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.

Surrey, not sorry

Much is written about integration, how vital it is, how difficult it is – but the honest detail of the latter rarely comes to light.

A case from Surrey gives some insight on the kind of issues that can bedevil an integration project.

An acute trust, three GP federations and a social enterprise providing community services won a joint contract from Surrey Downs Clinical Commissioning Group – with the acute as lead provider in the alliance. A few months later, the social enterprise brings legal action against the CCG saying it had been marginalised and as such the alliance had “materially changed” and the contract was therefore invalid.

It is easy to feel sympathy with the CCG that has let a contract to a consortium only to find the component parts fall out.

This dispute shows what can happen when statutory bodies create less robust arrangements and just hope everyone gets along.

The chair nobody wanted

The new chair of NHS England, which was announced, will be the Tory peer Lord David Prior. The name will be familiar to followers of the NHS’s upper echelons (having previously been a health minister and chair of the Care Quality Commission), as well as to keen readers of The Sun.

Lord Prior is what you’d call a reformer and is not one to keep his occasionally controversial views to himself. Yet, Lord Prior is not easily characterised and is no classic Tory headbanger.

Perhaps his most obvious flaw is understatement, having described the medical profession as “a bit dysfunctional” and Brexit as “a terrible mistake”.

One serious question as he comes into the job is will he want to get stuck in to making strategy and policy, and delivering the message – something Simon Stevens as chief executive has largely had to himself in NHS England’s Skipton House HQ.

AI and the NHS

As more and more NHS trusts partner up with tech companies to use patient data, the Department of Health and Social Care has released a new “code of conduct” for managing the relationship, particularly when artificial intelligence is involved.

Health minister Lord James O’Shaughnessy revealed this code at Health and Care Innovation Expo in Manchester, calling it an “important step towards creating a safe and trusted environment in which innovation can flourish”.

However, there remains little detail on whether this will entail replacing current systems, such as NHS Digital’s app library assessment or Medicines and Healthcare products Regulatory Agency’s medical software registration, or simply add to them.

Hancock abolishes Mondays

Secretaries of state are ambitious people and keen to make their mark. Matt Hancock has done this by dropping one of Jeremy Hunt’s more famous initiatives. The Monday meetings with the heads of the big arms length bodies would often also see trust chief executives (literally) called on to explain their performance issues.

Mr Hunt told the King’s Fund he would be surprised if they were not retained after his departure, given the diffuse and confusing architecture of the NHS.

Nevertheless, that is what Hancock appears to have done, signalling also a willingness to cede day to day responsibility for some areas to junior ministers.

Hancock’s own stated priorities are workforce, technology and prevention, so the new dynamic with the ALBs will be interesting. Especially given that a new NHS England chair is expected to be announced this week.

No calm before the storm

The East of England Ambulance Services Trust heads into what was already set to be a tough winter with fresh uncertainty surrounding its leadership after chief executive Robert Morton announced he will step down later this year.

The announcement followed a chaotic period including allegations patients were harmed because of ambulance delays, consistently poor response time performance and cultural concerns highlighted by inspectors earlier this year.

His supporters and detractors remained equally passionate in their positions following Mr Morton stating he would leave at an unspecified date this year, citing personal reasons.

Trust chair Sarah Boulton said she was “saddened” by his decision and that he left a “great” legacy. Critics like local MP Norman Lamb said he presided over an organisation with a “rotten” culture and his departure was not before time.

Whatever the reasons for the problems at EEAST, one person can never be held solely accountable for the failings, or success, of an entire trust – even the chief executive.

Drugs in 2026

Asking the government to speed up when it comes to Brexit may be a tall order, but the pharmaceutical industry did just that, urging an agreement to secure the approval of new generic and biosimilar drugs in the long term.

Although the Medicines and Healthcare products Regulatory Agency has reassuringly confirmed the generic supply for the next eight years should be unaffected, it has warned a “streamlined approach” is needed to approve UK marketing authorisation applications beyond that timeframe.

To reach such an agreement, it is crucial Britain maintains a good relationship with the European Medicines Agency. This was highlighted again with news in the Guardian that Britain no longer has a leading role in evaluating new medicines for patients across the EU.