Nominations for our project to identify the 50 most influential people in the integration of health and care services are to close on 1 May, plus the rest of the day’s news and comment

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6.00pm The chief executive of Norfolk and Norwich University Hospitals NHS Foundation Trust describes how the Top Leaders programme gave her a greater perspective and renewed belief in her leadership style.

5.30pmToo many leaders adopt a facade as they put on their suits for work,” argues Chris Lake, head of professional development at the NHS Leadership Academy.

“The trouble is, facades are doubly flawed: not only do they fail to act as the hoped-for armour, they are almost always transparent.”

5.05pm In the Nuffield Trust blog, its chief executive Nigel Edwards says Simon Stevens’ first appearance in front of the health select committee has “produced some interesting changes in tone”.

“The important was his signalling about localism. In Stevens’ view the centralised commissioning of specialised services, like chemotherapy and cystic fibrosis care, represents an over extension of the concept because it took in too many other services too quickly,” he notes.

“This is undoubtedly true as NHS England appears to have spectacularly overspent the budget – something that Simon Stevens himself acknowledged.”

“He also signalled in a number of areas that local resolution of issues is going to be required rather than centrally developed ‘cookie cutter’ solutions – particularly the application of urban models to rural areas.”

Click here to see how other commentators, including Steve Kell and Rob Webster, assessed his performance.

4.45pm Writing for Reuters, Ali Malsher, a clinical negligence partner at London law firm Anthony Gold and former nurse argues that the £200,000 fine given to Mid Staffordshire Trust for the death of a diabetic patient will not shock other trusts into shifting towards a culture of greater transparency.

She says: “Though patients may feel that the failings exposed at Staffordshire Hospital are present in other parts of the NHS – even endemically so – the criminal prosecution of Mid Staffs was in fact highly unusual. It was unique in terms of the scale of the failings at Staffordshire Hospital, and it was unusual in being brought by the Health & Safety Executive (HSE).”

She adds she has “started to see some slight culture change” with introduction of a statutory the duty of candour.

“Ultimately, the big effect of Mid Staffs has been that people have started highlighting problems in their own local hospitals. Patients have become more outspoken,” she writes.

“They didn’t use to complain about nurses, but after the fine on Mid Staffs, they know that they don’t have to accept nurses as God-given angels, but that in some circumstances nurses can have the same failings as anyone else.

4.00pm The Independent reports that NHS England has opened an investigation at the University of Derby, after syringe barrels were being reused by a heathcare worker in administering vaccainsaions and bllod taking.

More than 600 students who received blood tests and vaccinations from the healthcare worker have been contacted to have their blood tested over concerns that may have been put at risk of hepatitis or HIV.

The healthcare worker has been suspended pending the investigation, NHS England has confirmed.

Doug Black, medical director of NHS England’s Derbyshire and Nottinghamshire area team said there is an “extremely low possibility these errors may have put people at risk of infection from hepatitis B, hepatitis C or HIV.

“With this in mind, as a precaution, we have reviewed all available University health records and the 606 people identified have all been contacted and invited to attend a blood test at their local hospital or via their GP.

“We are extremely sorry for the undoubted worry and concern people we are contacting may feel on receiving this news.”

3.30pm Our sister title Nursing Times reports that leading patient safety advocate Robert Francis QC has given his personal support to a national nursing charity.

Mr Francis, who last year published his seminal report on care failings at Mid Staffordshire NHS Foundation Trust, has agreed to become a patron of the Florence Nightingale Foundation.

He said: “I am very honoured to be asked to be a patron of the foundation.  I believe that it is a beacon of everything which is valuable and admirable about the vocation of nursing.

“I look forward to supporting the foundation in promoting the values and standards which are so important for high quality care for patients,” he added.

3.00pm In our demand-led, internet age the public expect the NHS to work seven days a week. All groups have a responsibility to engage constructively to make this a reality, argues HSJ deputy editor Emma Maier in her leader column.

2.30pm EXCLUSIVE: Being admitted to hospital a few hours later in the day often means patients spending several days longer on wards, according to new analysis shared with HSJ.

The dramatic variation is the main finding of research by a team of NHS analysts who specialise in emergency hospital care.

The current major national initiative to extend NHS working hours has largely focused on the weekend. However, the work by the Manchester-based North West Utilisation Management Unit suggests changing working practices on weekdays could have more impact in reducing the amount of time spent in hospital.

2.00pm GSTS Pathology, a joint pathology venture majority owned by Guy’s and St Thomas’ and King’s College Hospital will rebrand in May as Viapath to “mov[e]… on from both the GSTS and King’sPath brands used until now”.

Viapath was set up five years ago as a joint venture between Guy’s and St Thomas’ Foundation Trust and the private firm Serco.

It won a contract to provide pathology services to Bedford Hospital Trust in 2009.

The following year King’s College Hospital Foundation Trust became a member of the joint venture. 

Viapath chief executive Richard Jones said: “Our record shows that transforming pathology services can lead to better services for clinicians and patients and deliver surpluses for investment.

“I am proud to lead a team of exceptional people – top scientists, clinicians, laboratory staff and business specialists.

“We have a clear vision of how our scientific and clinical knowledge translates into a market-leading portfolio of diagnostic tests and services – and a commitment to work in close partnership with hospital and community healthcare providers to improve the lives of patients, every day.”

1.45pm In a BBC interview, the chief inspector of social care Andrea Sutcliffe said she has not yet seen any footage from the Panorama investigation into poor care at the Old Deanery in Essex, but she said: “I know enough to be shocked and really angry about what Panorama have found”.

She added: “My heart goes out to the people who have been affect but also those all of those hundreds of thousands of people working in care homes, who actually try to do a good job, and every time we hear about this, people being failed, that undermines the good work that happens as well.”

She said: “The people who are running these homes need to know from us the regulator what standards we are expecting to achieve. We will monitor that. We will go in and inspect, and we will identify where there are problems and what people need to do to put them right. If necessary, we will take action against those homes.

“The most important thing here is that these are people’s homes. They have every right to be able to live there and to be treated with dignity and respect. We need to make sure that staff are supported to deliver that care in a safe and compassionate way.”

1.00pm A BBC Panorama Investigation, to be broadcast tonight, has found evidence of poor care at one of the largest care homes in England.

Undercover filming has shown residents at the Old Deanery in Essex being handled roughly and mistreated by staff. One resident was slapped.

The BBC reports that one staff member has since been sacked and seven have been suspended.

Allegations of poor care and mistreatment at the care home were first raised by 11 whistleblowers in August 2012.

The chief inspector of social care, Andrea Sutcliffe, said she was “shocked and really angry” about what the investigation had found.

12.30pm In his weekly HSJ column, Michael White says after a week of complaints about hospital data, regulators’ fines and where the NHS should and shouldn’t spend it’s money, he has a positive story from the service’s front line.

12.00pm In case you missed it when the story broke yesterday, the new NHS England chief executive has initiated a quick-fire review of the organisation’s national structure and systems, amid staff concern about its “hierarchical” approach, HSJ can exclusively reveal.  

Simon Stevens has asked commissioning development director Rosamond Roughton and Karen Wheeler to lead the review.

Ms Wheeler was recruited this month from the Department of Health to become the organisation’s director of transformation and corporate operations. He has asked them to report at the end of May.

11.45am Philip Hunt, a Labour peer and shadow spokesperson for health, says the DH’s procurement development programme must be taken up at the highest level in trusts.

‘Responsibility for the programme’s success now sits with every single person involved in NHS procurement, from those that make the purchasing decisions and spend money with suppliers, right through to the suppliers themselves,” he argues.  

11.30am The Department of Health’s new e-procurement strategy will make the NHS more efficient with its money and safer for patients, says Steve Graham, who is leading the programme.

11.15am More than two thirds of inpatients with learning disabilities in specialist units are given anti-psychotic medication, a census commissioned in response to the Winterbourne View Hospital scandal has shown.

The census also found that more than half (56.6 per cent) of the patients had experienced an “incident” during the three months preceding the census date such as self-harm, an accident, physical assault on the patient, hands-on restraint or seclusion.

11.00am Fresh thinking or a lack of commitment on budgets? Commentators including Steve Kell and Ruth Thorlby assess Simon Stevens’ performance in front of the Commons health select committee.

10.50am The NHS body charged with handling and safeguarding confidential patient data is to publish the findings of three key investigations into alleged misuse of its information “within weeks”, HSJ has learned.

The trio of probes were all launched in March by the Health & Social Care Information Centre.

Although the investigations are being carried out separately, they are all understood to be examining whether ‘pseudonymised’ Hospital Episodic Statistics data, supplied by the HSCIC, had been published in a format that could have identified patients.

10.35am Simon Stevens will not commit to an “artificial” timescale for re-starting the project, raising the prospect of fresh delays to the controversial flagship project, the health select committee heard yesterday.

Simon Stevens described the current six month “pause” period, which runs until September, as “an important moment to listen much more carefully to what a range of people have got to say” and said that the programme should not be tied to an “artificial start date”.   

10.25am Simon Stevens has been reviewing the split between NHS England and clinical commissioning group budgets in his first few weeks in his post, and said it will shift.

The new NHS England chief executive said he thought CCGs will thrive when they are given responsibility for primary care services. He would outline how the split between local NHS commissioning would “evolve” on Thursday, MPs heard.

10.10am Simon Stevens also told the health select committee that NHS England would lead a review on the future finances and sustainability of the health service.

He said NHS England, in collaboration with other national organisations, would by autumn publish a report on the health service’s future in light of the financial environment. He did not detail what this work would address but indicated it would consider funding after 2015, and how the NHS can change.

The news comes at a time of growing political debate about the future funding requirements of the NHS and also of social care, and with a general election a year away.

10.05am More from Simon’s Stevens first appearance in front of the Commons health select committee, the NHS England chief executive told MPs he does not share his predecessor’s concerns that competition law is standing in the way of health service reform.

Sir David Nicholson repeatedly raised concerns in the run-up to his retirement last month about the impact of competition law and regulation since the introduction of the Health Act 2012, and indicated legislation needed to be changed.

9.55am Nominations for our project to identify the 50 most influential people in the integration of health and care services are to close on 1 May.

In a project supported by Nutricia, HSJ and its sister title Local Government Chronicle have appointed 12 judges with vast experience across the health and local government sectors to use their expert knowledge to name the people who are doing the most to shape and lead the integration of services.

The readers of both titles are being asked for nominations of the people who are doing the most to drive integration, especially in individual geographical areas.

Our list will reflect the 50 people working in local government, the NHS, Whitehall, third sector organisations and businesses that are at the cutting edge of the changes, uncovering the ground-breaking projects and approaches they lead.

Candidates will be assessed on criteria including their personal success in integrating services, the level of innovation they have used and whether their ideas are influencing people elsewhere.

To nominate someone for inclusion in the list, please send an email to LGC features editor Rachel Dalton at with ‘Integration 50’ in the subject line, or on Twitter by using the hashtag #integration50.

Within your email, please include your nominee’s name, the organisation they work for, and a short explanation (100 words or fewer) of why you believe they should make the list.

9.45am Catch up on HSJ’s extensive coverage from Simon Steven’s first appearance in front of the health select committee yesterday afternoon.

His comments mark a significant change in direction from his predecessor Sir David Nicholson, who favoured centralising most specialist services into 15-30 centres.

7.00am: Good morning and welcome to HSJ Live. The cost of diabetes is projected to rise sharply to £17bn within 20 years. Robin Hewings and Barbara Young suggest some examples of best practice to reduce the cost per patient and ease pressure on already stretched resources.