HSJ Weekly Catch Up: Trials of FPP test, alienation of foreign workforce and the procurement bill that's due

Managers back professional regulation

The issue of whether senior NHS managers should be regulated like doctors or nurses has been an ongoing debate since the Mid Staffs public inquiry and the creation of the universally disliked fit and proper person test regulations.

The regulations are now being reviewed by Tom Kark QC and ahead of giving evidence the Managers in Partnership Union conducted a survey of senior directors affected by the fit and proper person test.

In what may be a surprise finding, more than 90 per cent backed the idea of professional regulation for NHS managers.

Mr Kark’s report is expected in a few months.

Barriers to recruiting international staff

The news that the Home Office planned to scrap the tier 2 visa cap for international doctors was welcomed across the board when it was announced in June.

However, even with this restriction lifted, it appears workers wanting to learn and practise in the UK are still encountering red tape.

A medical educator who has recently signed a deal with Health Education England enabling students from Grenada to complete their training in the UK has warned that the NHS needs to “reduce barriers” that prevent the recruitment of international doctors.

Matt Hancock’s letter to the NHS has even classed the removal of the tier 2 cap as “preparatory action” the government has undertaken in the case of a no-deal Brexit.

Trusts face hefty procurement bill

Amid continued pressures on the NHS wallet, there is likely to be some disgruntlement among trusts about how much they will have to fork out to pay for a new buying model imposed on them by the centre.

HSJ revealed that all trusts will, in effect, pay half a billion pounds between 2019-21 to fund the new NHS procurement behemoth named Supply Chain Coordination Limited.

Trusts will have a portion of their tariff income withheld, with the money instead sent to SCCL’s coffers.

While it has long been known that trusts will pay for SCCL’s operating costs, some trust procurement eyebrows have been raised over the amount (£260m by 2021), which is more than the turnover of some district general hospitals.

Consultant contract tough talk

The government’s team of contract negotiators better buckle up – according to consultants committee chair Rob Harwood, the British Medical Association is going to stop playing nice when it comes to talks over a new deal for this influential part of the workforce.

Dr Harwood told members the union will review the “measured collegiate approach” it has taken with this government so far, as it may no longer be the best way forward, considering the “derisory” pay offer announced by the government last month.

Such a stance isn’t surprising following some overwhelmingly negative reaction that Matt Hancock’s pay award was met with in the profession and could signal that the road ahead for future negotiations won’t be a smooth one.

How the chaotic chain of events will impact on the rest of the union’s senior leadership remains to be seen, perhaps all will become clear after its planned emergency general meeting in September.

Winter is coming

A Kent trust which cancelled hundreds of operations earlier this year is moving elective work to a new site in an attempt to avoid cancellations this winter.

East Kent Hospitals University Foundation Trust will move planned orthopaedic operations from the William Harvey Hospital, in Ashford, to the Kent and Canterbury Hospital, in Canterbury, at a distance of 15 miles.

The trust also plans to make use of spare capacity in its private wing at the Queen Elizabeth, the Queen Mother Hospital, in Thanet to continue planned surgery there without affecting its ability to admit emergency patients. The trust said it did not expect this to affect the private patients service or the income from this.

In the first six months of 2018, the trust cancelled 359 planned operations – the highest number of all trusts in the south east. It has also seen a growth in demand for planned orthopaedic inpatient surgery, which is putting pressure on waiting lists.

The isle of plight

Running England’s only fully integrated NHS trust is never going to be easy, and doing it on an island with no connecting bridge makes the task harder still.

But the scale of the problems facing the Isle of Wight Trust, which provides acute, community, mental health and ambulance services, has become worryingly large in the last couple of years.

The trust was placed in special measures in April last year – coinciding with a rapid decline in its financial health.

In the summer of 2017, the trust brought in two KPMG consultants to oversee a financial review, which uncovered a growing underlying deficit and poor control of pay and non-pay.

The consultants also raised concerns about the trust’s “significant lack of commercial expertise” and warned it did not have the “right critical success factors for a successful turnaround”.

It all comes as the trust is attempting to reconfigure its acute services, some of which have been unsustainable due to the difficulty in getting staff to the island.