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.

The revolving door spins on

Tom Kark QC is banging the drum for all seven of his recommendations from his report into the Fit and Proper Person Test, published earlier this year, to be adopted by the government.

He has revealed that officials in the Department of Health and Social Care are working on a recommendation, which he believes has been adopted, about the use of mandatory references.

This is intended to stop the so-called revolving door for NHS execs, as the mandatory references will make clear the full extent of their performance, regardless of whether a compromise agreement was signed or not.

A long overdue independent evaluation for NHS England’s 17 flagship care model schemes for mental health has been published.

The models, launched in 2016, essentially transferred responsibility for adult secure services, children’s and adolescent mental health services, and eating disorder services to groups of local providers.

The recent evaluation, which was finished in March 2019, was published, very discreetly, on the website for Niche, the consultancy company which carried it out. 

The reason for NHSE’s lack of fanfare? Perhaps its because the findings leave us with a glass half empty – or, indeed, half full.

Using data primarily from 2017-18, Niche found no evidence that any of the eight adult secure care NCMs had produced savings.

On the other hand, it did find the other half of NCM sites – those for children and adolescent inpatient services – produced significant savings from reductions in out of area placements.

Boris and the Brexit bonanza

If there is one message to draw from the Conservative party conference in Manchester this year, it is the insistence the UK will leave the EU by 31 October “come what may”.

If you chose two messages to take away, the second would be that the Conservative Party is “the party of the NHS”.

“The NHS is holy to the people of this country,” Boris Johnson said in his conference-closing speech on Wednesday. The sanctity stems from “the simple beauty of its principle” that when one is ill, “the whole country figuratively gathers at your bedside and does everything it can to make you well again”.

Arguably any signficant distinction between trusts and foundation trusts – if there ever was one – disappeared about five years ago, as many of the latter tipped into major quality and financial failings. Regulators began treating them the same way and FTs’ independent regulator, Monitor, was in theory merged into NHS Improvement.

Yet behaviours – and in this case laws – lag, and FTs, which continue to have freedom to set non-executives’ pay locally, have generally set it higher than what the NHS is allowed to pay NEDs in NHS trusts (which is controlled by the Treasury).

Regulators have found it increasingly difficult to find enough NEDs – let alone good ones – for the tough gig of trying to get unglamorous trusts on the path to recovery; and it’s become harder to argue FT boards have generally earned their premium.

So now – after, as they make clear, lengthy wrangling with the Treasury – NHS England and Improvement have set a pay framework intended to apply across both trusts and FTs. It is presented as a leveling up: trust NED and chair pay will substantially increase to become fairer over the next few years.

But the regulators also want convergence – meaning FTs would have to hold down or even lower what they are dishing out. 

Hip hip hurrah?

The government finally published its full “health infrastructure plan” document on Monday evening – some 36 hours after Boris Johnson’s NHS capital spending spree was revealed on Sunday.

Comprising a modest 23 pages, the HIP – as it will no doubt be known in the acronym-loving NHS – included several significant policy changes.

Perhaps the most striking was the DHSC’s support for NHS regulators to take control of FTs’ capital spending.

NHS leaders are often left frustrated at their lack of ability to invest in new technology and transformation.

But after several years of planning and negotiation, Salford Royal has managed to pull off a £25m partnership deal with Hitachi Consulting to streamline its care processes with data and digital technology.

The “digital control centre” project will be deployed across the hospital over the next 10 years. And it is expected to bring with it a handy reduction in the trust’s bed base and staffing costs.

Get ready for a slew of pictures of politicians in hard hats – the government has announced a £3bn capital investment plan to rebuild hospitals and replace diagnostic equipment.

As part of a new “health infrastructure plan”, six hospital trusts will receive £2.7bn to carry out major rebuilds of hospitals by 2025, including Barts Health Trust’s dilapidated Whipps Cross hospital and Leeds Teaching Hospital’s Victorian-era general infirmary. 

But wait, there’s more. A second phase will aim to deliver 34 hospital rebuilds between 2025 and 2030 by providing £100m of seed funding to support the development of business cases for 21 building projects across the country. There will also be a third phase of building from 2030 to 2035.

Data dilemma

Emails and documents leaked to HSJ reveal NHSE/I have encouraged trusts to use credit check company Experian to carry out checks on patient data to try and identify overseas health tourists not eligible for free care.

In one email sent earlier this year, the national body was encouraging 51 trusts to consider using Experian to conduct checks on historic patient referral data.

In addition, HSJ has learned Lewisham and Greenwich Trust has been using Experian to carry out such checks for at least five years.