Health Service Journal, Bureau chief - with special interest in the North West region.
Specialist journalist of the year - British Journalism Awards 2020
BREAKING:
Major London hospital declares 'critical incident' after running out of ICU beds due to surge in Covid-19 cases
One senior director in the capital just told me - 'this is f**king petrifying'
Free to view
Off record from a North West hospital chief:
'A&Es so busy this week we've had staff go home after their shift...come back 12 hours later, and they see the same set of patients in the department, still waiting to be admitted...
'I can't tell you how demoralising that is'
'Worst kind of insult' - Unison
'Pitiful' - Royal College of Nursing
‘Disappointment’ - NHS Providers
'Enormous slap in the face’ - Unite
'Kick in the teeth' - BMA
No wonder Rishi Sunak omitted to mention the 1% NHS pay rise in his Budget
Matt Hancock asked to clarify new lockdown rules by
@BBCRadioManc
"I'll make it absolutely clear...er...which is that its...um... its...theres a... um... distinction... er... between... er... the... er... guidance & the law...let me....let.......I'll absolutely get back to you"
BREAKING:
Steve Barclay appointed Health Secretary (again)
Last time round health leaders told us he viewed the NHS as a 'bottomless pit, resistant to change and unaccountable'
They also described him as 'vindictive, arrogant, a bully & micro-manager of the wrong things'
Off record from senior medic in Gr Manchester - re junior docs strike
'Whats App abuzz with colleagues coping...well resourced with a lot of support from all over the hospital. Shame the juniors don't get this on a normal day'
Struggling to get my head around HOW the Nightingale's cost £220m to set up...
That's the cost of running a decent sized hopsital for a full year, paying thousands of staff salaries.
Today's briefing.... Minister George Eustice claimed care home deaths were reducing.
He was asked for the evidence on this by two different journalists, but twice ignored the question.
BREAKING:
HSJ understands all 10 ambulance trusts now in 'critical incidents' due to extreme pressures from heatwave & high staff covid rates
One boss says situation is 'dire', with many ambos queued @ A&E with patients left in extreme heat in the back
FULL letter from managers in the emergency service at Royal Preston:
-Staff left "crying with frustration & anger"
-Routinely 50+ patients waiting for more than 2 days to be admitted
-Patients dying without dignity of privacy
-Rise in incidents, patient harm, pressure ulcers
BREAKING:
Clinical director & several senior managers warns A&E patients are having to wait over TWO DAYS to be admitted to a bed at Royal Preston Hospital -- in internal letter leaked to HSJ
Along with multiple other patient safety concerns...
Our coverage of how Countess of Chester dealt with concerns over Lucy Letby - FREE TO READ
We've seen documents showing the trust tried to force doctors who raised concerns about Letby to apologise to her
Leaked data shows around 6,400 ppl had waited >100 days after a referral to cancer services.
For the 1st time, it shows the length of the cancer waiting list in the wake of the pandemic peak, when much elective cancer care was paused.
from
@Rebeccasmt
A pretty important fact which Govt omitted from any of its PR on this has now been revealed by
@CNOEngland
Ruth May
-that just 7% of 50,000 were recruited from within UK , all the rest coming from overseas
When plan was set out was meant to be 75% from UK/better retention
🎯 5️⃣0️⃣,0️⃣0️⃣0️⃣
We've hit the target of 50,000 more nurses in the NHS - but we won't stop here.
The NHS Long Term Workforce Plan will expand the nursing workforce even more to help cut waiting lists and give patients the care they need.
Details:
Jesus...
Covid occupancy has now breached 30,000 in Eng for the first time (April peak was around 18k).
A very big rise in today's figures of well over 1,000 - driven by just about everywhere.
Stats from NHSE
Latest on the massive PPE stockpile that was never used & will likely now be binned.
Value of the inventory written down by £9.9 BILLION... as items either unusable, or were bought at huge inflated prices.
(from NAO)
Spot the difference in The Christie's press statement re whistleblower Rebecca Wight (left)....and what they said internally to 3,000 staff (right), where the CEO effectively calls her a liar
NHS trusts are meant to be ramping up electives to start tackling huge waiting lists
But reality of new covid wave means they're having to think about cancelling activity instead.
Last week Leeds, now
@mattdiscombe
reveals Newcastle having to cancel ops
BREAKING:
NHS England chief executive Amanda Pritchard has described the financial situation facing the health service as a "f**king nightmare"
HSJ has spoken to multiple sources at a private meeting of NHS chiefs yesterday...
Locum junior doctor wins right to accrued holiday pay after taking
@ELHT_NHS
to tribunal
Judge agreed she had worked for East Lancs in one continuous period of employment over 2yrs -making her eligible.
(trust had treated her employment as separate daily contracts)
Cumulative covid-19 related deaths in each region - charted against Italy at the same stage.
Within that, West Birmingham and the Black Country have had the highest number of deaths as a % of population.
Top number crunching from
@JackSerleHSJ
Revealed:
NHS balance sheets are in a far stronger position than pre-covid, with cash levels 3x what they were in 2019.
Much of the ££ that poured into the NHS during covid couldn't be spent -but finance teams were able to 'mask' that surplus
Thread🧵
Matt Hancock just saying how grateful he has been to Public Health England staff during the pandemic...
So grateful that his team briefed the Sunday press about PHE being scrapped before the org's staff had been informed
CEO of Public Health England says he's "sorry beyond words" that decision to scrap his organsiation was briefed to a Sunday newspaper before his 5,000 staff had been told...
reports
@SharonBrennan
Am told NHS Eng's weekend letter to hospitals about discharging patients before the strike, to ensure 15 minute handovers, didn't go down well with many staff...
One senior person said: 'Staff were like, no shit sherlock, we've been trying to do that for months already'
BREAKING:
Clinical director & several senior managers warns A&E patients are having to wait over TWO DAYS to be admitted to a bed at Royal Preston Hospital -- in internal letter leaked to HSJ
Along with multiple other patient safety concerns...
Statements about Amged El-Hawrani, a 55-year-old hospital doctor who has died after testing positive for coronavirus.
His son Ashraf, said:
"I am incredibly proud to say that for 18 years of my life, Amged El-Hawrani was my Father."
Much frustration at NHS Eng/DHSC paranoia over external comms.
Senior NHS boss in Cheshire (where C19 beds now @ 50% in Chester & Warrington A&E had to be diverted on Tues) tells HSJ they're effectively prevented from getting important msgs to public.
Breaking:
Number of covid patients at Royal Bolton Hospital DOWN by three today - to 41 - according to internal data seen by HSJ
Red line in the chart gives the current level, compared to Apr last year
"Shouldn't our entire focus for next 12 weeks be on saving lives, getting the 1st dose of vaccine out to every single vulnerable person, stopping the NHS collapsing & putting NHS front line satff at the front of the queue?"
@Jeremy_Hunt
questioning Hancock over school reopenings
BREAKING:
Govt has restarted ‘informal’ talks with junior doctors in bid to end strikes, HSJ understands
Thought to be first discussions in several weeks
(Free to read if you register)
🚨Really shocking Ambo response times from today, leaked to HSJ
C1 target (cardiac arrests etc) is 7 mins
C2 target (inc heart attack/stroke) is 18 mins
Some trusts could be down to 20-30% of normal crew capacity on Wed - which is seriously scary
NHS Eng just released official data on cancellations due to junior docs strike -
lots of big numbers but nowhere near full story (as many trusts avoid scheduling appts during strike)
Stats below perhaps more meaningful- suggesting more JDs walked out than prev rounds
Huge story here.....at least 40 patients in the East of Eng were harmed or died after 'significant ambulance delays' in 3 week period this winter, a senior whistleblower has told
@Jamesillman
BREAKING:
Senior NHS leader warns of ‘life-threatening’ situation where clinically vulnerable people are having their Gas & Elec disconnected due to unpaid bills.
Evidence that some in the North East have been admitted to hospital as a result...
🧵
It is disappointing that
@BMA_JuniorDocs
have decided to call for more strike action.
We made a fair and reasonable offer, and were in active discussions on a range of issues.
I am still keen to continue talks if these hugely disruptive strikes are called off.
Every day
@NightingaleLDN
all the clinical leads and teams who are free, gather for a quality and learning session. What have we learned and how can we implement improvements and do it quickly? Everyone on the same mission, trying their utmost to attend to every detail 1/2
This is really significant.
NHS Eng tells trusts they must include ethnicity & deprivation categories when reporting on performance targets.
We think these'll be published, which should create real pressure to tackle inequalities
via
@journo_kituno
EXCL
Hospitals are being pressured by NHS England to shift resources to treat patients with less serious conditions to meet 'politically motivated' A&E target by March - senior sources tell HSJ
(Elective target missed - so desperation now on A&E target)
BREAKING:
Ambulance trust chiefs make final plea to Gov/Barclay over Wed's planned strike action - stressing the extreme risks posed to patients
HSJ has seen leaked data showing servcies already in a dire state this eve...before the strike has even hit
EXCL: Desperation now from NHS Eng to hit 76% on A&E target in March - telling local CEOs to sign a declaration of commitment to delivering
Warned that failure would damage confidence in the NHS and risk funding cuts from Govt
1/🧵
NEW:
@LivHospitals
to bring 670 cleaners, porters & catering staff back in house at the Royal and Broadgreen sites.
These contracts have been outsourced to ISS Healthcare for many years.
Trust says staff will see improved T&Cs
'Every single system indicator is now flashing red , and winter virus season isn't even underway.
'Govt needs to urgently roll out its Plan B - working from home, mandatory mask wearing, covid passports for public events etc...'
Writes
@BWDDPH
for HSJ
BREAKING
Every ambulance trust now on highest alert level due to 'extreme pressures' (REAP 4), acc to internal comms seen by HSJ
Response times & handover delays deteriorating quickly - & major concerns about Thurs nurses' strike (impact on handovers)
Breaking down NHS Eng's letter to local leaders today-
Big message is Sunak's big pledge to cut NHS waiting lists has been ditched
(note they only refer to 'high priority' cases)
**Delivering financial savings are now the first priority**
🧵1/
New CQC grid for Pennine Acute - confirms the significant improvements over 3 years since it was taken over by Salford Royal...
(& without the ££££ that were given to the likes of Royal Free and Frimley when they took over struggling neighbours.)
Outpatient dept at Stockport hospital immediately closed after 'significant deterioration' to building
Much of the estate at Stepping Hill is pretty dire & trust has been trying to get towards the front of the Q for capital investment for a new-build.
To no avail so far
BREAKING EXCL 🚨🏥 Greater Manchester hospital 'immediately' closes major department as 'there has been signification deterioration of the structure of the building', it comes the day after an inspection report
@MENnewsdesk
This is pretty good from the
@LabourHealth
/
@wesstreeting
team - responding to Sajid Javid's promise of a 'digital revolution' for the NHS....
They've dug out 16 previous occasions in the last 10 years where health secretaries have made similar speeches
BREAKING
National alert over patients being held in back of ambulances outside A&Es for TEN HOURS
At internal meeting today, NHS Eng said some trusts are holding ambo patients outside as a 'management strategy' to cope with pressure inside hospitaL
New from
@HealthFdn
-Public health grants cut by around 25% since 2015
-Big reductions for stop smoking/drug & alcohol services
-Areas with high deprivation tended to have deeper cuts
If Govt wants to hold down NHS £ - then desperately needs to increase ££ for prevention
Major caveat on the £200m winter fund announced by Rishi Sunak
HSJ's seen a letter from NHS Eng saying its basically going to cover the costs of strike action (inc action earlier this yr), & "will not be available for new initiatives"
from
@HMAnderson39
Hearing A&E pressures in the North West extremely tough right now.
Royal Liverpool has declared Opel 4, with tough talks across Mersey about Ambo handover delays.
'Exit block' the worst it's ever been, says one source
Exclusive:
Letter leaked to HSJ reveals senior medics at the new Royal Liverpool Hospital - including a clinical director - told Execs they were 'ashamed & embarrassed' by standards of care being offered in the A&E dept
🧵1/7
Ambulance chief says a 'game changing thing for A&E would be a 'phone a friend' service for paramedics - where they're with a patient but don't know exactly what's wrong with them... They should be able to face time a hospital consultant for advice'
BREAKING:
Public inquiry into the NHS handling of Lucy Letby case upgraded to full statutory inquiry.
This will compel witnesses to give evidence under oath
You'll see lots of front pages tomorrow talking about a '£384m a week' bonanza for the NHS.....but the % increases over time give a more accurate view. Theresa May's settlement means similar rises to those under Thatcher govt.
Aug 2022
Steve Barclay summons CEOs of the worst hospitals for ambulance handover delays, in face of worsening crisis
Dec 2023
Victoria Atkins summons CEOs of the worst hospitals for ambulance handover delays, in face of worsening crisis
My nice old Dad got diagnosed with an incurable blood cancer in 2020
But its stabilised with treatment
@GSTTnhs
/
@uclh
& hes now set to cycle to Paris (500km) to raise £5k for
@MyelomaUK
-that supported him
Is v close to target if u can spare a few quid🙏
Lots of reports on ICU close to being overwhelmed in the North West
Important to distinguish between normal/surge capacity.
Some trusts are near normal capacity, but do have potential to >double that with surge beds.
Surge beds = redeploying staff & mass cancellations of ops
BREAKING
High level attempt to 'shame' private hospitals & staff to help the NHS++ in London
City leaders are 'profoundly uncomfortable' that routine electives continue in private hospitals, as NHS faces 'unthinkable' C19 pressures
Letter leaked to HSJ
'Crackers beyond belief'...while still apologising for Windrush scandal, the Home Office reckons its refusal of visas for 100 Indian doctors (recruited by north west NHS trusts) is 'in the national interest'
Great job
@boltonnhsft
for highlighting A&E pressures on 10 o' clock news... Doing all the right things to ease pressure, but still having to treat patients in really difficult conditions.
'Out of hospital care' is like calling women 'People who aren't men'....
Quote of the day at
#HFMA2018
from mental health & community trust boss
@ClaireCNWL
A senior NHS source told us private hospitals had 'taken the piss & walked off with the money' in early months of pandemic...
NHS now wants to ensure absolutely all clinicians possible are doing what's needed - & not working on private lists of non-urgent patients.
BREAKING
High level attempt to 'shame' private hospitals & staff to help the NHS++ in London
City leaders are 'profoundly uncomfortable' that routine electives continue in private hospitals, as NHS faces 'unthinkable' C19 pressures
Letter leaked to HSJ
BREAKING:
Roll out covid vaccinations to frontline NHS staff ‘immediately’ --- NHS Eng has told local leaders in a letter shared with HSJ
from
@Rebeccasmt
A good shout out for
@blackburndarwen
here from the NHS' chief operating officer - for the work it's done to increase vaccine take up in BAME communities
@BWDDPH
BMA source says latest signals from Govt suggest junior docs to be offered 5% + £1000 (all consolidated)
Would total around 9% for an FY1.
That'd be a better consolidated payment than nurses received - but obviously doesnt get close to 'pay restoration'
Source says latest Govt offer was an extra one-off £1.5k for 22-23, & then 5% for 23-24.
Much less generous than Govt offer in Scotland ( with the one-off element even less than that given to other NHS staff in Eng) - so **if correct**, not surprised it's been rejected
Today, we announce a 3rd round of industrial action from 14 – 17 June.
The Government’s 5% pay increase offer is an insult to junior doctors in England.
BREAKING:
NHS Eng review criticises prominent cancer trust The Christie for a 'defensive & dismissive' attitude to serious whistleblowing concerns..
How does it respond?
With one of the most bullish/dismissive responses Ive ever seen from an NHS trust
This would mean a 3% rise next year (eaten up by inflation) - in return for working harder. Nuffield Trust reckons the net result (taking into account the day less holiday) would effectively be a pay cut of 0.4%
BREAKING:
Briefing document seen by HSJ says the number of covid-19 patients in North West hospitals is 'extremely likely' to reach the levels of the April peak (almost 3,000) before the end of October...
PAC member Mark Francois going full Daily Mail now - saying there's lots of respect for clincians & frontline staff in the NHS, but 'desperate weaknesses in its management'....
Amanda Pritchard points out that 19 out of 20 managers in the NHS are clincians
Bas Sadiq started her NHS career as a receptionist 20 yrs ago, and has just been appointed chief executive of
@NHSHomerton
- great story
from
@Jamesillman
Good piece on
@BBCMoreOrLess
Professor Christl Donnelly saying we shouldn't pay too much attention to countries/regions doing 'better' or 'worse' than others on deaths - as so many other factors involved like population density, age profiles, inter-connectedness etc etc
NHS Eng's ranking of health systems revealed here
Frimley (green) the only 'consistently high performing' ICS
Shropshire, Norfolk, Cambridgeshire, Lincolnshire & Devon (red) all deemed to be at level equivalent to 'special measures'
From
@Davewwest
“It’s vital that we support our fantastic and hardworking hospice staff. So today I’m announcing an immediate £25m boost for our hospices and palliative care services.” – PM
@BorisJohnson
NHS Eng has on many occasions itself said the real cause of the A&E crisis is 'flow' & discharge delays
This intervention and March push appears to do nothing about that - so it's hard to see it as anything other than purely political in showing Govt it can deliver something
EXCL: Desperation now from NHS Eng to hit 76% on A&E target in March - telling local CEOs to sign a declaration of commitment to delivering
Warned that failure would damage confidence in the NHS and risk funding cuts from Govt
1/🧵
Hope people don't buy the strikes excuse
We knew in January that industrial action was highly likely...
& meeting the PM's waiting list pledge was always going to depend on Govt's negotiating ability & efforts to avoid strikes
Sunak admitted his pledge to bring down NHS waiting lists is in doubt - with a record 7.68m people waiting for routine hospital treatment
The PM said it was “very hard” to meet his targets due to ongoing strikes by NHS staff
@janemerrick23
reports:
CQC report for the Pennine Acute sites (now part of
@NCAlliance_NHS
) due out soon.
Going by these prelim findings, it's likely to be pretty positive.
-Better leadership, culture, governance.....& plans to mitigate risks associated with the v poor IT infrastructure
Long list here of NHS trusts with highest finance charges (interest + inflation) on their PFI deals (16-17)
New report from
@CHPIthinktank
suggests buying out all Govt PFI projects would be upfront cost £2.6bn, but then annual savings of £900m
BREAKING:
Big drop in vaccinations in the North West region - despite it being at the forefront of the new covid surge.
Region's leaders have been calling for programme to be scaled up - but analysis by HSJ shows its % share has dropped significantly
Pretty much everyone I speak to reckons that individually, these are really good appointments for ICS chair/CEO roles in North West region
But I know a lot of ppl will be disappointed by the lack of diversity
(still 1 chair to be appointed, in C&M, so still a chance?)
NHS often trumpeted as an efficient & 'lean' healthcare system (vs those abroad).
But when this is over, there could be a pretty strong argument it should, in future, run with much more capacity- ie staff & equipment.