Revealed: NHS Improvement abandons consultancy turnaround programme

A financial turnaround project where management consultants are sent to work with NHS trusts has been shelved by NHS Improvement, HSJ has learned.

The third wave of the financial improvement programme was due to start in early 2018 but sources involved told HSJ an “in-house” team will now work with the most troubled providers instead.


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NHS England vaccine advice 'increased risk of flu admissions'

More patients may have been admitted to hospital with flu this winter after NHS England asked GPs to order a less expensive flu vaccine, a senior doctor has warned.


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Updated: David Behan steps down as CQC chief

Sir David Behan has announced he will step down as chief executive of the Care Quality Commission in the summer.

Sir David joined in 2012, at a time of huge controversy about the behaviour of and standards at the regulator. It has made substantial changes to how it works under his leadership, many in response to the Francis inquiry into events at Mid Staffordshire Foundation Trust.

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Exclusive: A&E doctors tell prime minister patients are dying in corridors

Clinical leads for emergency departments warn prime minister of premature deaths in corridors
A&E waiting time performance has dipped to between 45 per cent and 75 per cent at times
Doctors say winter preparations failed to deliver and call for significant funding boost

Senior doctors in charge of more than 60 hospital emergency departments have written to the prime minister warning of “very serious concerns” about patient safety amid the winter crisis, including a case of patients dying prematurely in corridors.

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Exclusive: CQC suspends routine inspections over winter pressures

Routine inspections of some services cancelled by CQC due to winter pressures

Regulator says decision will allow staff to focus on caring for patients

Chief executives criticise decision as a “mockery” and counter to the policy of “minimum standards”

The Care Quality Commission is suspending routine inspections of some hospitals, GP practices and urgent care services during January due to winter pressures, HSJ can reveal.

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Daily Insight: Reshuffle bored

Today’s must know: Hunt confirmed as health and social care secretary

Today’s talking point: Trusts sought for new NHS ‘lean’ programme

Today’s inspiration: Leading NHS suppliers highlighted in shortlist for new HSJ awards

Today’s risk: Pioneering NHS ACO contract set back

Hunt stays put

So, after the speculation and longer than expected wait for news, Jeremy Hunt not only stays as health secretary but has expanded his job.


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Daily Insight: Cancelling at Christmas

New year’s resolutions

NHS England has told under pressure hospitals they can cancel non-urgent elective procedures to free up beds for patients coming through accident and emergency.


In a letter to trusts on Thursday afternoon, medical director Sir Bruce Keogh and national director for urgent and emergency care Dame Pauline Philip said the “expectation is that non-urgent inpatient elective care should be deferred until mid-January to ensure beds and staff are available for the sickest patients. By acting early, trusts can avoid last minute cancellations that can be costly and inconvenient for patients.”


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Department of Health gender pay gap revealed

Women working at the at the Department of Health earn up to 14 per cent less than men an hour – despite women making up two-thirds of its workforce.

The DH has published a report on its gender pay gap alongside other Whitehall departments, which reveals the scale of the challenge to achieve pay equality for women in the civil service.

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HSJ Awards winners announced

The winners of the Health Service Journal (HSJ) Awards 2017 were announced at a ceremony held at the InterContinental hotel in London. The awards highlight examples of outstanding practice and innovation that help to safeguard and improve patient care across the NHS.

Warning over surgery delays for thousands of patients

A leading surgeon was warned thousands of patients are not being prioritised for gallbladder surgery after pancreatitis – despite the risk of the condition returning that in some cases could kill them.

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Exclusive: One in four hospital trusts routinely pay suppliers late

More than a quarter of hospital trusts are now routinely delaying payments to their suppliers because of cash flow problems, analysis by HSJ reveals.

Data collected from annual reports since 2014-15 shows a threefold increase in acute providers paying more than half their invoices late, with dozens of trusts reporting a steep rise in late payments.

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Quarter of hospital patients denied rapid review – even on weekdays

More than one in four patients do not see a medical consultant within 14 hours of being admitted to hospital – even on weekdays, new data from NHS England reveals.

The information shows that on weekdays across all trusts, 73 per cent of patients see a consultant within the period, which is a key requirement under national “seven day service” standards.

The figure is even lower – 70.3 per cent – at weekends.

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Daily Insight: The price of avoiding a 5 million waiting list

Last week, Simon Stevens warned the NHS Providers conference: “On the current funding outlook, the NHS waiting list will rise to 5 million people by 2021… the government would have to publicly, legally abolish patients’ national waiting times guarantees.”

Waiting times expert Rob Findlay has calculated how much it would cost the government to get 18 week waits back on track. He says: “In short, the government has a choice: constrain the money and abandon the right to treatment within 18 weeks, or cough up and honour it.”

The abridged version is: “With some guesses about the costs per case, I calculate recovering 18 weeks sustainably might cost £2.1bn next year and £350m the year after, if other pressures and enough mainstream capacity are funded. Or £4.2bn next year and £1bn the year after, if austerity continues.”

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New Getting It Right First Time leads announced

Clinical leads for three areas of the Getting It Right First Time programme have been announced.

The £60m clinical efficiency and safety programme is run by NHS Improvement and sees clinician led teams look at service lines in every trust in England to determine whether they are operating at sufficient scale, among other factors.

Some trusts change their practices or stop providing some services as a result of the subject area GIRFT reports published so far on orthopaedics and general surgery.

The programme announced clinical leads for endocrinology, rheumatology and stroke medicine last week.

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Revealed: The cost of restoring 18 week waits

With some guesses about the costs per case, I calculate recovering 18 weeks sustainably might cost £2.1bn next year and £350m the year after, if other pressures and enough mainstream capacity are funded. Or £4.2bn next year and £1bn the year after, if austerity continues.

“Our duty of candour requires us to explain the consequences of [the current funding settlement] to help inform the difficult choices which will be made in the years ahead. On the current funding outlook, the NHS waiting list will rise to 5 million people by 2021… the government would have to publicly, legally abolish patients’ national waiting times guarantees.”

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Concerns as mixed sex ward breaches more than double

Mixed sex breaches in September more than double compared to same month two years ago

NHS Providers warn hard fought gains are being lost

Month on month A&E waiting time data shows improvement

The number of mixed sex ward breaches more than doubled over the last two years, prompting concerns from senior NHS managers about care quality and patient dignity.

NHS England’s latest mixed sex breaches data showed there were 969 breaches in September – a breach rate of 0.6 per 1,000 finished consultant episodes.

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Revealed: 'Broad principles' agreed for major pay reform

• Informal talks between Agenda for Change unions and NHS Employers agree on principles for reform
• Lack of money for pay rise meant talks stalled but budget could bring new impetus
• Increment reforms wanted by both sides but government ‘sleight of hand’ could be ‘toxic’ to a deal

Unions and employers have agreed ‘broad principles’ for reforming the terms and conditions of more than a million NHS workers, HSJ has learned.

The amendments to the Agenda for Change pay contract are on hold, pending the budget later this month. Senior sources have told HSJ if the Treasury releases funds for a “significant” pay rise for NHS staff, negotiations over reforming terms and conditions could start within months.

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Protect trainee doctors to protect patient safety

Annual trainee quality panels can help address bullying and other cultural and safety issues within local hospitals and training posts, say Zoe Oliphant and Iona Thorne

The Royal College of Surgeons (Edinburgh) has recently highlighted the widespread bullying of surgical trainees and its impact upon patient safety. RCSEd reported that around the time of an operation, disruptive behaviour contributes to 67 per cent adverse events, 71 per cent medical errors and 27 per cent perioperative deaths.

The Daily Telegraph has reported that trainee surgeons are being assaulted and that one in six surgical trainees suffer from post traumatic stress disorder.

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Exclusive: NHS England appoints new medical director

Medical director of London trust appointed to NHS England role

Professor Steve Powis to succeed Sir Bruce Keogh

Professor Steve Powis, the current medical director of the Royal Free Foundation Trust, has been appointed to replace Sir Bruce Keogh at NHS England, HSJ understands.

He is a professor at renal medicine at University College London, and has worked at Royal Free for 20 years, initially as a consultant.


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Cowper’s Cut: ‘The Tragedy Of The Commons’ meets ‘Only Connect’

With things looking quite dark in the NHS, we can only hope that the forthcoming Budget will improve the situation even as we try to put a quart of healthcare demand into a pint pot of healthcare resource, says Andy Cowper

‘The tragedy of the commons’ was a concept and phrase proposed in an 1833 essay by economist William Forster Lloyd. He proposed (in the context of unlimited animal grazing on common land) that within a shared resource system, self interested individual users may act against the common good by depleting or spoiling that resource through the totality of many such selfish individuals’ actions.


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