HSJ Health Check
By HSJ
HSJ Health CheckAug 20, 2021
Held to ransom
The NHS is facing weeks of disruption after pathology services across south east London were hit by a major cyber attack this week, affecting care from blood tests to transplants.
We cover the impact the attack will have on an already pressured system and the big questions facing the NHS and government around strengthening cyber security.
Return of the control totals
NHS England has announced incentives and penalties in a bid to improve the health system’s financial plans, so this week we discuss what the new regime involves and if it will make any difference to the national £3bn deficit.
Also this week we focus on two stories from Birmingham – more bullying concerns at University Hospitals Birmingham and an update on the long-delayed Midland Metropolitan University Hospital, which HSJ revealed is due to open without the funding needed to run it.
We also take a look at the latest pledges for the NHS by the political parties as the general election draws nearer.
With Nick Carding, Henry Anderson and Emily Townsend.
What the July election means for the NHS
Rishi Sunak has called a surprise election, so we cover what could be in store for the NHS over the next six weeks and the different scenarios it could face if there is a change is government.
Plus, we consider NHS England’s intervention in the ongoing debate about productivity (and how that might affect the service’s ask for extra capital investment) and also the aftermath of NHSE’s massive restructure.
With Henry Anderson, Annabelle Collins and Dave West.
Manchester’s financial meltdown
Greater Manchester ICS is under huge pressure to reduce its deficit after suffering a recent financial collapse.
And now the ICS must navigate this without its substantive chief financial officer, who has been seconded to a post within NHS England. We discuss if there is a way out of the red and what this will mean for local care quality.
Also this week, a leaked NHSE review that concluded the NHS has a severe shortage of nurses with digital skills.
CQC inspections become the inspected
The tables have turned for the Care Quality Commission. This week HSJ revealed the government is launching a review of it’s new inspection regime and whether its ratings are properly incentivising care improvements.
We discuss what prompted this review, which senior NHS figure is leading it and what it could mean for the regulator.
Also this week, a fifth of all of England’s GP premises pre-date 1948 and we discuss how this ageing estate risks hampering the workforce plan.
What ICB leaders really think
We delve into the detail of HSJ's comprehensive survey of integrated care board leaders, as well as new interventions on the future of ICBs from NHS England and Wes Streeting.
From leaders’ biggest worries, and their achievements thus far, to their plans for the future, HSJ Health Check highlights some of the more surprising findings.
Also, more on the shadow health secretary's recent comments on tensions between ICBs and foundation trusts, and NHS England's new assessment framework.
With Annabelle Collins, Nick Kituno and Dave West.
Are you going to lose your job?
This year sets the NHS one of its toughest financial challenges as pandemic cash dries up and funding shortfalls deepen.
We hear how three integrated care systems are already warning of significant consequences from the current financial requirements, and explore how the NHS plans to break even in 2024-25.
With Henry Anderson, Lawrence Dunhill and Nicholas Carding.
Send views and questions to annabelle.collins@hsj.co.uk.
You can listen to HSJ Health Check on this page, or subscribe on Spotify, Apple Podcasts, Amazon Music and all the other popular podcast platforms.
What the coroners say
This week guest host Ben Clover discusses alarming developments in urgent care plus the Silicon Valley firm getting established in the NHS, with HSJ reporters Emily Townsend and Joe Talora.
Why this winter was (a bit) better in the NHS
2022-23 was probably the worst ever winter for the NHS, after a steep collapse in performance. This year’s been a little better — new figures confirm — but how was this achieved, and what does it mean for coming months?
This week’s HSJ Health Check podcast reviews the latest figures on emergency care performance — across A&E waits, ambulance delays and response times, discharge and length of stay.
We discuss what the service did to claw back performance, and the prospects for the coming year.
With Dave West, Matt Discombe and Alison Moore.
Send views and questions to dave.west@hsj.co.uk.
The latest safety crisis for maternity care
On this episode we discuss the quality of maternity services in the NHS, which have remained firmly in the spotlight.
We cover a recent HSJ investigation into delayed inductions of labour and cover the broader challenges facing maternity services amid multiple inquiries and more 'inadequate' CQC ratings.
Also more on why families whose babies died in the East Kent maternity scandal are still having to prove legal liability to get any compensation.
The planning guidance is finally here
With one working day left before the new financial year, the NHS’s instructions for 2024-25 have finally been published.
HSJ’s James Illman, Annabelle Collins, and Dave West unpack what's in this year’s guidance and talk more about the sticking points that caused the long delay.
The £4bn hole in the NHS’s building plans
HSJ revealed this week the cost of building “40 new hospitals” in the NHS has increased by £4bn, so on this episode we dig into what’s driving this and if it will get past the Treasury.
Also this week – when PFI deals go wrong and how a fire at the Whittington Hospital in north London has led to a High Court case.
Scandal at ‘the safest trust in England’
This week we discuss the implications of a long-awaited independent review into a patient safety scandal at Salford Royal Hospital, in which multiple patients were harmed by John Williamson, the former head of the spinal division.
We cover why concerns about care quality resurfaced long after the trust concluded its review in 2016 and why it failed to properly investigate at the time.
Also more on news that an Australian tech firm backed by one of China’s richest people is set to win the majority of contracts to deploy new AI diagnosis tools across the NHS.
How to be a top NHS employer
HSJ Health Check debates the new NHS staff survey results, with trust CEO Matthew Winn, survey expert Chris Graham, and HSJ's Nick Kituno.
Some key findings are improved this year, but others reveal a service still struggling to recover from the pandemic. There's also an alarming increase in reports of discrimination.
Meanwhile, Matthew and Chris argue there can be no 'quick fixes' or gaming when it comes to being a good employer, so leaders should focus on looking after staff and making longer-term improvements. Staff survey results should also be used more when it comes to judging trusts nationally, they say.
The systems most reliant on the private sector
There has been a huge increase in the proportion of treatments done by the private sector compared to before the pandemic, and for the first time we’ve worked out which parts of the country send most patients to independent hospitals.
Also, more on news that NHS capital budgets have been raided to pay for staff pay rises and the cost of strikes.
Read our full regional analysis of private sector use at the following link:
A high stakes game of chicken
A controversial new care model has come under fire from trust leaders, who have warned patients and clinicians are coming to harm.
We discuss the concerns surrounding the national roll-out of Right Care, Right Person, and why the emergency services have ended up playing a “high stakes game of chicken”.
Also this week, we discuss NHS England’s ambitions to digitise one in three patient interactions with the NHS and bold new plans for the NHS app.
The victims of the DHSC's silent restructure
We talk more about the decimation of England’s national public health unit less than three years after it was created. We cover the motivations behind this, the impact it could have on integrated care systems’ plans and whether Labour will reverse it.
Also, the latest on the planning guidance and how its become entangled with the Budget negotiations.
With Dave West, James Illman and Annabelle Collins.
The targets holding up the planning guidance
This week we discuss a major obstacle in the planning guidance negotiations – how high to set the A&E four-hour target.
The government is pushing for a new target set at over 80%, while NHS England lobbies for one just one percentage point higher than the current target.
Also this week more on how the risk in emergency care has shifted from ambulances to acute hospitals and the thinking behind controversial regional guidance to prioritise patients in A&E who are less unwell to improve flow.
Two top CEOs argue ‘hospital groups are here to stay’
Two of the most successful NHS hospital chief executives – one current, Glen Burley, and one former, Dame Alwen Williams – join the HSJ Health Check podcast, arguing that the sometimes-contentious spread of the ‘group model’ and joint leadership will keep on spreading.
The Foundation Group CEO and former boss of Barts Health Trust – one of the mothers of the hospital group model in the NHS – also talk about how to make it work, managing exec time, staying in touch with the front line, and what it means for accountability.
And NHS management trainee Brigid McMorrow speaks about her analysis for HSJ which found one in three trusts now have a joint chair and/or CEO, often as part of a group model or a move towards merger.
You can read that analysis here: https://www.hsj.co.uk/acute-care/one-in-three-trusts-now-share-ceo-or-chair/7036353.article
Hosted by deputy editor Dave West.
The reality behind NHSE's flagship outpatient programme
This week for the first time a study has revealed the number of patients on PIFU pathways has not translated into a significant reduction in follow up appointments.
Also, a governance row across some of the biggest trusts in east London, while a major teaching hospital on the other side of the Thames sees its finances explode.
With Ben Clover, Annabelle Collins and James Illman
Dentistry’s missing millions
Dental budgets are being raided by ICSs to fund other services in the middle of an unprecedented access crisis.
We cover a broken financial system, a discredited contract and increasing political pressure to fix NHS dentistry.
Also we review how NHS England is faring on its pledge to increase overall primary care investment.
The specialised commissioning lottery
HSJ recently revealed the dramatic differences in access to specialist medical treatments around the country.
We discuss what’s driving this inequality, who is missing out and what big-city trusts are doing to improve access.
Also, an update on how the NHS coped during the longest ever junior doctor strikes over Christmas and the New Year and why the planning guidance for 2024 is still yet to be published.
HSJ’s predictions for 2024
In our final episode of the year we make our predictions for what 2024 could hold for the NHS, including the first integrated care system merger, how the strikes will pan out and manager regulation.
Thanks for listening and we’ll be back in January!
The target no one wants to talk about
Three years ago the NHS was the first healthcare system in the world to set an ambition to become net zero, but it struggles to prioritise this in the face of daily operational and financial pressures.
This week we discuss in depth the green targets, progress already made and why, despite competing priorities, they should still be high up leaders’ agenda.
Also, an update on what systems are being told to do to cope this winter.
A conversation with the Nuffield Trust's new CEO
This week we’re joined by Thea Stein, who recently moved into think tank world after nine years running an NHS trust.
We cover her reflections on her time at Leeds Community Healthcare Trust, why she is fed up of “visions” of integrated care and much more interested in the tricky detail, and the radical policies needed to recruit and retain more staff.
How the Fuller abuse inquiry will change the NHS
Leaders at Maidstone and Tunbridge Wells Trust have been heavily criticised in an independent inquiry into the actions of former maintenance supervisor David Fuller.
We cover the mistakes made by the trust that enabled him to abuse hundreds of bodies in its mortuary over 15 years and what the rest of the NHS must do in response to this horrific case.
Also, an update on the government’s pay offer to consultants and why its made the Royal College of Nursing so angry.
How NHSE's new data platform will work
US firm Palantir has officially been awarded the lucrative federated data platform deal, which is one of the biggest NHS data projects in recent years.
This week Nick Carding, Joe Talora and Annabelle Collins discuss the controversy surrounding the deal, what the risks and benefits are for the NHS and what’s next in its implementation.
How one trust changed England's A&E model
A trust that gave its name to a controversial A&E policy has seen performance improve significantly, so this week we discuss how North Bristol Trust handled the risks and how quickly its model could spread throughout the NHS.
Also, NHSE chief Amanda Pritchard told MPs this week there has been a ”misunderstanding” about productivity in the NHS - we discuss what’s actually going on behind the scenes.
What an election year will mean for the NHS
This week Annabelle and James are joined by Saffron Cordery, deputy chief executive of NHS Providers.
We’re looking ahead to winter and an election year, in which the NHS faces ongoing strikes, stalling progress on waiting lists and challenging finances.
We also cover the damage done by ’short-termism’ and why turnover of trust CEOs is getting worse.
The rise and rise of the hospital group
An increasing number of hospitals are appointing shared CEOs and chairs and with more large ’groups’ being created – this week we discuss the benefits and drawbacks to this new(ish) way of running things.
We focus on two recent examples - the Barts Health Group in London and University Hospitals of Leicester, which as of this week shares a chair and CEO with two neighbouring trusts.
With Ben Clover, Annabelle Collins and Dave West.
Barclay’s war on the ‘woke’ NHS
This week we’re joined by Roger Kline, academic and workforce culture consultant, to discuss Steve Barclay’s latest edict ordering the NHS to stop recruiting to equality, diversity and inclusion roles. Was the letter just red meat for the Daily Mail or could it do real damage?
We cover NHS England’s response, why the cost-savings argument doesn’t add up, and what's next for EDI roles.
With Nick Kituno, Annabelle Collins and guest Roger Kline
Mackey’s next move
Sir Jim Mackey is moving on from Northumbria Healthcare FT after 18 years and taking the top job at Newcastle upon Tyne Hospitals FT. This week we discuss what this means for the NHS in the North East and also for NHSE, where he will be leaving his chief operating office role.
And in other people moves, we also cover David Loughton’s retirement from Royal Wolverhampton Trust and Walsall Healthcare.
Labour’s plan to ‘underpromise and overdeliver’ on the NHS
On the podcast this week we bring you highlights and analysis from the Labour party conference in Liverpool.
We cover what a backlog recovery drive could look like under a Labour government and how Wes Streeting will take from Blair’s 1997 playbook to ‘underpromise and overdeliver’ on the NHS.
How much have strikes cost the NHS?
This week we discuss urgent high-level talks to address the £1bn funding gap - and ask whether strikes are really to blame.
Also this week, has NHS England come off the fence with its latest warning to the BMA?
Another maternity red flag
Nothing is more important than the process of giving birth, but hospitals are increasingly struggling to induce mothers-to-be on time.
HSJ has found multiple examples of pregnant women waiting too long for their induction, in what could potentially be a national problem for a hugely challenged area of healthcare.
Also this week, we hear why former NHSX CEO Matthew Gould is back in the news and discuss the latest on NHS England’s controversial flagship data project.
With Nicholas Carding, Alison Moore and Joe Talora.
Send views and questions to Annabelle.collins@hsj.co.uk
You can listen to HSJ Health Check on this page, or subscribe on Spotify, Apple Podcasts, Amazon Music and all the other popular podcast platforms.
I’m afraid there is no (winter) money
Rishi Sunak announced an impressive sounding sum of money last week, apparently to help the NHS cope with winter pressures.
But, as ever, what might sound like a lot of money is really just a drop in the ocean - and it turns out it will only be used to offset costs relating to strike disruption.
We discuss the precarious financial and operational position this leaves the health service in, and also dig into plans for a new outpatient strategy expected later this year.
With Henry Anderson, Annabelle Collins and James Illman.
Getting real about manager regulation
Manager regulation remains firmly in the spotlight so this week we ask: will it actually happen this time?
We discuss recent interventions from politicians, what’s stood in its way in the past, and take a closer look at NHS chief executive turnover, as we find more than half of trusts have a ‘first time’ CEO.
Also - more on audiology care failings, after it has emerged more children have come to harm across multiple trusts.
With Ben Clover, Annabelle Collins and Dave West.
The RAAC scandal and what it means for the NHS
NHS trusts have been told by the government to carry out urgent risk assessments if they have a certain type of lightweight concrete in their buildings.
This follows multiple school closures because of safety risks around “reinforced autoclaved aerated concrete”. We discuss the impact these safety fears are having on the NHS, why hospitals aren’t also being shut down and what this means for the New Hospitals Programme.
The fallout from Lucy Letby and what it means for the NHS
Last Friday, neonatal nurse Lucy Letby was found guilty of 14 counts of murder and attempted murder.
On this week’s episode we discuss how former leaders at the Countess of Chester Hospital had resisted a police investigation, the questions still to be answered by local and national leaders, and what lies ahead for the trust.
With Annabelle Collins and Lawrence Dunhill.
Patient experience in the post-covid era
This week we’re focusing on patient experience and the public perception of the NHS.
Annabelle is joined by Chris Graham of the Picker Institute and Jacob Lant from charity National Voices to discuss the crash in patient experience revealed by recent national surveys, how the findings should be used to improve quality and reduce health inequalities and the part ‘real-time’ measures could play in the future.
Why GP reform is finally coming
General practice - already under pressure - will be under the political spotlight over the next 12 months, with an election looming and the GP contract up for renewal.
We discuss what reform could be in store, and whether an example in Wolverhampton - where the hospital trust has taken over a big chunk of local GP practices - is one for others to follow.
With Mimi Launder, Dave West and Annabelle Collins.
Leadership standards revealed
NHS England has finally published its new standards for NHS leaders, so this week we discuss how the revised ‘Fit and Proper Person Test’ will work, and if it is enough to stop the revolving door of poor leaders.
Also - we reveal where consultants were paid the most to cover shifts during the junior doctors’ strikes.
With Annabelle Collins, James Illman and Nick Kituno.
Under the skin of the strikes
This week we assess the damage after one of the toughest weeks of NHS strike action, with junior doctors and consultants both taking action.
We ask what impact this had on the recovery effort and look at some of the surprising trends to emerge from the strike data. With Annabelle Collins, Ben Clover and James Illman.
Who’s to blame for the latest A&E crisis?
A “shocking” volume of mental health patients are attending A&E accompanied by the police - but who’s fault is it? And what is the solution?
On this week’s episode we get into the debate sparked by comments made by a senior NHS director who called for an “absolute solution”.
Also this week, the results are in on which integrated care systems are the most digitally mature. But did the NHS need to pay McKinsey £7m to tell them?
Missing Sunak’s pledge
This week bureau chief Ben Clover is joined by colleagues to discuss some of the biggest stories ahead of the junior doctors’ strike.
Matt Discombe reveals the results of an inquiry into an ambulance trust found to’ve withheld key details of patient deaths from a coroner. The report is damning but some stakeholders have said it is more notable for what it doesn’t cover.
Recorded on Wednesday before the longest junior doctors’ strike yet, James Illman and Henry Anderson explain how NHS England’s finance director may have let the cat out of the bag about something ministers deny – that the huge round of cancellations caused by industrial action mean the service might miss the PM’s pledge to have waiting lists falling.
The workforce plan – worth the wait?
This week bureau chief Ben Clover is joined by colleagues Nick Kituno and Zoe Tidman.
The long-awaited NHS workforce plan finally arrived last week, missing lots of the detail that managers and professional associations were crying out for. What was in it, what was not in it and a few surprises are covered in this week’s podcast.
Also, what are the prospects for the NHS’s crumbling estate. Correspondent Zoe Tidman takes us through the latest in the convoluted quest to get some refurbished hospitals finished this side of 2030.
Big beasts of policy name their best and worst
This week HSJ is joined by Nigel Edwards, chief executive of the Nuffield Trust, and Richard Murray, chief executive of the King’s Fund, who are both nearing the end of long stints at the think tanks.
Two of the most influential voices on health policy and leadership, the pair reflect on what has gone right and wrong over the last three decades, and why history keeps repeating itself.
They spoke to Annabelle Collins and Lawrence Dunhill.
Palantir’s latest NHS deal explained
NHS England’s surprise decision to hand US tech giant Palantir a further £25m deal this week without a competitive process provoked a mixture of fury and confusion. We explain what the new contract means and why its so controversial.
Also this week, we review the latest government mandate for NHS England and its luke-warm response to the Hewitt review of integrated care systems.
Live from Confed
We're joined by Matthew Taylor, NHS Confederation chief and HSJ Health Check fan, to discuss Amanda Pritchard's speech and other developments on day one of the ConfedExpo conference.
21 days stuck in A&E
We discuss data revealing the true scale of long A&E waits for mental health patients and what acute trusts are trying to do about it without any extra national funding.
Also: most GP practices are still using old-fashioned paper records, despite a commitment four years ago to get rid of them. We discuss whether it’s worth GPs’ time and money to make the switch.
With Annabelle Collins, Joe Talora and Emily Townsend.