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 just too busy to keep up, HSJ Catch Up will ensure you are still in the know.

Dalton’s diktat

NHS Improvement has told providers their activity, workforce and financial plans for the new financial year “do not look realistic or achievable”.

In an email to the sector on Wednesday afternoon, NHSI chief executive Ian Dalton said plans submitted by some trusts are “not sufficiently robust” and further work is needed to address several issues before final submissions are made at the end of the month.

He said each trust should set out bed numbers, capacity, planned activity, planned financial position and “genuinely” anticipated performance levels for each month.

Joint planning guidance published in February by NHSI and NHS England said trusts are required to deliver a combined breakeven position in 2018-19, after accounting for new money announced in the Budget and released by the Department of Health and Social Care.

Dame Julie retires

One of the most respected trust chief executives in the NHS has announced her retirement.

Dame Julie Moore is to leave the newly merged University Hospitals Birmingham Foundation Trust, probably by the end of the summer though a date has not been finalised.

In an email to staff, seen by HSJ, she said she had intended to retire two years earlier but stayed on until the merger between UHB and Heart of England FT was complete.

Dame Julie said the process of bringing the organisations together had “not been straightforward” and took “longer than anybody anticipated”. 

Since joining the NHS as a graduate nurse, Dame Julie has become one of the most renowned chief executives in the health service.

She was made a dame in 2012 and in 2013 was named among the 100 most powerful women in the UK by Radio 4’s Woman’s Hour. She has frequently been named in HSJ’s top chief executives list and the HSJ100.

Attacks against NHS staff increase

Research by HSJ and Unison has found an absolute increase of 9.7 per cent in violent attacks on NHS hospital staff.

HSJ submitted freedom of information requests to all NHS trusts and received responses from just over 75 per cent. The research revealed sharp increases in attacks on staff working for acute trusts, but also a levelling off in assaults in mental health settings.

The work is part of an HSJ special report sponsored by Unison, which explores the reasons behind the rise in violence and the variation across NHS trusts.

The data gathered showed 56,435 reported physical assaults on NHS staff in 2016-17. Extrapolating numbers from this sample to cover the whole NHS in England, this suggests there were an average of just over 200 reported physical assaults on NHS staff every day.

The report includes case studies of trusts that have implemented a range of interventions to prevent harm to staff and Mersey Care Foundation Trust chief executive Joe Rafferty writing about the trust’s initiatives to reduce physical assaults.

Tough choices

NHS Improvement’s rejection of University Hospitals of North Midlands bid for £15m in capital funding to open 75 new beds has provoked a mixed response from HSJ readers.

Some back the regulator and question the trust’s need for capital to create more beds, when the focus should be on delayed transfers of care, while some are in the trust’s corner putting NHSI’s logic process under scrutiny.

Both sides bring up relevant issues.

On the one hand, you have a trust with up to 200 patients medically fit to be discharged, a bed deficit of 133, continuing pressures on acute services that have forced the trust to cancel electives and (some readers said) lack of robust community service provision.

Another argument is that the capital would be better used to shore up social and community provision with the intention to reduce DTOCs and free up existing beds.

Both scenarios leave system leaders in a difficult position. Do they give the trust, which is undeniably struggling to meet demand, the capital to address its current situation; or should the capital go towards shoring up and developing community services for the future? The latter, however, would need significantly more than £15m.

CCG takes swipe over app

Commissioners in south London have complained to counterparts elsewhere in the capital about GP at Hand – claiming patients who switch to the online service are not clearly told they could lose access to their existing GP.

Richard Rice, who chairs Greenwich clinical commissioning group’s primary care committee, outlined his concerns about the online GP practice in a letter to Hammersmith and Fulham CCG managing director Janet Cree last month.

GP at Hand, a partnership between a Fulham practice and online provider Babylon Health, has been enormously successfully in attracting NHS patients by offering free video GP consultation services via a mobile app.

Mr Rice said Greenwich GPs had reported losing patients to GP at Hand only for the same patients to return once they realised they were no longer registered with their local practice.

Responding, Ms Cree said Hammersmith and Fulham CCG had not seen an increase in complaints from patients unaware they were deregistering from their existing practice when moving to GP at Hand.