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.

Monstrous collapse

Official data for December has laid bare the collapse in the NHS’ performance against all its core access targets.

The data will come as little surprise to those in the service, although it is perhaps at the worst end of the spectrum of what insiders could have predicted.

The long-term decline in performance against the service’s core targets has normalised failure to the point where the usual monthly data records a new incremental dip which is all but ignored, making only modest ripples in the national media and rarely prompting any comment from ministers.

But this was not just the usual monthly dip. It was a monstrous collapse in performance, the likes of which have not been recorded since the four-hour target’s introduction nearly 16 years ago.

Eye delays

New light has been shed on the risk of serious patient harm caused by widespread delays to follow-up appointments.

A report from the Healthcare Safety Investigation Branch highlights a growing problem in ophthalmology, where around 22 glaucoma patients a month are suffering severe or permanent sight loss due to lack of timely follow-ups.

Particularly harrowing is the case of a 34-year-old woman who lost her sight after 13 months of delays, and now cannot see the faces of her young children or read books to them.

“Challenging behaviour” among senior clinicians and “disconnected” working between departments has been uncovered at the troubled Isle of Wight Trust.

England’s only fully integrated care trust has been in special measures since 2017 and it is currently at risk of losing some of its trainee doctors due to gaps in the workforce.

A Health Education England inspection report — released to HSJ under the Freedom of Information Act — has highlighted major problems with the trust’s training programme, particularly in acute care.

Backlogged

Is the LeDer programme — the initiative for reviewing deaths of people with learning disabilities — fit for purpose?

Recent figures on the thousands of deaths still waiting for review suggest that, as it stands, the programme is not working as it was intended to.

In May 2019, NHS England promised it would invest £5m to address concerns about a growing backlog of reviews which had not been completed. HSJ has now discovered that, despite this funding promise, the backlog increased between May and November from 3,699 to 3,802.

Hundreds of sexual assaults are reported each year on mixed-sex mental health wards in EnglandHSJ has revealed, highlighting the urgent need for investment to improve facilities.

New figures obtained by HSJ show there have been at least 1,019 reports of sexual assaults between men and women on mixed wards since April 2017 to October 2019.

This compares to just 286 reports of incidents on single-sex mental health wards over the same period.

As mental health correspondent Rebecca Thomas discusses in her latest briefing newsletter, without major change there is often no meaningful choice for inpatients who, in not unusual cases, are vulnerable and traumatised.

Covered up culture uncovered

Staff at a mental health provider complained about a “cover-up culture” where allegations of poor care and abusive behaviour were concealed by falsifying records, according to a new Care Quality Commission inspection report.

The CQC’s inspection of the leadership of St Andrew’s Healthcare, a charity that provides mostly NHS-funded care in the Midlands, said staff complaints “pointed to a culture in which management sought to actively manage how their service was perceived by CQC”.

The regulator’s report, published after visits in October, said: “Patients, staff and relatives raised concerns that management may either not be aware of or are not responding to issues including poor and selective reporting, falsifying records, intimidation of staff, and active deception of [the] CQC.

“[They] attributed these behaviours to management. However, it was not always clear from comments whether ‘management’ referred to senior leaders, or ward level management.”

More NHS providers are breaking health and safety laws on protecting their staff from assault than are actually meeting them, figures released to HSJ reveal.

We reported last month that the Health and Safety Executive was inspecting a batch of health and care providers, because the sector sees a higher level of violence than most, including several staff being killed in recent years.

New information released to us has revealed that, once the HSE inspectors arrive, in two-thirds of cases they find that laws aimed at protecting staff from violence and aggression are being breached.

It has inspected 37 NHS organisations since April 2018 and found 25 of them – 67 per cent – were in breach of these laws.

Forgotten your password?

“Getting the basics right” is a phrase often heard when NHS staff are asked how technology can help them in their jobs.

This message has filtered through to NHSX, which looks set to place a far greater focus on fixing trusts’ existing infrastructure, moving away from the previous approach of supporting the most digitally advanced trusts to lead the way with their flashy solutions, as per the “global digital exemplar” programme.

An early example of this can be seen in the Department of Health and Social Care’s announcement over the weekend, which set out plans to spend £40m on improving login times for staff across the provider landscape.