HSJ Health Check

This week HSJ revealed the final trusts added to the ‘new hospital’ programme, which are also thought to have some of the most dangerous estates in the NHS. We discuss why only now they are in line for an upgrade and also what the perfect ‘new’ hospital might look like. Also this week - what do we know so far about the NHS winter plan? We ask whether it is radical enough to contend with the troubled winter ahead

Significant tensions between a mental health trust and an ICS have prompted the trust’s chief executive to resign. We discuss how things escalated to become quite this bad and whether we could see more power struggles as ICBs find their feet. Also this week, the government is investigating a surge in excess deaths in England and we ask what’s causing this rise, plus warnings from an A&E department in Wigan that deaths are becoming “increasingly common”.

The NHS needs “fewer layers of management” - this is according to Tory leadership hopeful Liz Truss and is one of the first significant comments made about the NHS by either candidate this summer. We talk more about the other pledges made about health and social care so far by both candidates and where they might look to make their mark. Also £75m has been announced to create more mental health beds - will this ease pressures in this incredibly “hot” running system? This and more from our interview with NHS England mental health director Claire Murdoch. Link to interview: https://www.hsj.co.uk/mental-health/exclusive-new-capital-fund-to-boost-beds-and-aande-capacity/7032952.article Featuring Annabelle Collins, Jack Serle and Emily Townsend.

This week we revisit the thorny subject of A&E standards, following calls for a new six-hour target to be introduced. This aligns with clinical evidence about patient harm but it is at odds with NHS England’s plans to replace the four-hour standard with ‘a basket’ of ten new metrics, which does not include a six-hour target. Also this week - we discuss news that more trusts have started publishing data showing thousands of 12-hour waits in their emergency departments, representing a huge difference to the numbers published nationally, for which the clock starts from a later point in the patient’s journey. Annabelle is joined by Matt Discombe and James Illman.

Hospital leaders have warned there is a lack of accountability in the NHS, warning this could undermine public and political trust in the service. In a roundtable hosted by HSJ, the most well-respected chief executives have spoken candidly about the slow pace of reform, why talking about how tired the workforce is doesn’t always help and why command and control leadership has its place. Also in 2019, £250m was awarded to the shiny new NHS AI-lab, but a government watchdog has recently given it a damning review. We ask, what went wrong?

The NHS must find the money to fund an extra £2bn of the staff pay bill, after the government decided to increase it beyond the 3% rise that was budgeted for. We discuss the impact this is likely to have on services and also why a particular group of senior managers are particularly demoralised. Also this week: An HSJ investigation has highlighted the horrendously long waits faced by mental health patients while waiting for an inpatient bed in A&E. We talk more about how the health service got to this point and what should be done about it. Link to investigation: Exclusive: ‘Outrageous’ long A&E waits for mental health patients increase 150pc | News | Health Service Journal (hsj.co.uk)

On Monday night all ambulance services in England declared the highest level of alert. We discuss why the NHS is under such terrible pressure in July and the dangerous impact this is having on patients, staff and services. Also more discussion about major job cuts announced within NHS England - is this a necessary change or will it consume too much time at a crucial moment for the NHS?

Tough times are ahead for the NHS, with a “nightmare” new health and social care secretary appointed and performance spiralling. On this episode we discuss the shocking true extent of the cancer care backlog after leaked figures revealed there are now over 10,000 people waiting over 104 days following a cancer referral. Also this week, disappointing elective activity has forced NHS England to look at watering down elective financial targets, while one trust starts using “social value judgements” to decide who gets treatment first.

The NHS is facing a major reorganisation this year, including within NHS England itself. On this episode we discuss the challenges and power struggles that lie ahead and who has the toughest job of all; the newly appointed chief workforce officer. Annabelle is joined by HSJ editor Alastair McLellan.

Race and racism in NHS leadership and workforce, and health inequalities, are the subject of this week’s HSJ Health Check podcast. We look back to some of the debates on the issues at – and around – last week’s NHS ConfedExpo conference. We explore the prospects for progress, and important context including diversity in integrated care system leadership and NHS England’s leadership. With HSJ equality, diversity and inclusion correspondent Nick Kituno, finance correspondent Henry Anderson, and deputy editor Dave West.