HSJ Health Check

Amid four “inadequate” ratings and a new leadership inspection, is the writing on the wall for one of the NHS’ worst performing trusts over the last decade? We discuss what the latest inspection of Norfolk and Suffolk Foundation Trust means for the organisation’s future, and whether the trust will survive in its current guise with two local MPs now in charge of the government. Also on this episode, we discuss the growing in-tray awaiting the new CEO of under pressure Tavistock and Portman FT and hear the curious tale of how one NHS provider earned a tenth of its income from Kuwait – and why it matters to the rest of the NHS.

NHS trusts have more than £18bn in covid cash reserves, but how helpful is this extra money? We cover why cash levels are three times higher than before the pandemic, whether this money will help trusts cope with final pressures and the “technical accounting” measures being used to keep the bottom line healthy. Also on this episode, just a few weeks before its move to a new, smaller building, Royal Liverpool Hospital declared it was at full capacity. We discuss staff concerns about the move and the inflexibility of NHS planning. Annabelle is joined by Lawrence Dunhill and Henry Anderson.

In a week that saw Liz Truss replace Boris Johnson as prime minister, the HSJ team assess the challenges faced by her new health secretary Therese Coffey, plus the dire state of ambulance services. Ms Coffey set ambulances as one of her four “ABCD” priorities, alongside the elective backlog, care and doctors and dentists. Bureau chief Ben Clover is joined by Alison Moore and editor Alastair McLellan. 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. Send feedback to annabelle.collins@wilmingtonhealthcare.com.

The NHS has been told by the government to cut management consultancy spend and completely freeze recruitment at a national level. Is this Steve Barclay’s first - and maybe last - move to force the NHS be more efficient? Also this week we discuss the dire impact midwife shortages are having on the quality of maternity services and how these shortages have threatened the roll-out of an NHS England-backed model of care. Annabelle is joined by Lawrence Dunhill and Henry Anderson.

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)