HSJ Health Check

On this episode the tech bureau join Annabelle to discuss the final report from the National Commission into the Regulation of AI in Healthcare - a review that had promised to deliver a “new regulatory rulebook”. We cover the key recommendations, including a tougher role for the medicines watchdog, and the big questions that remain. Full story on the review here: https://www.hsj.co.uk/technology-and-innovation/fine-ai-firms-that-harm-patients-demands-tech-commission/8124267.article

NHS is slipping down the government’s list of priorities. We cover the questions that ministers cannot avoid – such as how to tackle funding social care and how far to push the NHS on devolution – as well as the things they should really be decisive about… but probably won’t.

In a significant intervention this week the national safety watchdog has effectively called for a pause in the rollout of NHS England’s “advice and guidance” policy after linking it to two patient deaths. On this episode we cover what prompted this review, why NHS England has been pushing the use of A&G for the last few years and what it’s future could look like.

On this episode we cover two interesting tech stories. Firstly, new estimates have suggested the federated data platform could have a benefit value of £1.7bn less than a figure given by NHS England a year ago. We talk more about this latest FDP story and what it could mean for the extension of the controversial Palantir contract next year. Also, the national safety watchdog announced last week it has launched in investigation into AI use within the NHS. We ask what prompted this and what it will explore. We also talk more about the news a North Devon maternity unit is closing due to a lack of doctors, and how trusts and the government are approaching this national problem.

“I had no idea this happened. Were we informed? I am very concerned about duty of candour here… Why weren’t the victims informed immediately?” This was NHS England’s response after learning of the records breach at University Hospitals of Liverpool Foundation Trust, revealed in emails obtained by HSJ this week. On this episode we talk more about what happened next, including the independent investigation ordered and Sir Jim Mackey’s warning to trusts. Also this week we discuss a story that speaks to the ongoing concerns about culture within ambulances trusts.

This week we’re talking about the latest on neighbourhood health, and what Prime Minister Andy Burnham’s push for social care reform means for the NHS. As ministers launch a major review of adult social care, we ask whether the shift could boost the neighbourhood health agenda, or set it back. Will it reshape NHS and council funding, and could it deliver the NHS savings Mr Burnham says must be considered before any tax rises? We also talk more about neighbourhood health contracts and their slow progress since they were announced in last year’s 10 year plan for health, and why some in primary care are calling for an even longer pause.

This week we discuss why a £300,000 exit payment to a former ICB CEO has proved so controversial, and how NHS England has tried to justify the move. We also look at what the row reveals about the wider pressure ICBs are under, as they face deep cuts and continued uncertainty over their future role. This includes the questionable use of public money in wider ICB restructures, which are in many cases forced to pay for redundancies they may one day regret. And with devolution to mayoral strategic authorities, how do ICBs and ‘places’ fit into the new world?

Now the dust has settled on two major maternity reviews, HSJ Health Check is joined by Dr Bill Kirkup to discuss what happens next. Dr Kirkup has been investigating maternity scandals for over a decade, including Morecambe Bay and East Kent. We discuss how the sector has responded to the tranche of recommendations, whether a public inquiry is needed, and how leaders should respond when things go wrong in their organisations. He also touched on more contentious issues, warning that the current clinical negligence system is set up to be “adversarial”, and how the NHS needs to avoid “othering” maternity services.

Many breathed a sigh of relief when the resident doctors accepted the latest government pay offer, putting an end to years of strikes. However, just a week later, consultants voted for industrial action. We discuss the demands of the British Medical Association’s consultants committee and how the government could avert another set of damaging strike action. We also talk more about the first complaints made about clinicians’ use of AI, as revealed in HSJ this week, and how the national AI regulation review could change how it is used in the NHS.

This week Dave West and Henry Anderson are joined by health economist Anita Charlesworth, who is co-chairing a commission into NHS productivity for the Health Foundation. We discuss the workforce “boom and bust”, why the covid-19 pandemic cost the NHS £20bn in lost care and how the health service can recover at a time when public spending is under pressure.

NHS maternity services are again in the spotlight after an independent review revealed serious, systemic failings at Nottingham University Hospitals. The report by Donna Ockenden criticised NHS executives for refusing to speak to the review - leading the government to threaten prison time for staff who do not cooperate. Will this make a difference for future investigations? And, amid growing calls for a public inquiry into the state of maternity care across the country, we ask what this would mean for the NHS. With Henry Anderson and Emily Townsend. Send thoughts and ideas to annabelle.collins@hsj.co.uk

Sparks are flying over how the centre of the NHS will be run once NHS England is wound up next year. HSJ Health Check discusses the options, why they matter, as well as our exclusive interview with the minister leading the changes through Parliament. Karin Smyth argued government had sought to “minimise” the powers it is taking as a result of abolishing NHS England. She also spoke about the other big aim of the bill - paving the way for a single patient record. With Annabelle Collins, Alastair McLellan and Dave West. Linked articles: ⁠ We have ‘minimised’ Health Bill power grab, says minister⁠ Trusts ‘should recruit more managers locally’

We talk staff, racism, the funding squeeze, and trust groups, on the HSJ Health Check live from the NHS Confederation conference in Manchester. NHS Alliance CEO Ciarán Devane, who took up post two months ago, and University Hospital Tees CEO Stacey Hunter, join HSJ deputy editor Dave West. Guests discuss the challenges of growing racism against staff, including how it can mean some minority ethnic staff don't want to work in particular parts of the country. We also cover wider pressure on staff, as funding is squeezed and services restructure to cut costs. And we talk about the dilemmas of the wave of trusts sharing leaders, one of whom is Stacey as CEO of two Tees foundation trusts.

Hundreds of non-British NHS England staff face losing their jobs because their nationality prevents them working in the civil service. We discuss why this threat – that seems to fly in the face of NHS values – has come about, and what it says about the wider restructure process. Also this week - the first ‘advanced foundation trusts’ have been confirmed so we cover who made the cut and the benefits this could bring for the chosen few. And on the subject of reorganisation, we discuss whether government will take the leap and overhaul primary care networks for the neighbourhood health era.

On this week's podcast, with increasing examples of staff accessing patient records inappropriately, we ask how widespread this practice really is - and whether regulators need to do more. And we dig into the NHS's elective recovery figures, which show a dramatic improvement in the final month of the year helped the service meet its headline government target by the narrowest of margins.

This week we talk more about the government’s plans for a new “single patient record” - the legislation for which was in last week’s Health Bill - and why primary care could be a stumbling block. It was hoped the Bill would provide clarity on how the new data sharing requirements would be achieved but there remain many unanswered questions. On the subject of primary care, we cover why the latest collective action being taken by the the GPs’ union may in fact help pave the way for sorting out data sharing.

We discuss Wes Streeting’s tumultuous 22 months in charge – and analyse the Health Bill he has left in his wake, which was published on Thursday. The bill will give ministers sweeping new powers, as well as abolishing NHS England, and make important changes affecting foundation trusts, integrated care boards, and councils. The HSJ Health Check podcast welcomes Hugh Alderwick, Health Foundation director of policy and research, to help unpick the 200-page legislation and what it will mean for the service.

This week we talk in more detail about HSJ’s Top 50 CEOs – not only who topped our annual ranking of hospital leaders, but also interesting trends from this year and beyond, and a behind the scenes from the judging. We cover the surprising new entries, why a third of individual chief executives included in the rankings over the last 12 editions have appeared just once, and why London and ambulance trusts are finally coming out top. The full top 50 can be viewed here.

Millions of people are turning to AI chatbots to manage their mental health, driven by a combination of long waiting lists and not meeting clinical thresholds for treatment. We cover how regulation is running to keep up with this surge in demand and why suppliers are not finding compliance straightforward. Also this week, the NHS has a legal duty to reach net zero by 2040. We discuss how – and how well – is it being held to account.

On this week’s podcast we talk about relationships between CEOs and chairs - and why the CEO of East Kent Hospitals has not been at work since mid-November. And with staff pride at a record low in the Care Quality Commission, according to its latest internal survey, we cover what will be in the in-tray of its new CEO and why the regulator wants to find someone with “clear political licence”. (Update): On Thursday evening, following the recording of this podcast, East Kent Hospitals Trust issued a statement stating Ms Doherty was stepping down so that the organisation could “appoint a chair who can focus exclusively on leading East Kent through the next phase of improvement work ahead.” Ms Doherty remains chair of Maidstone and Tunbridge Wells Trust and is also the president of the Royal Society of Chemistry.