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

Official index reveals tech leaders and laggards

On Tuesday, HSJ revealed the results of the new NHS England assessment of “digital maturity” across the NHS, which showed significant variation among providers.

Experts told us that the new data specified how well the provider sector is using technology, but warned about its limitations because it is based on self-assessment.

The data will be used alongside the “local digital roadmaps” to monitor progress against the NHS’s target to be paperless by 2020.

Trust forced to downgrade A&E after locum doctor crisis

HSJ broke the story on Wednesday evening that Lancashire Teaching Hospitals Foundation Trust will be downgrading its Chorley accident and emergency department on Monday.

The unit will run as an urgent care centre between 8am-8pm. The trust’s A&E in Preston will remain open.

Chief executive Karen Partington told HSJ it had only half the middle grade doctors needed to staff its two A&Es, after locum doctors resigned to work at other North West hospitals which are paying over the cap for temporary staff.

How was the £200m transformation fund spent

NHS England has released details of how it spent the £200m fund for transforming the health service in 2015-16 – we published the full details on Thursday.

Primary and acute care systems are the best funded part of the vanguard, receiving over £5m per site on average – and the only part to more than match the transformation funding with their own resources.

As much as £132.6m went on vanguards and around £34m was spent on the national support package for vanguards. Other central programmes which benefited were, the success regime and diabetes prevention.

Head to for all the details, including which vanguard was the only one to receive next to no cash.

Vanguards need clarity on procurement law

Are vanguards in breach of procurement law? Can commissioners and providers be joined together by a central authority with a mandate to transform their health systems, and can non-members challenge them where they’ve been excluded?

New EU procurement rules, which kick in next week, clear up the issue somewhat: everything should be publicly advertised; all bidders must be treated equally; and commissioners can be taken to court if they don’t.

The new “light touch regime” has applied everywhere else in the public sector for a year – the NHS was given 12 months to prepare for the changes.

Attempts at health and social care integration in Somerset scuppered

On Thursday we reported how the Public Contract Regulations 2015 have already scuppered attempts at health and social care integration in Somerset.

Somerset Clinical Commissioning Group wants the health and care providers on its patch to form two “accountable joint ventures” in the east and west, with each venture holding an outcomes based budget to pay for their population’s care.

David Slack, the CCG’s managing director, revealed that Somerset County Council had decided against rolling its social care money into the new contracts because “the legal advice was that they could not participate in that”. The CCG intended to establish the contracts through a non-competitive “most capable provider” process, and the new regulations prevented it from going down this route.

GPs may be allowed self-assessment

HSJ has learned that GPs could face fewer inspections in future under a proposal being considered for the sector’s support package to be launched next week.

Under the changes, after all GP practices have been inspected once by the Care Quality Commission they could then self-assess on a number of performance measures.

One source knowledgeable of the changes told HSJ: “I have heard the term “self-assessment” coming in [alongside] this ’light touch’ idea,” in reference to the proposed changes to CQC inspection.

In October the CQC set out several options for health and care regulation from 2016 to 2021.

The roadmap, to be announced by NHS England, has been described by its chief executive Simon Stevens as “substantial and wide ranging”.

Wards shut due to critical care nurses shortage at Leeds Teaching Hospitals Trust

HSJ revealed on Friday that wards have been closed and liver transplant operations cancelled at Leeds Teaching Hospitals Trust because of a shortage of critical care nurses.

Leaked documents and emails seen by HSJ show the trust was forced to close two critical care wards at Leeds General Infirmary and St James’ University Hospital.

As a result, eight patients awaiting the transplants missed out on the procedure because there were no intensive care beds available.

Senior clinicians said the region was suffering from a critical care bed crisis. Multiple sources blamed the introduction of agency caps for exacerbating the situation.

Junior doctors urged to exclude paediatric services from emergency care strike

Leaked emails from inside the BMA show junior doctors’ committee chair Johann Malawana urged his union colleagues to exclude paediatric services from next week’s emergency care strike.

Dr Malawana warned it would be a “difficult line to defend” but the plea was rejected by the committee and a full withdrawal of labour by thousands of trainee doctors is to happen at 8am-5pm on 26 and 27 of April.

It will be the first time that junior doctors have taken strike action that will not include providing emergency care to NHS patients.