Salford Royal chief executive leads team to look at “superhead” style of management, plus the rest of the day’s news and comment

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4.05pm Waiting times expert Rob Findlay gives a full analysis of the latest 18 week waits data from December 2013.

3.57pm In our comment section The People Manager Blair McPherson writes that the appointment of Stuart Rose is an example of “too much emphasis on leadership and too much admiration for private sector management”.

3.39pm Our story on former M&S boss Stuart Rose undertaking a leadership review of the NHS has gathered lots of comments. Here’s a selection:

“Here we go again - some things don’t change but just go in endless cycles. Do we learn nothing from the past? The naive belief that bringing in someone from the private sector to advise on public sector management in the NHS will somehow result in locating the magic formula that has eluded those working within the sector has been found to be wanting. Yet politicians continue to let their faithful followers and benefactors loose on perhaps the most complex management challenge there is - and certainly infinitely more complex than anything M&S has had to encounter or is ever likely to. The seductive belief that there are generic management skills that can be readily imported from one sector to another devoid of context is baffling given the evidence from previous failed attempts to apply the ‘wisdom’ of private sector managers to the complexities of the NHS. If history is any guide, it will be business as usual after Rose has been and gone. I wonder if Rose has even used the NHS?”

“Unfortunately, he’ll never be allowed to make the real contribution he could. Anyone who has run a national chain retailer knows that the way you make best practice common practice is through central management. As long as we continue to run hospitals on the independent local Co-Op society model (i.e. Foundation Trusts) we’ll never have true efficiency. We could save all the money we need to and deliver infinitely better customer service if we didn’t have all this nonsense of local boards and local targets. Until we fix that, we’ll have the postcode lottery we have now and obscenities like parking fines for visitors as petty bureaucrats scratch around to try and meet narrow local targets.”

“On the plus side, getting a fresh pair of eyes is an admission that things aren’t working, and incentives are misaligned. Griffith report points still have not been fixed. Some ideas 1. Retail and business relies on strong Informatics systems : better data to make better decisions. 2. Bribe consultants e.g. 25% to go onto 5 year contracts with 6 month notice of termination. Would be worth it to get rid of non-performers. 3. Set up a management training stream/ academy for doctors with a management qualification.”

“It’s easy to be cynical as there seems to have been a string of high profile business people willing to fix the NHS. Can we just bear in mind that what is on offer is a mentoring function, and that Mr Rose is not being paid for this role? Isn’t a bit of reflective support for the CEOs of the 14 trusts likely to be helpful? Even the act of verbalising a problem brings clarity. Perhaps best to reserve judgement for now and revisit in 12 months?”

“Breaking News….. Former NHS CEO, Sir David Nicholson will be flown into M&S to turn around its struggling non-food retail business.”

2.51pm There are some interesting reader comments on our story about Sir David Dalton leading a team looking into the setting up of hospital “chains”.

“Grouping trusts together under a single management? My word - The NHS maybe?”

“Grouping together non-contiguous trusts would largely avoid prohibitions by the competition authority, but a change to the competition regime is an alternative.”

“This is a really good idea. We should encourage providers who have a particular expertise to take this and do it elsewhere, however Trusts exist to serve their local populations so to make this work we would have to completely change the constitution of trusts.”

“Won’t this render the already too small CCGs even more impotent? Already many of them are like so many mosquitoes buzzing around large supertanker FTs with none being majority shareholders. What chance of them wielding influence on the doings of a large chain? Or is that the point?”

“Something else to stop us doing our day job”

2.11pm NHS Confederation has commented on the announcement that the majority of actions by special measures trusts are due to be completed by the deadline.

Rob Webster, chief executive of the NHS Confederation, said: “Over the past year the NHS Confederation has worked closely with the 14 Trusts currently in special measures to ensure their experience is both meaningful and valuable.

“Good progress is now being made. There is, of course, more work to be done. There can be a renewed confidence that everything is being done to ensure those hospitals deliver the best possible standard of care to patients and the NHS openly takes onboard the experience of others.”

2.00pm Unite has said that the involvement of Stuart Rose in an NHS leadership review represents a “conflict of interest” because he sits on the board of a private equity firm with a multimillion pound stake in private healthcare firm Care UK.
The union argues that Sir Stuart’s focus on tusts in special measures could conflict with Care UK’s bid to take over the running of George Eliot Hospital.  
Rachael Maskell, Unite national officer, said: “People will be utterly stunned and then angry that the health secretary Jeremy Hunt has put an individual who could make a fortune out of hospital takeovers in a position of responsibility in the NHS.  This clear conflict of interest is gob-smacking - what was the minister thinking?
“With the people of Nuneaton now in a fight to stop their hospital falling into private sector hands as Care UK and Circle battle it out to take over the running of George Eliot Hospital,  Sir Stuart must make it clear now that he will not in any way personally profit from this bid.”
1.35pm To get a sense of Stuart Rose’s leadership style our reporter Will Hazell has collected some of his quotes on the subject.

Here’s one: “Leadership isn’t about always being right. Leadership is actually more often about getting enough people behind you to agree that you’re going to move in a certain direction. Because at some point you’re going to make a mistake. I’ve made loads of mistakes…But doing nothing is not an option.”

1.28pm The Evening Standard reports that leaked plans show that nine out of ten specialised centres in London treating brain cancer will be closed to NHS patients.

Around 50 patients waiting for treatment have been told to transfer to other hospitals.

The paper writes that leaked details of a national review by a senior NHS official suggest that all but one — or two at most — centres in London would be closed to NHS patients. Across the country, between 11 and 18 out of 25 such centres would close to NHS patients under the plans.

1.17pm Is the NHS over-regulated? This was the subject that loomed large in a recent HSJ 100 roundtable debate.

There were contributions from David Prior, Chris Hopson, Mark Newbold and Anna Bradley and concerns were raised over a reliance on regulation to drive standards up.

12.38pm In a very special edition of Endgame we have an exclusive with a Valentine theme.

12.34pm In our comment section NHS Employers director Dean Royles calls for less reports and more time for NHS leaders to work on improving their services.

12.30pm In an exclusive interview with HSJ Secretary of State Jeremy Hunt said that in some cases NHS managers should be paid more than the prime minister.

He also said the job of an NHS manager is “far more difficult than being a manager in the private sector”.

12.00pm In our leader column from HSJ editor Alastair McLellan, in which he looks at the drafting in of Sir Stuart Rose to undertake a leadership review, he writes: “The health secretary is very keen to avoid any suggestion that Sir Stuart’s review is a Trojan horse for a private sector take over, while at the same time suggesting the NHS could benefit from talent recruited from outside the NHS.”

11.40am The man behind the latest leadership review - the executive editor of Retail Week delivers a profile on Sir Stuart Rose.

11.07am Join our twitter chat at 12pm today to discuss the best way to commission end of life care. Follow @hsjnews and @mariecurieeolc and the hashtag is #hsjeolc.

11.03am Yorkshire Ambulance Service Trust bosses are urging the public to use the emergency service wisely during planned strike action staff.

Unite the Union represents around 7 per cent of Yorkshire Ambulance Service staff and, although recent industrial action involved less than 2 per cent of the Trust’s workforce, the strikes between 3.00pm and 8.00pm today and Monday will, once again, take place without any concessions from Unite for the most seriously ill and injured patients.

David Whiting, Chief Executive at Yorkshire Ambulance Service NHS Trust, said: “Our plans to maintain high standards of patient care and minimise any impact from previous episodes of strike action were effective and we have taken steps to ensure our service remains just as resilient this time.

“We would like to reassure members of the public that our contingency plans continue to focus on providing a safe, responsive and high-quality emergency service which remains the Trust’s top priority.

“We would appreciate the co-operation of the general public and would, once again, like to remind people to use our services wisely.  Please only call 999 for an ambulance when someone has a life-threatening or serious illness or injury.  Anyone requiring advice or treatment for a non-emergency situation or minor ailment should consider options such as self-care, a visit to a local pharmacist, contacting the NHS 111 urgent care service or their GP, visiting a walk-in centre or minor injuries unit.

Cosmetic surgery leaders said they were aghast at the the lack of proper regulation put forward by the government’s response to an independent review into the future of the sector.

Ministers have failed to agree to a key recommendation from NHS medical director Sir Bruce Keogh, whose review followed the PIP breast implant scandal.

10.52am Here’s a short HSJ summary of NHS leadership reviews, in light of the Sir Stuart Rose announcement today.

10.45am Here’s an extract from our story on the new leadership review announced today:

Sir Stuart Rose will examine how the best managers from both the private and public sectors can be encouraged to take on the most difficult jobs in the NHS.

In an exclusive interview with HSJ, health secretary Jeremy Hunt said: “Where we have hospitals in difficulty then clearly getting the right leadership in place is the number one priority and that is where I think Sir Stuart can help us. He was an inspiring leader, he did a very good job of reconnecting M&S to its customers.

10.43am The Foundation Trust Network has responded to the government’s announcement on the new reviews.

Chris Hopson, chief executive, Foundation Trust Network, said: “The Secretary of State is right to identify how difficult senior leadership roles in the NHS are given, as he says, the complexity of what senior leaders have to do, the fact that they are dealing with life or death situations on a daily basis and the huge pressures that NHS Trusts are under.

“Senior leaders play a key role in supporting clinicians to deliver the best and most compassionate care for patients 24 hours a day, 365 days a year. These roles are often far more difficult than being a manager in the private sector and this should be reflected in how the NHS values them. 

“The FTN welcomes the recognition that there are particular issues for the most challenged Trusts in ensuring that there are enough capable leaders willing to take senior leadership roles. Some of the Trusts facing the greatest hurdles have had real difficulties in appointing and retaining the right permanent senior leadership teams. We hope Sir Stuart Rose’s review will not just look at how we recruit, attract and develop the best leaders but also at what the NHS system needs to do to support those leaders, given how difficult and complex their roles are. Marks and Spencer has a reputation for supporting its store managers and focussing their organisation, systems and processes and culture to enable these key roles to deliver for customers. Although they wouldn’t necessarily use the same analogy, many NHS provider chief executives tell us that they wish the NHS system worked in a similar way and that they, and their teams, were better supported by the NHS system to deliver for patients.

“The FTN welcomes Sir David Dalton’s review of how the best Foundation Trusts and Trusts – who are world class in the outcomes they deliver and the care they provide - can help drive improvement across the sector as a whole. Given the unprecedented challenges facing the provider sector, we need to look at different ways of ensuring that we deliver outstanding care for patients. Most NHS improvement initiatives tend to be top down and centrally driven whereas in other sectors - for example, local government - improvement has been led from within the sector, by the sector, for the sector. We have consistently argued the case for this approach and many of our members are at the forefront of this thinking. We therefore welcome the opportunity to look at, and contribute to, its development within the NHS. It is important, however, that all patients receive great care and any new approach must consider patients whose needs are provided in community, mental health and ambulance settings. Sir David is well placed to lead this thinking as he understands the NHS from top to bottom and runs a high performing organisation with quality of care at its heart.

“The FTN also welcomes the report on progress of the special measures regime. We look forward to working with the Government and its agencies on how the special measures regime develops over time to ensure that it delivers its stated purpose of enabling Trusts to improve the care they provide. We will, for example, shortly be hosting a roundtable for the Trusts in special measures and the CQC, Monitor and the Trust Development Authority so the Trusts themselves can share what they believe is working with the regime and what changes they think are needed for it to provide even greater and more effective support”.

10.40am Times columnist Phillip Collins writes on Ed Miliband’s Hugo Young lecture on public services. He says the Labour leader instincts to “help the little guy” are right, but this will not be achieved by forming committees.

“Real power in the NHS means patients having control of budgets,” he argues.

10.39am Also in The Times, three quarters of parents of overweight children are in denial about their children’s weight, according to a study by Imperial College London.

10.38am The Times reports on doctors criticising the government for not backing up their promises of a crackdown on cosmetic surgery with new laws.

10.36am The Telegraph reports that men are 50 per cent more likely to die from cancer than women, according to a report by Cancer Research UK.

Experts said men were more likely to be diagnosed with the types of cancer that are harder to treat, such as lung and liver. This was a global study, which found that men in central and eastern Europe are most likely to die compared to women.

A report published by Monitor and the NHS Trust Development Authority today reveals that in addition to 49 board level managers leaving, the trusts have recruited 650 extra nurses or nursing assistants, and 130 additional doctors. 

10.12am Retail Week’s executive editor George MacDonald has written a profile on the “outspoken, controversial and never dull” Sir Stuart Rose, the former M&S boss who has been brought in to the NHS to do a leadership review.

In an exclusive interview with HSJ, the health secretary appeared to backtrack on his previous criticism of the pay of very senior managers.

He also said being an NHS manager was “far more difficult than being a manager in the private sector”.

9.55am Jeremy Hunt has announced that Sir David Dalton will be leading a team looking into how trusts can group together in “chains”.

The Salford Royal Foundation Trust chief executive will also look at what barriers prevent hospitals from working in larger, non-geographic groups.

HSJ exclusively reported on Wednesday that discussions were underway about a chain arrangement for trusts.

7.00am Welcome to HSJ Live. Later today, HSJ – in association with Marie Curie Cancer Care – will be running a Twitter chat to discuss the importance of partnership working in end of life care.

Dr Peter Nightingale, the joint Royal College of GPs and Marie Curie clinical lead for end of life care, will be online taking questions and offering his thoughts.

Follow the @hsjnews and @mariecurieEOLC Twitter accounts on to take part. We will be using #HSJEoLC – you can use this hashtag now to post questions and contributions for the debate.

The Twitter chat will begin at 12pm.