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.

Hancock’s clear blue water

Matt Hancock is still developing his position as the new health and social care secretary and used the NHS Providers conference to put more clear blue water between him and former secretary of state Jeremy Hunt.

Asked by Chris Hopson to define his role, Mr Hancock made a very pointed reference to Mr Hunt’s time in Victoria Street saying he had no interest in spending Mondays delving into the details of individual trusts – something Mr Hunt considered a core part of being health secretary.

Mr Hancock instead wants to be an “executive chairman”, setting system direction and leaving the day to day business to Simon Stevens. Whether this slightly hands off approach will survive the winter remains to be seen.

Elsewhere in his video interview, Mr Hancock signalled areas of frustration that he wants to see tackled.

New mission

In another clear attempt to show he is a man on a new mission, Matt Hancock has opened up not so old wounds over the junior doctors’ contract, pledging to invest some additional money to iron out glitches to “put the past behind us and move forward”.

Again Mr Hancock is trying to show he is not Jeremy Hunt – a health secretary who became vilified by the NHS workforce and hated by thousands of junior doctors who blamed him personally for the strike action in 2016.

Mr Hancock, in a letter to the British Medical Association, also pledged his continuing desire to show junior doctors, and consultants, that he values their contribution. He has asked NHS Business Services Authority to change the way it handles tax charges against staff who breach their pension allowance so individuals no longer have to stump up.

Centralised where?

Stroke reconfigurations always cause local concern, even when they are done for the best of reasons – to improve outcomes.

Two years ago, plans to centralise services in West Sussex were “paused” because of concerns that putting services at either Worthing Hospital or St Richard’s Hospital in Chichester would increase pressure on other units nearby which would inevitably be closer for some patients – for example a service moved to Chichester might mean some patients were left nearer Brighton.

There the matter seemed to rest until NHS England started to put pressure on Coastal West Sussex Clinical Commissioning Group to revisit centralisation this summer.

Trust ‘lunacy’?

Is it a good idea for a trust to reduce its bed base before winter? Not according to the Royal College of Emergency Medicine’s vice president, who called the Dudley Group Foundation Trust’s actions “tantamount to lunacy.”

Figures the trust shared with HSJ showed its bed base reduced from 679 in June 2017 to 637 in December.

This coincided with the trust having a very difficult winter which resulted in its being rated “inadequate” by the Care Quality Commission following a December inspection.

COBRA and anatomical waste

There has been lots of shouting about HSJ’s story, which exposed issues around the disposal, or otherwise, of human body parts and other dangerous waste by waste management company Healthcare Environment Services.

While most of the reporting has understandably focused on some of the more gruesome elements of the story, relatively little has been said about why the government did not draw the public’s attention to HES’s failures to incinerate its waste and the knock-on effect on the NHS.

Following the story’s publication, Yvette Cooper, the MP whose constituency includes Normanton (where excess waste was stored at five times the maximum allowed), fired off a series of questions on Twitter – including why Parliament had not been told of the issue given a COBRA meeting had been held.

Shadow health secretary Jonathan Ashworth also got involved, asking an urgent question in the Commons, on that exact subject.

Move of money

NHS England and NHS Improvement published proposals that could have far reaching consequences for the provider sector.

The document confirmed what HSJ had already learned, that the government was looking to make outpatient appointments cost the same whether or not you see a consultant. At a stroke, trusts would be incentivised to have outpatients seen by someone who is not necessarily a senior medic.

Whether this is an overdue move towards a right-sizing, right-skilling of the workforce and who does what, or a dangerous incentive to have patients seen by underqualified staff remains to be seen.

Holding the NHS to ransom

More than a year after the WannaCry ransomware virus hit, the most disruptive cyber attack in NHS history, the government has finally put a figure on the damage done.

According to an “October 2018 progress update” released by the Department of Health and Social Care released, the estimated cost to the NHS was £92m.

Only £19m of this was incurred in the week or so when NHS services were severely disrupted, with ambulances diverted and more than 19,000 appointments and operations cancelled.

The DHSC response also does not directly address the funding shortfall in bringing trusts up to the “minimum bar” standard for cyber security, which could be as high as £750m.