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.

Deal or no deal

This week’s NHS Confederation conference was heavy with chatter that a government announcement on a new NHS funding settlement may be imminent, potentially as imminent as this weekend.

The prime minister committed back in March to delivering a “long term” budget deal this year, and if she is to avoid humiliation she now needs to announce something fairly weighty by the time of the NHS’s big seven-oh bash on 5 July.

But negotiations, with the need to get a sceptical and stretched Treasury to support decent growth, have been hard work – on Thursday Jeremy Hunt told the conference talks were “difficult and ongoing”.

NHS thinkers have said real terms annual growth of at least 4 per cent is needed, while the chancellor’s starting point was around 2 per cent – HSJ has previously predicted we’d end up with something starting with a three.

Shortfall of workers

Unless the NHS changes the way it is planning and managing its workforce, it will have a shortfall of 115,000 workers in 10 years’ time according to the head of Health Education England.

Ian Cumming laid out the challenges facing the NHS in a stark presentation that also showed an additional 16,000 full time equivalent nurses have left the NHS due to higher turnover rates in 2017 than in 2012.

He also set out how 40 per cent of doctors who qualified as GPs five years ago are not substantively employed in the NHS.

Javid turnaround

NHS leaders around the country may well have breathed a sigh of relief following reports that the Home Office is relaxing restrictions on the number of tier two visas issued to non-EU skilled workers.

For the past six months, thousands of visa applications have been turned down by the Home Office, as doctors and nurses are not only competing against each other but also against other skilled workers for the limited number of visas.

NHS Employers, the British Medical Association and various Royal Colleges have all spoken out about the cap and called for action from the government, making clear that the cap is affecting patient safety and causing severe rota gaps.

Home secretary Sajid Javid has listened to these calls and this represents his first major policy change since taking on the role.

Get off the pot

The great and the good of the NHS have been making their case to the government, and more specifically the prime minister, about the need for a decent funding settlement and stability for the NHS.

NHS Confederation boss Niall Dickson told HSJ that predictable funding over a long period would pay dividends and that the year-by-year settlements had looked like the Himalayas when plotted on a graph.

He said anything less than a 4 per cent real terms rise would enforce a “managed decline”.

The national media have all trailed that there is something coming but not when, or how much. Sources spoken to by HSJ expect the true number maybe somewhere between 3 and 4 per cent.

All change in provider land?

Mr Dalton also promised a “long, hard and important look” at clincial services and provider organisations that house them.

Mega-chains? Another spate of mergers? The Getting It Right First Time programme given more power?

The language was a little vague but matches up with earlier comments about taking a firmer approach to reconfiguration – an agenda that has languished in the face of ever-increasing activity and the focus on governance that can accompany sustainability and transformation partnerships.

Un-innovation

Health minister Lord O’Shaughnessy has spoken to HSJ about his innovation and life sciences brief – themes sure to have finance directors’ cheque books itching at the thought of whizzy drugs and devices proliferating at a rate of knots.

His comments contain the perennial balancing act between the desire for more clever stuff (also thus keeping industry happy); and the taxpayer having to pay for it (via the NHS), when there might be better value elsewhere.

The minister indicates some stuff should be taken up quicker, giving the example of the prominent new Hepatitis C drug whose introduction NHS England has phased.

But he also seems to buy the oft-held view in the NHS that the most urgent thing in the “innovation” sphere is to spread uptake of existing good practice; rather than generating new techniques.

DHSC curbs GMC’s powers

A raft of new patient safety measures have been announced, perhaps most dramatically the rolling back of the General Medical Council’s power to appeal tribunal decisions on doctors’ fitness to practice.

The move is part of the fall out of the Hadiza Bawa-Garba case, which saw a paediatrician struck off by the High Court in January after the GMC referred a tribunal decision to it.

There was an outcry from professional groups and others that the ruling failed to reflect the systemic pressures that led to the death of a six-year-old boy, and that the trainee doctor’s reflective practice notes were used against her.

Health and care honours

Sue Hill, chief scientific officer at NHS England and previously in the Department of Health and Social Care, was made a dame, with particular reference to her work in recent years on genomic medicine.

Outgoing King’s Fund chief executive Chris Ham received a knighthood for services to health policy and management. David Haslam, currently chair of the National Institute for Health and Care Excellence, also got a Kt, for services to NHS leadership.

CBEs in the centre included Yvonne Coghill, NHS England’s director of workforce race equality standard implementation, who has championed diversity in NHS leadership; and Rob Shaw, NHS Digital deputy chief executive.