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.

Keep calm and Carillion

A big sigh of relief has been taken in the Black Country after the government announced it would provide the rest of the funding required to complete the new Midland Metropolitan Hospital.

The hospital, built for Sandwell and West Birmingham Hospitals Trust was a victim of construction company Carillion’s liquidation, with a third of the facility yet to be built when the firm went under in January.

Following eight months of negotiations with affected parties, trust chief executive Toby Lewis described the government’s promise as “fantastic news”.

The hospital, with its 15 operating theatres and 670 beds, is now set to open by 2022 – four years behind schedule.

Unanswered questions

NHS Improvement wants to draw a line under the financial meltdown at Barking, Havering and Redbridge University Hospitals Trust.

There have now been three investigations into what happened at the troubled provider, including the role played by a senior employee of NHS Improvement, and the regulator considers the matter resolved.

But the terms and nature of the investigations, as well as the findings themselves, prompt further basic questions for the regulator.

HSJ does not feel the questions and concerns have been adequately addressed, but you can make up your own mind by reading the questions and response in full.

The standalone debate

Data published by NHS Improvement has shown 17 out of 55 community providers failed to meet their own staffing plans for registered nurses over the last three years.

The regulator has also published analysis of trust fill rates by the three different types of provider.

Interestingly, NHS Improvement’s analysis suggested that on an average, standalone trusts met their staffing plans more frequently, while integrated acute and community trusts appeared to perform the worst.

It also raises questions over whether NHS Improvement and trusts are measuring the right metrics when it comes to safe staffing in community hospitals.

All in it together?

Health Education England has had a difficult few years as the plaything of the Treasury. Ministers have changed policy on funding for the NHS workforce multiple times and left HEE to cope with the consequences.

Then chancellor George Osborne’s accounting trick to deliver extra money to NHS England in 2015 meant HEE was forced to save 20 per cent of its running costs and cut spending on areas like workforce development, or continuing professional development.

In its latest annual report, the £5bn education and training body reveals the costs of staff redundancies at almost £17m over the past two years.

But while staff have faced losing their jobs, some of HEE’s most senior executives have benefitted from boosts to their pay.

ALB wields axe

The next two years will see a major shake up of the NHS’s national digital agency, with significant job losses expected, as exclusively revealed by HSJ.

NHS Digital told more than 600 of its roughly 3,000 staff would be part of the first wave of a restructure, known as “Org2”. It declined to put a number around the job losses, but unions expect it to be in the hundreds. The reason for changes is two fold.

First, NHS Digital has inherited staff from legacy organisations with skills that no longer match the digital services it is expected to deliver.

Second, the agency’s funding is projected to drop by nearly a fifth by 2020-21 and with staffing the only major adjustment cost, shrinking the workforce is the obvious place to make cuts.

NHS Digital has told staff the status quo is no longer viable, and change is needed to remain useful to the system.

Are you bothered?

What was the Big Secret behind a struggling hospital’s accident and emergency performance miraculous recovery from languishing at 81 per cent in July 2017 but topping 95 per cent just a year later?

Making staff “bothered” about the four hour metric and recognising it was a “quality standard not a performance target”, a senior trust chief has told HSJ.

Nick Hulme, chief of the newly created East Suffolk and North Essex Foundation Trust, said turning around Colchester Hospital’s woeful A&E performance had required a “little bit of [changing] systems, but was largely hearts and minds”.

His approach was inspired by a chat with a locum registrar who has worked in 50 NHS A&Es.

Holy Grail

The quest for the holy grail of patient safety is to find a solution to the stubborn reoccurrence of incidents that everyone accepts should never happen.

At a rate of more than one a day, patients in the NHS suffer “never events” such as wrong site surgery or equipment being left inside them.

Despite efforts to improve safety, the number of never events reported by NHS trusts has remained far too high. There were 469 such incidents reported between April 2017 and March 2018.

Former health and social care secretary Jeremy Hunt asked the Care Quality Commission to review why this was the case and how these incidents could be eradicated.

A presentation by the CQC seen by HSJ suggests the quality regulator is considering standard operating procedures be imposed across the NHS to try and reduce harm incidents.