news focus it was a dirty start to a year which ended in tension for trusts without stars.Laura Donnelly reflects on the year that was

Published: 20/12/2001, Volume III, No.5786 Page 11 12 13

January Dirty hospitals hit the headlines.

Over a third of those inspected in the first round of Patient Environment Access Team inspections are deemed to be failing.Of 699 hospitals, 35 per cent are red, 42 per cent are graded yellow and just 23 per cent green. Follow-up visits - to be carried out without warning - are promised within two months.

Department of Health human resources director Hugh Tay lor is promoted to a new post of director of external and corporate affairs. Kathy Doran becomes NHS director of primary care. New year’s honours for Northumbria Healthcare trust’s chief executive Sue Page spark questions about whether her national public profile is at odds with her reputation at grassroots level. Bedford Hospitals trust chief executive Ken Williams is forced to step down when pictures of bodies in the chapel hit the headlines.

February Health secretary Alan Milburn promises a police inquiry after the report into Alder Hey Children’s Hospital, Liverpool, criticises inadequate management and blames suspended chief executive Hilary Rowland for a failure to act on warnings about rogue pathologist Dick Van Velzen.A fourth inquiry is announced into the radiology department at Hammersmith Hospitals trust.

The inquiry into breast screening follows three into the trust’s imaging department.

Welsh health minister Jane Hutt announces plans to abolish health authorities and give commissioning responsibilities to 22 local health groups.National Savings finance director Richard Douglas is appointed NHS finance director.

He was deputy to former NHS director of finance Colin Reeves for three years until 1999.

March The DoH says it has not ruled out using the private sector in a programme of elective care centres. Health workers are warned to keep away from farms as foot and mouth disease spreads. An inquiry into child death rates at Harefield Hospital finds serious inadequacies in national and trust data, but says higher death rates at the hospital are not caused by major clinical failure.

Acting regional directors John Bacon (London) and Ruth Carnall (South East) are appointed to the substantive posts. A white paper on learning disabilities is launched. An audit of Hammersmith Hospitals trust finds six breastscreening errors and chief executive John Cooper asks the Commission for Health Improvement for advice.

London region director of primary care Dr David ColinThomé takes on the role nationally. The national service framework for older people promises eight standards to be delivered by 2005, but offers little new money.

April David Fillingham is appointed director of the NHS Modernisation Agency. The number of primary care trusts rises from around 40 to 122.

Finance directors warn that lack of resources - in particular in teaching and inner city hospitals - risks blighting NHS plan targets.Mersey Regional Ambulance Service trust chief executive David Todhunter goes on sick leave after a report blames a personal row between him and a colleague for a three-hour delay in a helicopter transfer for a female patient who later died.

The number of ‘dirty’hospitals drops to 41. The appointment of NHS Confederation human resources policy director Andrew Foster as NHS HR director is welcomed by the service. A National Patient Safety Agency to run a national database logging all errors is announced.

Barbara Harris, chief executive of the Royal United Hospitals Bath trust, is made director of the NHS Leadership Centre. CHI launches an investigation into Hammersmith Hospitals trust.

May A survey by HSJ and the King’s Fund finds 48 per cent of managers think Labour has the best health policies. But 72 per cent think morale has worsened slightly or significantly in the past four years. Plans to ‘abolish’ regions and HAs are leaked to The Guardian ahead of Mr Milburn’s speech outlining the proposals at the Modernisation Agency launch. Tayside University Hospitals trust chief executive Paul White swaps massive financial difficulties for the ‘poisoned chalice’ of Barts and the London trust. The government drops clauses abolishing community health councils in the race to get the Health and Social Care Bill overhaul of hospital food overseen by TV cookery presenter Loyd Grossman, promises mung beans, couscous and very cheesy sauce to the masses just before the general election campaign is launched.

The Conservatives promise the patient’s guarantee, Labour’s pledges centre on NHS plan targets, and the Liberal Democrats offer more of everything: staff, pay, beds, free long-term care and funding for complementary therapies. Sharron Storer, whose partner has cancer, attacks prime minister Tony Blair over the state of healthcare services at Queen Elizabeth Hospital, Birmingham, during an election trail visit. In one of the most memorable images of the campaign, junior health minister Gisela Stuart is seen smiling nervously on camera. DoH director of communications Helen McCallum quits. Sources blame a ‘frightening level of ministerial control’.David Todhunter of Mersey Regional Ambulance trust resigns. Two-thirds of GPs take part in a British Medical Association ballot; 86 per cent say they would submit postdated resignation letters if a contract is not in place by April.

June Labour wins the general election.

Health minister John Hutton takes over John Denham’s primary care portfolio.Mr Denham takes a ministerial role at the Home Office. Jacqui Smith takes over John Hutton’s previous portfolio with responsibility for social services and mental health.

Gisela Stuart returns to the backbenches and is replaced by Hazel Blears. Former GMTV political correspondent Sian Jarvis is appointed DoH director of communications.Dr Richard Ta y l o r , a retired consultant from Kidderminster, wins in Wyre Forest, on a health concern platform following the campaign against the downgrading of local acute services. Tony Blair orders the creation of a delivery unit at the DoH to ensure public services live up to expectation, with Chris Ham, former director of Birmingham University’s health services management centre, at its helm. Simon Stevens, one of Mr Milburn’s special advisers, takes a new role as health policy adviser to Number 10. The Institute of Public Policy Research questions the ability of public-private partnerships to manage hospitals. Chief executive of Stoke Mandeville Hospital trust Sue Nicholls is suspended, and an investigation launched into waiting-list irregularities.West of London breast screening service is suspended after the unit that runs the service at Hammersmith Hospitals trust is deemed unable to keep to national protocols.

July A new NHS appointments commission is launched, ending MPs’ powers to recommend candidates. Professor Paul Corrigan replaces Simon Stevens as special adviser to Mr Milburn.

A white paper on clinical negligence includes an option for a no-fault compensation system.

At the annual NHS Confederation conference, Mr Milburn says he intends to hand negotiations on the GP contract over to the confederation.

Margaret Edwards, chief executive of Heatherwood and Wexham Park Hospitals trust, is appointed NHS director of performance. Loughborough GP Peter Green is jailed for eight years for sexually assaulting patients. The Bristol inquiry, chaired by Professor Ian Kennedy, finally reports after three years, criticising surgeons who were ‘too ambitious’ and ‘flawed’ management. It calls for an expanded and independent role for CHI, which would run a new body, the Office for Information on Healthcare Performance, to co-ordinate monitoring of clinical performance. The latter gets immediate approval from Mr Milburn. Professor Kennedy proposes an independent role for the National Institute for Clinical Excellence, whose guidelines would become mandatory, and a Council for the Regulation of Healthcare Professionals.

August Shifting the Balance of Power in the NHS, the DoH consultation document on service restructuring, is published, and attacked over ‘unanswered questions, loose ends and apparent inconsistencies’. Chief executive of Hillingdon PCT David Panter announces plans to head Brighton and Hove city council. Tees HA chief executive Mike Farrar is appointed to head the NHS Confederation’s negotiating team. The sexual health and HIV strategy is published - four years after the government promised to tackle the issue - offering£47m over three years. All staff affected by NHS restructuring are guaranteed employment for a year. Stephen Thornton is to leave the NHS Confederation after four years. Epsom and St Helier Hospital trust chief executive Nigel Sewell steps down, days before publication of CHI’s most damning review so far, and John de Braux, from West Middlesex University Hospital trust, is seconded to replace him. University College London Hospitals trust announces plans to buy the private London Heart Hospital.

Consultation begins on the shape of 28 SHAs. Gerry Marr, director of performance and planning for the NHS in Scotland, takes over as chief executive of financially troubled Tayside University Hospitals trust.

September Junior health minister Hazel Blears proposes to replace CHCs with agencies called Vo i c e s , based in local authorities and covering SHA areas. Tim Brett, chief executive of troubled Tayside health board, resigns.A CHI investigation into heart and lung transplant services at St George’s Healthcare trust says the deaths of 10 patients in 10 months was probably due to ‘inadequate’ selection procedures. The NHS intranet system, NHSnet, is struck by lightning - 80,000 e-mails are blocked when the back-up system fails. The CHI review of University Hospitals Coventry and Warwickshire trust is damning, but the board, including chief executive David Loughton, remains in place. Ruth Carnall, John Bacon, Peter Garland and David Nicholson are appointed the four new regional directors.

NHS and emergency planning is reviewed in the light of the terrorist attacks in New York on 11 September. Traffic lights become stars - the 12 worst are nicknamed ‘the dirty dozen’: six chief executives are put on three months ‘notice’ and six are given a year. The day before, chief executive of no-star Ashford and St Peter’s Hospital trust Stephen Fash is seconded to lead work on delayed discharges in South East region.Dartford and Gravesham trust chief executive Anne-Marie Dean goes on sick leave until resigning in November. Susan Williams and Sue Osborn, joint chief executives of Barking and Havering HA, are given a job share to run the NPSA. Funds are diverted from research and development to frontline services.

October Regional offices ask where extra money invested in the NHS has gone, having learnt activity is almost unchanged despite large funding increases. Finance directors blame pay, inflation and pensions. Information Authority chief executive Nigel Bell steps down suddenly. Concordat 2, an agreement between private and statutory sectors on long-term care, is announced, alongside a£300m ‘cash for change’ programme to tackle bedblocking.Northern Ireland health minister Bairbre de Brun demands investment in healthcare to match the rest of the UK. Bedblocking in Birmingham reaches crisis levels, with ‘the equivalent of a hospital full’ of people awaiting discharge.Mr Milburn announces plans to send 500 patients abroad for treatment in pilot schemes by the end of the year.Northern Ireland’s centre for neurosurgery, the Royal Victoria Hospital, instructs GPs to stop all nonurgent referrals until next spring because of underfunding. The NHS strikes a£17m deal with Microsoft.No-star Ashford and St Peter’s Hospital trust gets a thumbs-up in its CHI review, highlighting disparities between CHI and the star criteria.Mr Milburn angers social services managers by announcing plans to introduce star ratings for social services by next summer.

Limits to CHI’s powers are demonstrated when the DoH stalls when asked to hand over the findings of a confidential inquiry into breast screening at Hammersmith Hospitals trust to CHI, for its investigation into the service.

November Dr John Nicholson, the highprofile chief executive of the UK Public Health Association, quits following months of unrest.

Managers at Calderdale and Huddersfield trust are branded ‘prudes’ after turning down£3,000 for its cancer unit, raised by a group of friends who stripped for a ‘saucy’ calendar.

The NHS Reform Bill - a legal framework for the structural reorganisation of the service - is put before Parliament. The CHI report on Royal United Hospital Bath attacks an ‘inner circle’ culture with a ‘serious disconnection between the executive team and the rest of the organisation’. Its former chief executive, Barbara Harris, takes extended leave from her job running the NHS Leadership Centre. It later emerges that the trust is conducting reviews of its finances and waiting-list data.

What looks like the first franchise takes place as the management team led by Sue Jennings running three-star Basildon and Thurrock General Hospitals trust takes on the running of no-star Dartford and Gravesham trust. Alder Hey Hospital chief Hilary Rowland is dismissed for her handling of the organ retention scandal.

Chancellor Gordon Brown promises£1bn for the NHS next year and releases the interim findings of the Wanless review, which calls for major increases in funding. Stephen Thornton leaves the NHS Confederation.

December BUPA’s Redwood Centre in Redhill, Surrey, is, in effect, to be converted into an NHS treatment and diagnostic centre.University Hospitals Coventry and Warwickshire trust chair Gary Reay steps down, and says that ‘in his heart of hearts’ beleaguered chief executive David Loughton knows he will have to leave soon.

A former manager at Carlisle’s flagship private finance initiative hospital is awarded a ‘substantial’ payout after an employment tribunal rules that Jayne Holt was unfairly dismissed, in favour of one of her colleagues. The government is warned of real pressures, even after the most generous financial allocation to the NHS ever. Bill Gates, head of Microsoft, meets NHS chief executives - and the health secretary - for a conference on IT.

An audit commission report shows misprescribing in hospitals has risen, and finds a five-fold rise in deaths caused by adverse effects of medicines since 1990. The first part of the diabetes national service framework is launched.As HSJ goes to press, the boundaries for SHAs are due to be announced, and their chief executives appointed soon. The NHS pay award brings 3.6 per cent to nurses and hospital doctors. GPs do better, with 4.6 per cent.

Barbara Harris stands down from the Leadership Centre and is given a role working on DoH internal projects.Meanwhile, four of the six ‘no-star’ chief executives originally put on three months’ probation are waiting to hear whether they will survive their 31 December deadline.