Make sure you are up to date with the events of the last seven days with our insight into the stories that matter most
Hunt hits back and BMA steps up strike
“The matter is closed” – that’s what health secretary Jeremy Hunt said when asked by HSJ if there was anything that would prevent the government from imposing the new junior doctors’ contract.
The health secretary also said that the proposed contract was “right for doctors”, and was “much safer” than the current deal.
The health secretary was speaking at a meeting convened by HSJ to discuss the government’s health policy and Mr Hunt’s leadership. Also present at the meeting were British Medical Association council member and Tower Hamlets Clinical Commissioning Group chair Sir Sam Everington, Nuffield Trust chief executive Jennifer Dixon, Central and North West London Foundation Trust chief executive Claire Murdoch and HSJ editor Alastair McLellan.
The meeting took place on Tuesday, before the BMA’s junior doctors committee announced on Wednesday that it will escalate strike action planned for next month.
A full walkout, including emergency cover, will take place at 8am-5pm on 26 April and 8am-5pm on 27 April.
Emergency care will still be provided by juniors outside these hours, however all other junior doctors will be striking for the full 48 hours. Consultants, nurses and other staff will be providing emergency cover.
Requirements for local digital roadmaps spelled out
HSJ revealed on Wednesday that NHS England has sent out draft guidance setting out the requirements for local digital roadmaps.
The long awaited guidance sets 10 core digital targets that local areas must be able to “demonstrate substantive delivery” on by March 2018.
But on the crucial question of funding, the guidance says the process for “accessing and criteria for allocating funding” was still being agreed.
It adds: “Over the next five years, funding of £1.3bn is to be distributed across local health and care systems to achieve the ambition of paper-free at the point of care. This is made up of £900m capital and £400m revenue.”
The new guidance will help local areas shape their plans. But finding out how they can get their hands on more money – regardless of how much there is – remains a key issue to clarify.
DH sends external accountancy firms into 20 organisations
In a “desperate” measure to balance the budget in 2015-16, the Department of Health has sent external accountancy firms into 20 NHS organisations, just as they are preparing to close their accounts, HSJ revealed on Thursday.
The DH is perilously close to breaching its spending limit agreed by Parliament for 2015-16, and the review is designed to “support the health group accounts”.
One expert called the move an “act of desperation”, while an NHS finance director said it “goes against the grain of professional accounting and auditing”.
Focus areas will include “overly prudent” accounting around deferral of income and third party disputes, and “unnecessary provisioning” for restructuring.
Sir David to lead Pennine Acute Hospitals Trust
Sir David Dalton’s already extensive influence in Greater Manchester increased significantly on Tuesday, after he was put in temporary charge of Pennine Acute Hospitals Trust.
He will split his time between Salford Royal Foundation Trust and the troubled four-hospital acute, along with chair Jim Potter.
This comes after the sudden announcement last month that Dr Gillian Fairfield, chief executive of Pennine Acute, was going on secondment to Brighton and Sussex University Hospitals Trust.
The move appears to fit neatly into Sir David’s ambition of a large scale “hospital chain” in Greater Manchester.
Wrightington, Wigan and Leigh Foundation Trust are already on board, Bolton FT are flirting with the idea, and suddenly whopping great big Pennine Acute is in his hands.
Stuck down a cash cul-de-sac
On the day after NHS England denied it had been “leant on” to reduce its five year funding demands on the Treasury from £16bn to £8bn, the HSJ editor has argued that the health service should stop pleading for money.
In Monday’s editorial, Alastair McLellan says “asking for something that is not going to be delivered undermines credibility”.
He continues: “Calling for a boost similar to that delivered in 2002 (which was on the back of a decade of improving economic performance) suggests naivety at best.
“But more importantly, calls for extra cash let the government off the hook. They allow the debate to be diverted into the “strong economy, strong NHS” cul-de-sac.
PHSO whistleblowers expose ‘toxic environment’
HSJ has spoken to six former and current staff from the Parliamentary and Health Service Ombudsman about their concerns over the way public complaints are being handled and the culture of the ombudsman.
Hundreds of new investigations carried out by the NHS ombudsman are “relabelled” assessments and being carried out by staff who face “unachievable” targets in a “toxic environment”, they said.
The whistleblowers claimed PHSO staff tried to warn that rebranding the assessment of complaints as investigations would affect quality and increase workload but they say this was ignored and tougher targets introduced, and this meant the quality of investigations declined. The PHSO insisted it had quality control checks in place to ensure standards were being maintained.
The six, who are a mix of current and former managers and investigators, spoke separately to HSJ but gave consistent accounts of the culture and problems within the service.