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.

New kind of leadership

It is six weeks since NHS England and the British Medical Association announced the new five-year GP contract deal.

The agreement proposed a rapid national spread of primary care networks: organising primary care clinicians into multidisciplinary teams, working across a group of practices that cover 30-50,000 people.

NHSE’s primary care lead, Nikki Kanani, told HSJ that, in some areas, this new job is attracting GPs who have not engaged with the system before. “[They] have started to get more interested in what’s going on around them” and “a different style of working” that PCNs represent, she said.

Feeding off scraps

The death of Private Finance Initiative (and its short-lived successor PF2) was confirmed by the chancellor in his spring statement, while a consultation document from the Treasury appears to also rule out any off-balance sheet models with PFI/PF2-like characteristics (though stopped short of banning off-balance sheet models altogether).

The sudden desire for transparency and signal towards on-balance sheet funding models should be firmly welcomed by fans of probity in public finance.

But this may well leave the NHS feeding off scraps for the foreseeable future.

Given the relatively generous revenue settlement already confirmed, health is going to be towards the back of the queue when it comes to the scheduled spending review later this year.

Perhaps not all talk

NHS Improvement chair Baroness Dido Harding is getting a reputation for going around saying some strong stuff about her own organisation and how poor management and leadership is in the NHS.

She went one step further at the Commons health committee, indicating she may support some form of professional regulation for senior NHS managers.

This could have serious implications as the government put Baroness Harding in charge of responding to the recommendations made by Tom Kark QC from his recent report on the fit and proper persons test.

More well-timed words

At HSJ’s inaugural cancer forum, the previous cancer tsar Sir Mike Richards said capital budgets meant for diagnostic machines had been continually “raided” to prop up trust revenues.

He said, as a result, the NHS has been left with “woefully poor” diagnostic kit, with MRI and CT scanners well at the bottom of the Organisation for Economic Cooperation and Development league table.

His thoughts followed on from an HSJ story which revealed Barts Health Trust was forced to cancel hundreds of MRI scans when its equipment broke down after “historic underinvestment”.

The true scale of underinvestment across England is not clear but, given Sir Mike’s concerns, it is very plausible the problem Barts faced may be one other trusts are battling.

Apparent downgrades

Frimley Park Foundation Trust was the first trust to be rated “outstanding”. It then took the brave decision (helped by a wodge of money) to merge with failing neighbour Heatherwood and Wexham Park FT. Since then, Wexham Park has been reinspected and has substantially improved, with its rating moving from “inadequate” to “good”.

The merged trust was still referred to as “outstanding” on the CQC’s website, and it is only now that a full reinspection has taken place. That has seen Frimley Park Hospital retain its “outstanding” rating and Wexham Park its “good”, but the trust overall classified as “good”.

Merged trusts – with more than one rating – present methodological issues for the CQC until they are reinspected.

But this should not distract from a very good CQC report which showed that Frimley Health FT had much to be proud of – and was aware of many areas where it could improve.

Search for the truth

Last summer, HSJ highlighted several new concerns about maternity care at the Shrewsbury and Telford Hospital Trust as the families who were part of an initial group of 23 cases called for the probe to be widened. Although the NHS initially resisted this, health and social care secretary Matt Hancock agreed to broaden the review.

Then, last week, there was widespread criticism of NHS Improvement for what was perceived as an attempt to interfere with the independent review being led by Donna Ockenden by setting up a review panel, which was eventually disbanded after it was revealed many of its members had a conflict of interest.

Now, in response to those concerns, Ms Ockenden has written to families involved in the inquiry, making it clear her team of experts are determined to “search for the truth”.

We also learned from the message that the review is looking at more than 250 separate cases – more than 10 times the initial number.

Target practice

NHS bosses have set out controversial plans to ditch the NHS’ four-hour emergency access target, despite concerns removing the uniform benchmark could lead to quality standards being watered down.

A testing period for the new standards will run from April 2019, a further rollout following in autumn 2019 and then full rollout from April 2020 (should it pass the pilot phase).

To summarise

Eight months ago, the Dudley Group FTs chair Jenni Ord received a whistleblowing letter from 42 senior clinicians, raising concerns over the behaviour of the trust’s chief executive, former chief nurse, medical director and head of HR.

Fast forward to the end of last week, a summary of a long-awaited report into these allegations has been published, concluding the claims could not be substantiated by the law firm tasked with carrying out an independent review.