HSJ Health Check

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.

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.

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.

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. On nearly all measures, services have been better this winter than the year before, but only a little bit, and still well down on 2019 levels, which were already poor. 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.

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.

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.

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.

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.

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.

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: www.hsj.co.uk/quality-and-perfor…ls/7036620.article

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.

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.

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 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.

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

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.

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.

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!

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.

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.