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.

End of year bonus

As more trusts give up on their financial plans, a huge pile of cash is mounting up to reward those that can stay on track.

Under the control total system currently governing NHS finances, trusts that miss their financial plan have their allocations from the £1.8bn sustainability and transformation fund dished out to providers that do meet their targets.

In 2016-17, this created huge disparity between those that received bonus STF payments, and those that got nothing.

But with the overall deficit getting worse in 2017-18, the distortive impact looks set to be even greater.

According to the latest forecasts, there will be £780m of uncommitted STF at the end of the year (which is likely to increase – see below), compared to £420m at this stage last year.

Under the bonus pot rules, this cash will be divvied up between trusts that hit their control totals, on top of the money received from their original STF allocations. Around two thirds of trusts are likely to benefit.

Staff survey results revealed

The percentage of NHS staff who say they have experienced violent attacks from patients, relatives and the public is at a five year high, according to the NHS staff survey results published on Tuesday.

The results of the survey, carried out from September to November, show that 15.2 per cent of staff reported having experienced physical violence – a rise from 15 per cent in the 2016 survey.

One of the biggest changes from 2016 was the share of staff satisfied with their pay – falling to 31 per cent, down 6 percentage points on 2016. The number of staff working additional unpaid hours remains at a similar level to last year – 58 per cent.

HSJ’s analysis of the survey results includes:

Trust sorry after patients fatally attacked

An NHS trust has been accused of a “cover up” over the killing of two patients in an attack on a hospital ward by a patient with paranoid schizophrenia, whose antipsychotic medication had been stopped despite warnings.

The attack happened in 2015 at one of the UK’s biggest hospitals, St James’s University Hospital in Leeds, and has never been made public nor been subject to a coroner’s inquest.

Ken Godward, 76, and Roger Lamb, 79, were beaten with a walking stick by 70-year-old Harry Bosomworth. Mr Bosomworth’s antipsychotic medication had been stopped by hospital staff the previous month, despite repeated warnings from his family.

The families of the victims accused Leeds Teaching Hospitals Trust of “hoping this doesn’t get out”, not answering questions and taking them “for a ride”.

The trust said it was “fully cooperating in the [investigation] process”. In a detailed statement responding to our questions about the events, the trust offered “sincere apologies” to the families of Mr Godward and Mr Lamb.

One in, one out

After two and half years in charge, Nick Moberly is stepping down as chief executive of King’s College Hospital Foundation Trust.

In his email to staff on Thursday morning he said “the world in which we operate has become ever more challenging”.

“Challenging” is certainly one way of describing the situation at the south London trust.

Mr Moberly’s announcement follows the public reignation of former chair Lord Kerslake last year when he accused the government of underfunding organisations like King’s. In November, chief operating officer Jane Farrell and finance director Colin Gentile also left.

Meanwhile, another Shelford Group trust this week confirmed its new chief executive.

Former University Hospitals of Morecambe Bay FT boss Dame Jackie Daniel will be the CEO at Newcastle upon Tyne Hospitals FT, taking over from Sir Leonard Fenwick who was sacked for gross misconduct last year.

Pressure points

Performance against the four hour accident and emergency target dipped again in February to 85 per cent – its worst since records began – according to Thursday’s official data.

The overall performance figure set out in the NHS England numbers was only marginally lower than the 85.3 per cent recorded in January.

But it came despite a significant fall in emergency admissions from 525,897 to 476,800, suggesting a high level of acuity. Overall attendances also fell month on month from around 2 million to around 1.8 million attendees.

Clatterbridge chief resigns

The chief executive of an outstanding rated trust has resigned and his deputy has been suspended following the discovery of a “close personal relationship”.

Andrew Cannell, chief executive of The Clatterbridge Cancer Foundation Trust, resigned “following the discovery of a close personal relationship with another member of the senior executive team”, a trust statement said today.

Both he and deputy chief executive Yvonne Bottomley have been suspended from the trust while an independent investigation is carried out.

Pension cap

High earning NHS employees, including medical consultants and senior managers are choosing to leave the service because of government caps on the amount of tax relief that can be applied to pension schemes, the Department of Health and Social Care has admitted.

The DHSC said in its latest evidence to the Review Body on Doctors’ and Dentists’ Remuneration – published in January – that “there is evidence of high earning individuals opting out of the scheme” or “leaving NHS employment through early retirement”.

The report said this may be “due to the effect of the new lower lifetime and annual allowances tax limits”, which could “potentially affect some high earners”.