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.

User error

Atos has provided IT services to the Department of Health (and, latterly, Social Care) since 2012, and, over time, NHS England, NHS Improvement, the Care Quality Commission, and Health Research Authority.

In 2017, these bodies got together and started planning what to do when the contract with Atos expired – with no possibility of renewal – in April 2020. Thus, the future services programme was born.

But the CQC has been demanding changes since April last year. In October, the regulator ordered an independent review of the programme. The review recommended urgent changes to avoid a costly extension of the Atos contract, which would violate procurement rules.

When the CQC felt NHS England and other partners didn’t take the review to heart, it quit the programme in November. Upon departing, it sent its soon-to-be-former-partners a letter listing the programmes failings, including poor governance, no exit strategy, and slow decision making. It also suggested it might be best if the programme were abandoned entirely.

Six months on

It is exactly six months since HSJ broke the news that the government had taken action against Healthcare Environmental Services for stockpiling hundreds of tonnes of waste – including human body parts – from NHS hospitals.

Half a year later, the sector is still reeling from the demise of one of its biggest players. 

HSJ revealed a number of trusts have warned NHS Improvement about problems with the collection and disposal of their waste, forcing some to implement contingency plans, such as storing waste on-site in temporary containers.

Don’t call the midwife

The abrupt closure of Neighbourhood Midwives, a small independent midwifery provider, came as a shock to the women using its service.

The company was running a pilot continuity of carer service in Waltham Forest, producing positive results commended by service users and NHSE.

However, the company had to close after building up nearly £1m in net liabilities. The question arises as to how a company with significant losses already on its balance sheet won such a contract in the first place.

The CCG, NHS England, the company’s directors, and other stakeholders have started investigating what happened. It will be interesting to see what they conclude.

Calling it a day

The half-hour debate on the effect of the tapered annual allowance on NHS pension scheme members may have been frustrating for many.

While health minister Jackie Doyle-Price said there was “clearly an impact on the behaviour of practitioners”, she also said a general review of the annual allowance taper and broader systems of relief are matters for the chancellor.

Ms Doyle-Price clearly recognised that pensions tax would contribute to decisions of senior clinicians to retire early. But, other than saying the government would look at potential further measures, she made clear clinicians would not be treated differently to other taxpayers and gave no suggestion of what action the government might consider.

A 21st century budget?

The CQC chief executive Ian Trenholm has not wasted time tackling the big issue facing the regulator. He made clear in his November interview with HSJ that the CQC’s legacy systems needed to be tackled and the watchdog placed on a 21st century footing.

Now a leaked email passed to HSJ has revealed the regulator is moving ahead with plans to top slice the budget of its five directorates to release £12m to invest in a new central change team to deliver the digital transformation work.

The regulator has confirmed there will be fewer people working in its hospital inspectorate team by the end of 2019-20 as a result of the decision. However, the watchdog added staff would be encouraged to take on secondments within the new central team so no redundancies were planned overall.

Network subversion

NHS England published another trove of papers, fleshing out the details of how it wants GPs to develop primary care networks – and how it doesn’t want them carrying out the task.

PCNs will be entitled to funds to cover most of the salaries for new members of staff hired to fill five specific clinical roles. But these new team members must be brought on-board in addition to existing staff.

To make sure nobody tries to get around these rules by relabelling their existing staff members to pocket the cash, CCGs have been tasked with carrying out a baseline exercise to figure out how many of the non-GP clinical staff already work in primary care.

This “additionality principle” is to protect existing investment in workforce and NHSE is not going to hold back in defending it. It said, if there is “any suspicion” of deliberate attempts “to subvert the additionality principle” then that will lead to a fraud investigation.

Capital grab

In an update to mental health providers, the Care Quality Commission’s mental health lead Paul Lelliott told trusts the regulator will start to look at how actively they pursue any capital funding they need.

The new criteria will sit in the “well-led” part of the CQC’s inspection and is designed to monitor how active mental health trust leaders are in addressing poor estate. 

Justice delayed

You could write a PhD on the vagaries of the NHS’ internal disciplinary processes.

But these processes become doubly important when the cases involve whistleblowing, which makes a recent case involving NHS Professionals unsettling.

The case HSJ reported, in which a staff member was left on suspension for almost three years because his case had gone uninvestigated, suggests these processes are not fully ironed out, or that they are inconsistently applied.

The case has now been through both an employment tribunal and the Employment Appeal Tribunal yet the results of the initial whistleblowing complaint, about understaffing, remain unclear.