Solving the £20bn productivity puzzle

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 [email protected]