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.

Sea change in top CEOs list

Marianne Griffiths is the first woman to take the number one spot in HSJ’s annual assessment of trust chief executives. But the Western Sussex boss was run close by East London’s Dr Navina Evans, while Sarah-Jane Marsh from Birmingham Women and Children’s secured third place.

HSJ’s fifth ranking of all 249 provider trust chief executives is notable not only for women taking the top three places, but also for the rise of mental health chief executives and the relative demise of their teaching trust counterparts.

There are the same number of female chief executives in this year’s Top 50 compared to 2017 (22), but only six among the top 15, the same as in 2016 but two down on last year. However, this will surely be overshadowed by the fact that the top three are all women.

The results are a sharp contrast with the first HSJ Top 50 in 2014. That year, the top 10 were ranked and only one – Dame Julie Moore – was a woman.

Another very significant sign of the times is that the Shelford Group of NHS teaching trusts has only five of its 10 chief executives represented in the top 50.

Spring statement lacks bounce

In the spring statement today, chancellor Philip Hammond pledged to provide extra cash for an NHS pay rise if management and unions can reach a deal on “pay modernisation”.

This sounded like a return to the old debate over pay progression and automatic increments, though this would conflict with an apparent unofficial briefing to The Guardian last week, which suggested ministers had agreed to take pay progression off the table.

Instead, the newspaper reported that the government’s demand for greater productivity would come from staff sacrificing one day of annual leave.

Or perhaps a reduction in annual leave is exactly what the chancellor means by modernisation.

The lack of clarity reflects the fact that negotiations are still live, and as the BBC’s political editor reported this morning, there is no consensus at the top of the government about NHS funding.

NHS Improvement’s existential angst

The news that NHS Improvement has hired McKinsey to help clarify its purpose and develop its organisational model has been greeted with predictably little acclaim from HSJ readers.

The national body is paying the consultancy giant £500,000 to help with “internal organisational development work”, and to clarify NHSI’s “purpose and operating model”. Work is at an early stage but moving quickly.

As part of the project, NHSI executives were conducting interviews with provider chief executives and chairs on “what’s working well, what they find frustrating, what they think our purpose should be and what activities we should concentrate resources on”.

We’ll leave judgements about how much central bodies ought to be spending on management consultants to others. But it is worth asking whether there would have been quite so much spent if they had a fixed and clearly defined purpose in the first place.

Capital consequences

The consequence of repeated raids on capital funding have been “coming home to roost” for NHS trusts.

Barts Health Trust is among those worst affected by the squeeze on capital, and has cited “significantly higher” risks around fire, medical equipment, and IT vulnerabilities after a recent plea for loan support was turned down.

It needed £29m from the Department of Health and Social Care to complete its capital programme for the year, which covered “only essential items, but has been given just £12m.

Barts was one of the trusts worst affected by the WannaCry cyberattack last year.

Saffron Cordery, policy and strategy director at NHS Providers, said: “NHS Improvement and the Department of Health and Social Care are trying to keep within the spending limit and that’s where the cumulative impact of the capital to revenue transfers comes home to roost.”

The question at hand

GP at Hand (the controversial video consultation service by Babylon Health) has ruffled plenty of feathers since its arrival in November.

NHS England too has entered the fray, though more quietly than most (for more details on whys of this read our story from January).

On Tuesday, HSJ published an interview with NHS England’s chief digital officer, Juliet Bauer, her first on the digital GP service causing such consternation.

Ms Bauer acknowledged that questions around the “cherry picking” of younger, healthier patients, creating unsupported costs for Clinical Commissioning Groups and other GPs, and increasing accident and emergency demand were legitimate and needed robust answers.

But she also pointed out there was clear patient demand for GP at Hand – the practice’s patient list has grown fivefold in six months.

So, if the service is safe and effective, Ms Bauer suggested maybe the NHS will need to change to accommodate GP at Hand and similar digital health providers.

Mixed results in staff survey

More than one in five NHS England staff said they had been bullied, harassed or abused in the past year in its latest staff survey, which also shows improvements in several areas.

The overall scores of the NHS England Census 2017 survey, distributed internally in recent weeks, have been leaked to HSJ.

Several scores were improved on the 2016 NHS England staff survey, for example 62 per cent said they would recommend NHS England as a place to work – up from 58 per cent in the previous survey.

Twenty two per cent said they had been bullied, harassed or abused at least once in the past 12 months – down from 24 per cent in the 2016 survey, according to the result documents for 2017 and 2016 seen by HSJ.

The NHS England 2017 survey found 60 per cent said they felt able to report bullying and harassment – up from 58 per cent in the 2016 figures.