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HSJ Health Check

HSJ Health Check

By HSJ

HSJ Health Check: Weekly analysis of the biggest issues in health policy and leadership, from HSJ's expert journalists. The go to place for an independent, informed and immediate take on health and care news.
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Currently playing episode

Off target: The four-hour standard and how long waits do harm

HSJ Health CheckJan 17, 2020

00:00
31:49
The £4bn hole in the NHS’s building plans

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. 

Mar 22, 202436:05
Scandal at ‘the safest trust in England’

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. 

Mar 15, 202436:11
How to be a top NHS employer

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.

Mar 08, 202446:47
The systems most reliant on the private sector
Mar 01, 202424:30
A high stakes game of chicken

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. 

Feb 23, 202428:24
The victims of the DHSC's silent restructure

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.

Feb 16, 202432:48
The targets holding up the planning guidance

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. 

Feb 08, 202427:36
Two top CEOs argue ‘hospital groups are here to stay’
Feb 02, 202445:21
The reality behind NHSE's flagship outpatient programme

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

Jan 26, 202439:25
Dentistry’s missing millions

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. 

Jan 19, 202419:44
The specialised commissioning lottery

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. 

Jan 12, 202443:53
HSJ’s predictions for 2024

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! 

Dec 22, 202341:49
The target no one wants to talk about

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.

Dec 15, 202330:38
A conversation with the Nuffield Trust's new CEO

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. 

Dec 08, 202337:20
How the Fuller abuse inquiry will change the NHS

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.

Dec 01, 202327:38
How NHSE's new data platform will work

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. 

Nov 24, 202330:06
How one trust changed England's A&E model

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.

Nov 17, 202339:12
What an election year will mean for the NHS

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. 

Nov 09, 202335:11
The rise and rise of the hospital group

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. 

Nov 03, 202329:22
Barclay’s war on the ‘woke’ NHS

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

Oct 27, 202328:10
Mackey’s next move

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. 

Oct 20, 202330:13
Labour’s plan to ‘underpromise and overdeliver’ on the NHS

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. 

Oct 13, 202326:33
How much have strikes cost 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?

Oct 06, 202330:30
Another maternity red flag
Sep 29, 202331:29
I’m afraid there is no (winter) money

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.

Sep 22, 202328:10
Getting real about manager regulation

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. 

Sep 15, 202337:42
The RAAC scandal and what it means for the NHS

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.

Sep 08, 202331:59
The fallout from Lucy Letby and what it means for the NHS

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. 

Aug 25, 202331:15
Patient experience in the post-covid era

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. 

Aug 18, 202340:37
Why GP reform is finally coming

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.

Aug 11, 202330:17
Leadership standards revealed

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. 

Aug 04, 202328:47
Under the skin of the strikes

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. 

Jul 28, 202328:13
Who’s to blame for the latest A&E crisis?

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?

Jul 21, 202328:07
Missing Sunak’s pledge

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.

Jul 14, 202333:22
The workforce plan – worth the wait?

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.

Jul 07, 202332:59
Big beasts of policy name their best and worst

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.

Jun 30, 202356:17
Palantir’s latest NHS deal explained

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.

Jun 23, 202330:35
Live from Confed

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.

Jun 14, 202323:11
21 days stuck in A&E

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. 

Jun 09, 202328:44
The elective activity the NHS wants to cut - but can't
Jun 02, 202330:28
The fate of ‘40 new hospitals’

The fate of ‘40 new hospitals’

After seemingly endless delays, the fate of the ‘40 new hospitals’ has finally been revealed by the government.
With eight key schemes pushed back until the next decade, the programme set to receive £10bn less than requested and funding subject to “future spending reviews”, we cover the immediate reaction and what’s next for NHP trusts. 
Also - more on Labour’s vision for the NHS if they win next year’s election.

May 26, 202328:38
The missing £1bn in capital funding

The missing £1bn in capital funding

The government’s 40 “new hospitals” has dominated headlines - and decisions - over NHS capital funding in recent years, but this week HSJ revealed dozens of trusts are still waiting for money promised by the previous big capital programme.

 

We discuss why over £1bn is yet to be received for capital schemes announced in 2017 and 2018 and what impact this has had on services.

 

Also this week, an update on the latest chapter in The Christie Foundation Trust’s whistleblowing saga, after the publication of a CQC report that downgraded the trust's treasured ‘outstanding’ rating. 

May 19, 202327:45
CDCs, the election cycle and fixing primary care

CDCs, the election cycle and fixing primary care

This week bureau chief Ben Clover stands in for Annabelle Collins and introduces two important stories, one that got national coverage and one that HSJ broke. Deputy editor Dave West takes us through the strange delay of some community diagnostic centres, which some suspect is politically-motivated as the government looks to what it can deliver before an election next year. Correspondent Mimi Launder then takes us behind the announcements on the primary care recovery plan. This received a lot of national attention earlier this week but HSJ obtained internal documentation showing just how patchy the roll-out is of some of the technology the government is counting on.

May 12, 202332:14
Revealed - Why Jim Mackey is back

Revealed - Why Jim Mackey is back

On this week’s episode Alastair reveals why NHS England’s elective recovery director Jim Mackey is replacing David Sloman as national operations lead later this year.

 

We also discuss why Tim Ferris was the right man for the national transformation job, but arrived at the wrong time.

 

Also this week: what’s next for the Agenda for Change pay deal and concerns raised about the poor care experienced by eating disorder patients in acute hospitals.

May 05, 202343:56
‘Cash is King’ again as deficits bite

‘Cash is King’ again as deficits bite

NHS leaders are being told they must prioritise balancing the books above all else, with some trusts even being asked to keep staff numbers down to save money. 

 

We discuss the tricky relationship between ‘productivity’ and recruitment and the impact an intensified focus on finance could have on other important priorities.

Apr 28, 202331:35
The NHS’ latest PFI problem
Apr 21, 202331:03
The latest casualties of the NHS data bidding war

The latest casualties of the NHS data bidding war

A consortium of British companies have been knocked out of the hotly contested competition to win a £480m contract to provide the NHS with a new data platform. 

 

We discuss who is left in the running, including a number of American tech firms with little or no experience of working with the NHS. 

 

Also this week - an update on how the NHS has coped with the junior doctors’ strikes this week, and a quick look at the latest performance data, which for the first time has revealed the extent of the 12 hours waits in A&E.

Apr 14, 202338:27
Does the Hewitt review matter?

Does the Hewitt review matter?

Patricia Hewitt’s much-anticipated review of ICS autonomy was published this week. We discuss its recommendations, the politics behind it, and what meaningful, lasting impact it could have.

With Alastair McLellan, James Illman and Annabelle Collins.

Apr 13, 202338:31
Bad Blood: The NHS agency engulfed in a racism scandal

Bad Blood: The NHS agency engulfed in a racism scandal

NHS Blood and Transplant has been embroiled in allegations of racism that stretch back several years.

 

On this episode Annabelle is joined by Lawrence Dunhill who has been reporting on the agency’s failure to address these systemic problems. 

 

The story spans secret recordings, a bitter employment tribunal and high profile resignations, with the organisation seriously struggling with blood stocks and staff shortages.


Mar 31, 202330:08
The NHS pay deal and who's left out

The NHS pay deal and who's left out

This week we discuss a quirk in last week’s pay deal between health unions and the government, which could see staff at the top of Agenda for Change paid more than senior managers.

 

We also dig into the “shameful” planned cuts to social care budgets to the tune of £550m, as revealed by HSJ last week.

Mar 24, 202330:18