Your essential update on health for the week.
HSJ Catch Up
This weekly email gives HSJ subscribers a vital update on the biggest stories 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.
Release the 2015 report
At its board meeting on Thursday, Great Ormond Street Hospital’s chair indicated the trust was drawing a line under its gastroenterology scandal, which saw children given potentially unnecessary invasive treatment instead of talking therapies.
But, since the organisation has never released the key report from 2015 into what happened to these kids, any line-drawing seems somewhat premature.
While complying with the law in this case, the trust discovered the published version of a 2017 report into the scandal, carried out for it by the Royal College of Paediatric and Child Health, was incomplete.
The version, which was provided to the trust’s board, NHS Improvement, NHS England and the Care Quality Commission, did not include scathing criticism from the parents of children treated by the service.
Rumours of a merger between trusts in the north east have been doing the rounds for some time now, although the logistics of it and answers to other pertinent questions have not been quite clear.
But HSJ has now confirmed discussions about consolidating North Tees and Hartlepool and South Tees Foundation Trusts have indeed taken place recently and seem to be breaking out into the open.
One of the reasons combining NHS England and Improvement has been resisted for a few years now is the long and drawn-out distraction from the day job, with damage to morale and miserable agonising over job losses and people’s future.
Probably less of a consideration is that of the redundancies, including the high-value senior ones.
Yet NHSE/I and ministers last year decided they would bite the bullet; adopting plans for an ever closer union, accepting they needed to share a single finance director. Then, early this year, it was decided they also needed to share a top-dog chief executive (and even a single comms director) – culminating in the pushing out of Ian Dalton and Matthew Swindells.
This week, the impact across the organisation is there for all to see, with a staff consultation on the biggest phase, affecting the large majority of the organisation and putting more than 900 people at risk of redundancy, launched on Tuesday. Some have noted the unfortunate timing, shortly after NHSI’s accounts, which reported the substantial redundancy payouts to some of the senior victims of the restructure at NHSI last financial year.
Dudley’s road ahead
When Dudley Group FT published a much-anticipated independent report into whistleblowers’ allegations of bullying and harassment within its leadership, some would have thought the issue was put to bed.
The report, carried out by law firm Capsticks and released in May, did not substantiate the concerns raised last year by 42 anonymous consultants about a culture of “systemic bullying” from some of the trust’s executive team.
However, according to doctor’s union the Hospital Consultants Specialist Association, the concerns are very much alive among a significant number of consultants. The union told HSJ it has been contacted by “dozens” of consultants who say the concerns have not been addressed and believe the independent report was a “whitewash”.
This has prompted the union to call on the health and social care secretary to intervene.
Trimming the digital tree
Like many arm’s-length bodies, NHS Digital has a patchwork history of mergers, name changes and shifting briefs.
The organisation has historically been focused on collecting and publishing NHS data. In more recent years, its brief has expanded to leading the national bits of NHS IT strategy.
A 2017 review found many people who worked with NHS Digital believed it wasn’t up to its expanded digital brief. Some said it wasn’t clear what NHS Digital was for.
That review precipitated a massive clear-out of staff which cost the organisation £11m in redundancy payouts in 2018-19.
Big reconfigurations are always a lengthy process; drawing up a proposal, meeting NHS England’s requirements, consulting the public, and then actually implementing change can take several years.
Less willing to wait and see how things will pan out are the staff at threatened services, who tend to quickly move onto other opportunities.
That’s what’s happening with Kent and Medway’s controversial reconfiguration of its stroke services, which will close three units and turn three others into hyper acute stroke units. The plan as it stands was to close the units in Tunbridge Wells Hospital and Medway Hospital, and open the HASUs in Maidstone Hospital and Darent Valley Hospital next March.
But staff shortages at Tunbridge Wells Hospital have now made continuing a safe service there unviable. So, from late September, all stroke patients will go straight to Maidstone Hospital where an additional stroke ward will be opened. It’s a temporary move officially but is unlikely to be reversed before the planned reconfiguration date of March 2020.
Computer says everything is fine
Fewer pieces of software are more important than NHS Pathways when it comes to the life and death of NHS patients.
Every year, the software, run by NHS Digital, is used by NHS 111 and 999 call handlers when 16 million patients call with a health concern, from minor to life-threatening.
These call handlers have not been clinically trained and rely almost completely on NHS Pathways to advise them on what to tell patients, whether to call them an ambulance or whether to tell them to call the GP in the morning.
In most cases, this system works. But sometimes it doesn’t, and, as an HSJ investigation has uncovered, this has contributed to the deaths of at least 11 people.
Bursary back on the table?
Comments made by Simon Stevens last week have sparked debate on whether the nursing bursary could be brought back to life after a hiatus.
Speaking at a King’s Fund summit, Mr Stevens said the debate over reintroducing the bursary was “clearly back in play”, because of the NHS’ need for a bigger pipeline of new nurses.