriate”, although she adds she cannot say the transfers contributed to her death.
Been and gone
It’s just five months since NHSX came into being, but already more than half of a team tasked with the digital transformation of the country’s health system has left.
Over the space of a month, five members of the digital transformation team — including director Sam Shah — have departed, which NHSX says is due to their contracts ending.
It is now unclear what will happen with the dozens of projects the team was working on, including the digital transformation of urgent and emergency care, and whether the roles will be filled again.
Return of the Mack
Integration may be the name of the game at the moment but, according to ex-NHS Improvement chief Jim Mackey, NHS staff care more about a sense of belonging than what it means to work in a ‘system’.
“People are worried services will get closed or rationalised, or moved to work from there to somewhere over there,” Sir Jim, current chief exec of Northumbria Healthcare Trust, told delegates at a Westminster Health Forum event last week.
More controversially, perhaps, he said leaders and organisations themselves should be circumspect about doing everything as a system, when it could sometimes be counterproductive.