Your essential update on health for the week from hsj.co.uk

HSJ Catch Up

This weekly briefing 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.

New names in the HSJ100

The HSJ100 is our analysis of the most powerful and influential people in the English NHS and health policy. We have published it at the end of each calendar year since 2005 but this year we decided to produce a summer “refresh” – recognising that much can change in a year.

The original plan was to publish the refresh in May or June, but the election put paid to that plan and the change the refresh captures is even greater than it would have otherwise been.

Names now missing from the HSJ100 – in some cases for the first time in years – include: Sir Mike Richards, Ed Smith, Lord Prior, Mark Porter, Sir Bruce Keogh, Samantha Jones, Professor Keith McNeil and Jonathan Fielden.

The turnover created by these departures and a series of seismic events – most significantly this year’s election – means there are 32 new entries, while eight figures have fallen by 20 places or more and 14 have risen by the same amount. Of the top 20, only nine people survive from 2016, while five are new entries and the remaining six have all risen at least 15 places.

STP recruits Capita to help set up ACS

An STP pegged to create one of England’s first accountable care systems has decided to accept a helping hand from the private sector.

The Nottinghamshire and Nottingham STP has called on the expertise of Capita and Centene UK, an offshoot of the major US healthcare insurer.

The companies have agreed to assist the STP in developing their ACS, for the not too altruistic amount of £2.7m.

While hsj.co.uk readers’ comments were unenthusiastic about another Capita-NHS partnership, the outsourcing giant has subcontracted Centene to do most of the work.

The firm is a provider of data analytics and IT systems, whose parent organisation provides health insurance for the US government’s Medicare and Medicaid schemes.

The man leading the creation to this ACS, Stephen Shortt, admitted commissioners do not yet have the expertise to develop something this complex but hoped that “over time we will develop our own levels of expertise and knowledge and become more self-sufficient”.

NHS has ‘defensive culture’, says new PHSO

Senior leaders in the NHS have believed owning up to mistakes was not the right thing to do for too long, the new Parliamentary and Health Service Ombudsman boss told HSJ.

Rob Behrens warned that the NHS was still too defensive about mistakes and that it failed to invest in proper complaint handling.

Mr Behrens said: “We have a very defensive NHS culture. We have complaints handlers in the NHS who don’t have the skills or the authority or seniority to do their job to the best of their ability, and we have an absence of flexible resolution techniques to deal with issues. These things will need to change.

“This is a big issue and I don’t have easy answers but I think one of the problems for the NHS has been a senior management view that to own up to a mistake is not a good thing to do. I don’t think the real world is like that.”

New brooms for Norfolk

Norfolk and Waveney STP is now fully back under NHS control following the appointment this month of Antek Lejk to replace Norfolk county council leader Wendy Thomson as its executive lead.

The move came swiftly after the STP’s non-execs appointing former health secretary Patricia Hewitt as independent chair in June, and follows Ms Thomson declaring it was the “right time” for an NHS figure to run the show.

Mr Lejk, already the joint chief officer of North Norfolk and South Norfolk CCGs, and Ms Hewitt take the reins of an STP rated “advanced” by NHS England, but which has much to sort out.

He also set out plans for a potentially commissioning reorganisation and his desire to see a similar move carried out by his acute provider counterparts. The CCGs will vote next month on plans for a joint committee that would “ideally” broker “single contracts” for all five CCGs with all their major providers.

Cash problems keep flowing

Trusts are facing increasing cash flow pressures after NHS England instructed local commissioners to stop making advance payments on block contracts.

CCGs in the North have received a directive from NHS England to pay block contracts via 12 monthly payments, after some had entered local agreements to pay trusts in 10 instalments.

Using 10 instalments means providers receive all their 2017-18 revenue by January, and ensures trusts are not short of cash if their cost improvement plans do not yield savings in the first part of the year.

However, HSJ understands some trusts, particularly those behind their financial plans at the end of the first quarter of the year, will be seeking distress funding over the next few months to cope with having less cash.

Three trusts told us they will be seeking talks with NHS Improvement and the Department of Health to ensure they have enough working capital.

CCG mega-merger

Three CCGs that cover one of the most financially strained health economies in the country have proposed a full merger as part of a wider reconfiguration of services.

Bristol, North Somerset and South Gloucestershire CCGs have confirmed plans for a formal merger. The new organisation would have a combined health budget of £1.15bn.

The proposal is unlikely to come as a surprise with suggestions as early as September 2016 of a move towards a “single commissioning voice”. The CCGs already run a joint commissioning board with one chief executive Julia Ross.

Unregulated risk

NHS patients are being put at risk from thousands of unregulated clinical physiologists working in hospitals across the service.

The Registration Council for Clinical Physiologists, which maintains a voluntary register of 6,000 people, has spoken out over its fears for patient safety after its members identified 19 incidents of harm or concerns relating to physiologists over two years.

Physiologists work in a variety of areas in the NHS providing diagnostic tests and invasive procedures, which can cause significant harm to patients if done incorrectly.

The RCCP feels the risk to patients is too high and wants the government to bring in statutory regulation to force physiologists to meet basic levels of training and standards.