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.

Bed shortage

Our exclusive on Monday that NHS national leaders have estimated the service is at least 4,000 beds short for next winter and are pushing for fresh funding this year to help plug the deficit raises a number of issues.

It’s not unusual for the NHS to ask for more cash (or get it). But a cash boost would mark a significant policy change, after the NHS England planning guidance published in February said “there will be no additional winter funding in 2018-19”.

The NHS’s 70th birthday and debate about a longer term funding settlement are, of course, convenient for the cause, but does the service have sufficient credibility in the bank with the Treasury to get it?

It is no secret that people in the Treasury and Number 10 have not been impressed by the NHS’s apparent lack of financial grip. But one area NHS bosses are convinced they can show an ability to (at least partly) deliver on a plan is delayed discharges.

The NHS actually missed its flagship delayed transfer of discharge target (reducing DTOCs to 3.5 per cent of bed base by September). But there is no doubt the system made a good dent in the problem, which had been building for years.

The prize on offer for cutting length of stay (when clinically safe) is huge. HSJ was told if the NHS reduced its super stranded patients by 25 per cent this would release the equivalent of 4,000 beds alone.

New CQC chief

The new chief executive of the Care Quality Commission will be Ian Trenholm, the current chief executive of the NHS Blood and Transplant Authority.

Mr Trenholm will take up the role in July and replace Sir David Behan who is stepping down after six years at the regulator.

Mr Trenholm has worked at the authority since 2014 but started his career as an inspector with the Royal Hong Kong Police before moving to Surrey Police as a uniformed custody and patrol sergeant.

He has previously worked as chief operating officer at the Department for Environment, Farming and Rural Affairs and was chief executive of the Royal Borough of Windsor and Maidenhead.

Review into missed cancer screenings

More than 400,000 women missed their final routine breast cancer screening over nearly a decade because of an IT failure, Jeremy Hunt revealed this week.

The health and social care secretary said in Parliament on Wednesday it was not known how many deaths were linked to the missed screening tests, but it was estimated between 135 and 270 women had their “lives shortened” as a result of the error.

Of patients affected by the failure, around 140,000 have since died but the remaining 309,000, now all over 70, were being contacted to be offered additional screening.

All of them will be offered a screening date before the end of October this year.

Mr Hunt said an independent review, chaired by Macmillan Cancer Support chief executive Lynda Thomas, would examine the harm caused, the nature of the failure and how it went undetected for so long.

Tip of the iceberg?

The shortage of radiology staff across the NHS is no secret, but the fatal consequences of the problem have been underlined at one trust.

After being ordered to review its backlog of 30,000 unreported plain films (x-rays of patients’ chest, spine, and abdomen), Portsmouth Hospitals Trust found a handful of patients who have either died or suffered severe harm due to their scans being inappropriately reviewed.

While there have been previous examples of huge backlogs discovered at trusts, the findings at Portsmouth were so concerning to the CQC that it launched a national review last year.

This review is expected to report back in the summer.

Portsmouth’s leadership have apologised “unreservedly” for the failings, but have also pointed to a report by consultancy Verita that concluded the number of patients affected was within the “accepted error rate of a qualified radiologist”.

The trust says it has strengthened governance processes, which were criticised by Verita for not offering the board enough oversight of the decision by the radiology department to deprioritise reporting of plain films back in 2007.

However, this will be scant consolation to the patients affected and their families.

Full circle

A legal challenge by Circle Healthcare has derailed the procurement process for the Nottingham Treatment Centre.

Commissioners confirmed on Thursday that they will no longer award the £150m, three year contract as planned this year. Instead they will allow Circle to continue operating the centre for a further year. A new procurement process for after then will be launched later this year.

Circle pulled out of the procurement in March and started legal action against Rushcliffe Clinical Commissioning Group, which is the lead commissioner for the treatment centre on behalf of all Nottinghamshire CCGs.

HSJ understands the dispute focuses on significant cost reductions and efficiencies built into the contract, which reduces its annual value to £50m a year. In 2017-18, the contract was valued at £67m for the year.

The current procurement process will be cancelled and will restart later this year for after July 2019 and an advert for potential bidders is due to be released in coming months.

Digital dossier

A new security centre to defend the NHS from cyberattacks has been delayed for months after the Government Digital Service raised concerns, papers released to HSJ reveal.

The papers, released to HSJ under the Freedom of Information Act, were presented to a subcommittee of NHS Digital, the agency responsible for protecting the NHS from cyberattacks, late last year.

They also detailed a litany of concerns about the system’s ability to cope with another WannaCry style cyberattack. These include additional funding being rejected, difficulty attracting cybersecurity staff and “suboptimal” preparation among local NHS organisations.