Make sure you are up to date with the events of the last seven days with our insight into the stories that matter most

Junior doctors’ contract dispute: Talks extended

Talks to resolve the junior doctors’ contract dispute have been extended until Wednesday.

The British Medical Association and NHS Employers were in intensive negotiations last week, with talks going into the night on several occasions. The talks were due to end on Friday after an initial agreement to pause the contract imposition and further industrial action for five days.

Sir Brendan Barber, chair of Acas, said in a statement: “Both parties have committed themselves over the whole of this week to highly intensive negotiations in an effort to resolve this long running dispute. The talks have been conducted in a constructive and positive atmosphere. In my judgement some real progress has been made to address outstanding issues.”

Grilling over Carter review

On Monday afternoon Jeremy Hunt, Simon Stevens, David Williams and Bob Alexander lined up to face the Commons health committee.

In a session lasting two and a half hours, the men from the Department of Health, NHS England and NHS Improvement were grilled on the department’s budget, social care spending, and the efficiency drive spearheaded by the Carter review.

The health secretary told fellow MPs the reforms from Lord Carter’s work were “really motoring”, which committee chair Sarah Wollaston took issue with – as did HSJ editor Alastair McLellan.

Earlier in the day, the HSJ editor’s leader had a different take to Mr Hunt on the progress of the Carter review. He says the review “remains the most useful piece of work done to date on this challenge” but “it is going nowhere fast”.

He then sets out six ways to deliver the Carter review – read the full piece on

Detailed breakdown by NHS England to save £22bn

NHS England has offered its most detailed breakdown yet on how it believes the health service can save £22bn by 2021 – which is required as part of the Five Year Forward View.

The document, submitted to the health committee, estimates £6.7bn of these savings could be “nationally delivered” through measures including maintaining the 1 per cent cap on public sector pay growth until 2019-20; renegotiating the community pharmacy contract; and reducing NHS England central budgets and administration costs.

Another £1bn will come from savings on non-NHS provider contracts and CCG running costs, while £8.6bn will come from provider savings, driven through 2 per cent per annum efficiency requirement in prices. The remainder is expected to come from other efficiencies.

‘Muddled leadership damaging digital agenda’

Kingsley Manning’s exclusive interview with HSJ was likely to ruffle a few feathers, not least those of former NHS England director Tim Kelsey.

The outgoing chair of the Health and Social Care Information Centre singled out Mr Kelsey as he argued muddled leadership and competing agendas were damaging the NHS’s digital agenda.

“There is always a problem about visionary missionaries [like Mr Kelsey], and I think it’s about delivery, detail, breadth of understanding of the practical reality of delivery,” Mr Manning said.

Speaking in a personal capacity, he also said the imminent appointment of a new central chief technology officer would likely only add to the “multi-headed hydra” of NHS decision makers.

Outsourcing PCS poor choice by NHS England

NHS England’s decision to outsource a set of unglamorous but utterly critical primary care support functions last year is not currently looking like a wise one.

It’s (relatively) early days, in that Capita is only a few months into a seven year contract, but after a period of calm, it is clear that there are now systemic problems with PCS.

First, routine tasks like moving paper records from one GP practice to another; supplying pharmacists with the right paperwork; and invoicing and payments seem to have broken down.

Second, Capita’s call centre has not been able to cope with the amount of order queries and complaints it has had to deal with.

CEOs take on the CQC

After it was rated “inadequate” by the Care Quality Commission, kidney transplant surgeons at Addenbrooke’s were asked by their patients if the procedure they were having (at a recognised centre of excellence for that work) was safe.

This point of detail in the King’s Fund’s new report, The Chief Executive’s Tale, shows both the importance and the unfairness of “regulator-max”, the souped up hospital inspection regime Jeremy Hunt brought in.

The snippet was cited by former Addenbrooke’s boss Keith McNeil as an example of “the damage [the CQC] can do”, and the reputation shredding that an “inadequate” rating can give.

Cameron’s contract crew revealed

Last autumn the prime minister announced that general practice was to get a new “voluntary contract option”, to accelerate and support the development multispecialty community provider type arrangements. David Cameron also claimed it was a way to help extend GP access outside office hours.

In the GP Forward View last month, NHS England said six areas were “working intensively with us to complete the design of the contract”, with the intention of going live with practices “on a voluntary basis” next April.

On Tuesday HSJ was able to reveal where those six areas are:

  • Dudley;

  • Better Local Care (Southern Hampshire);

  • Manchester;

  • Modality (Sandwell and Birmingham);

  • West Wakefield; and

  • Whitstable, Kent.