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 execute full walkout

The first full walkout of junior doctors in NHS history appears to have passed relatively quietly.

HSJ revealed that a number of medical and workforce directors have serious worries about the impact of the new junior doctors’ contract at the heart of the dispute.

Meanwhile, Jeremy Hunt told Radio 4 that health secretary was “likely to be my last big job in politics”. HSJ editor Alastair McLellan tweeted that the interview was “very, very important” and indicated that Mr Hunt was happy to be reshuffled. A government source then told us this was not Mr Hunt’s intention and he wanted to remain in post for a long time.

And the first steps towards contract imposition have already been made.

NAO’s scathing assessment of NHS England

On Wednesday the National Audit Office issued a fairly damning assessment of NHS England’s commissioning of specialised services.

The auditor said the national commissioner did not have “an overarching vision or strategy” for specialised services and lacked the information necessary to improve them.

Jonathan Fielden, the former medical director at University College London Hospitals Foundation Trust, has just started in the role as NHS England’s director of specialised services. His arrival on the scene provides a perfect opportunity for NHS England to begin a new chapter in the commissioning of these services.

Colchester FT risks being in failure regime

Colchester Hospital University Foundation Trust, which has been in special measures since 2013, was told by regulators on Thursday if it does not form a “long term partnership” with Ipswich Hospital Trust it risks being put in the failure regime.

At worst the controversial process could result in the trust’s liquidation, as when it first used to address finance and quality issues at South London Healthcare in 2012. That trust was dissolved in October 2013.

The Care Quality Commission and NHS Improvement have said partnering the two trusts “is the only way of securing services for patients long into the future”.

Reviews into hospital closures

Last September patients at Bootham Park Hospital were moved out with just six days’ notice after the Care Quality Commission ruled it was not fit for purpose and closed the site.

On Wednesday, HSJ revealed the details of two reviews into what caused the closure and how it could have been handled better.

The report for York city council by former Local Government Association chief executive John Ransford is critical of the local and national systems. 

Criticism of the Pennine trust

We already knew the leaders of Manchester City Council and Pennine Acute Hospitals Trust were not best pals, but a few eyebrows were still raised when Sir Richard Leese chose to publicly criticise the trust’s approach to transformation.

At a meeting of the health and wellbeing board this week, the council leader accused the former management of Pennine Acute of being too focused on “institutional preservation”. The local authority is currently leading a review of hospital services in the city, and HSJ has previously highlighted the tensions over the future of North Manchester General Hospital.

In late February, it was announced that Pennine Acute’s chief executive, Dr Gillian Fairfield, was going on secondment to Brighton and Sussex University Hospitals Trust.

CCGs face payment issues

Clinical commissioning groups risk unpaid tax bills and fines for breaching rules on off-payroll payments to governing body members, HSJ revealed on Monday.

Investigation has found variations in the way CCG governing body members are paid, with many remunerated off-payroll, without deductions for income tax and national insurance. Treasury guidance issued in 2012 said CCG board members with significant financial responsibility should be on the public payroll.

HSJ research has found some CCGs have paid senior leaders as NHS employees since they were set up, while others have changed arrangements over the past three years to put staff on the payroll.

Commissioners’ confidence takes a hit

We’ve published a number of pieces from HSJ’s latest survey of clinical commissioning group chairs and accountable officers.

Among findings from the 100 respondents – representing nearly of England’s CCGs – were:

Southern Health leadership in the soup

Southern Health Foundation Trust’s chair, Mike Petter, announced his resignation ahead of the publication of a damning inspection report from the Care Quality Commission.

The CQC inspected the trust in response to the earlier highly publicised report by audit firm Mazars, which criticised the trust’s failure to investigate and learn from patient deaths.

It commented that risks were “not driving the senior leadership or board agenda” and that there was “little evidence” the leadership was “being proactive in identifying risk to the people it cares for or of taking action to address that risk before concerns are raised by external bodies”.

Pay for national managers falls by a quarter

The latest report from the Senior Salaries Review Body, which makes pay recommendations for very senior managers at arms length bodies, reveals pay for these senior leaders has fallen by 23 per cent, in real terms, since 2009-10.

It also criticised the Department of Health who it said had failed to provide sufficient evidence to the review body to allow it make recommendations on pay for VSMs in 2016-17.