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.

Same old, same old

The chancellor’s spending round this week told us little we didn’t already know, and the only genuine new money announcements for the NHS – the £250m AI fund and the uplift in continuing professional development – had been trailed.

The latter will cover nurses, midwives and allied health professionals and is supposed to provide £200m extra in real terms to Health Education England in 2020-21.

Welcome as this money is, the overall HEE budget is still less than it was in 2018-19 and the health think tanks were quick to point out the money was about a third of what was required to start fixing the staffing crisis.

Preparing for Armageddon

Of all the places that stand to get a raw deal from no deal, Kent is near, if not at, the top of the list. The county is home to the major ports at Dover, Folkestone and Ramsgate, while its road network is already stretched by ongoing maintenance and upgrade work.

That’s why the NHS in the garden of England is doing some serious prep work. This includes block-booking hotel rooms for staff who may find themselves stranded and working with the police to help ferry patients and workers to the hospital through gridlocked traffic.

One senior source said trusts were working very closely with local emergency services in a way “very similar to major incident planning”. Another mused: “If it is no deal then we are planning for Armageddon, which I guess is better than not planning for Armageddon.”

Too many cooks

Mark Radford’s appointment as new chief nurse at Health Education England is a bold step by NHS England and chief nurse Ruth May to ensure more coordination on workforce issues, particularly nursing, at the national level.

There is no doubt that in recent years there were far too many bosses and not enough workers, especially when considered in light of the 40,000 nurse vacancies.

Mr Radford is widely supported by the profession. But the NHS does not need more of the same. The people plan could well be delayed further given the chaos in Westminster. Ms May and Professor Radford would do well to capitalise on this vacuum now and reverse some of HEE’s more odd decisions and start pulling nationally in the only direction that matters – the growth of the registered nurse workforce.

Regulatory responsibility

Yet another independent mental health unit has been rated “inadequate” by the Care Quality Commission. Yet again, the report highlighted issues with staffing levels.

For this unit, based in Staffordshire and run by Elysium, the CQC cited some worrying figures over staffing, including a finding that 90 per cent of staff were “unqualified support workers”.

This stark figure no doubt prompted one reader to comment: “Who commissions care from this place and what have they been doing?”

The reader raises an important question – what responsibility do commissioners have for overseeing the quality of services they spend money on?

The procurement that never was

Non-emergency patient transport services do not feature regularly in the news, yet a somewhat mysterious procurement process in London has caught Daily Insight’s attention.

Earlier this year, Chelsea and Westminster Hospital Foundation Trust launched a procurement for a new provider of non-emergency patient transport services. Worth several millions of pounds, the contract procured was binding for up to seven years and was undoubtedly of interest to various suppliers.

However, as the trust closed in on a preferred bidder, one of the contenders – Ambulance Transfers Ltd – abruptly pulled out of the process.

The company’s chief executive Stewart Lawson told HSJ he received a tip off from a whistleblower that members of the trust’s moderation panel were biased in favour of rival bidder and incumbent provider Hats Group.

Mr Lawson said he told the trust he was concerned about the process. Then, a few weeks later, the trust announced it had abandoned the procurement. In a letter to bidders, its head of procurement Suzanne Scannell said CWHFT was “unable to make an assured and unequivocal award under the current procurement process”.

She continued: “In order to ensure that the trust complies with its procurement law obligations, the decision to abandon the current process has been taken.”

No new procurement will be held.

The ambitious end of the scale

Walk-in patients will be unable to access emergency care at a major hospital trust without a referral from a colocated urgent treatment centre, its chief executive has told HSJ.

The plans put forward by East Suffolk and North Essex FT, which runs Ipswich and Colchester hospitals, propose to cut emergency department activity by 50 per cent as a result of the changes.

Colocating the UTCs and emergency departments and redesigning pathways to stream patients more rapidly to specialties is in line with national policy set out in the NHS long-term plan and common across the service. 

But, while others are implementing similar models, the ESNEFT’s plans represent the ambitious end of the scale.

Joint appointment

The appointment of Beverley Bryant as joint chief digital information officer across two Shelford Group organisations is another step in the ever closer union between the trusts.

While no one has said Guy’s and St Thomas’ FT will merge with its neighbour and rival King’s College Hospital FT, moves like this do little to brush off the impression that it is happening gradually.