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NHSE launches £37bn framework for ‘new hospitals’

NHS England has launched a £37bn framework for the largest hospital-building drive in decades, in a bid to bolster market capacity.

It is hoped this will address concerns over a lack of construction market capacity that has been considered a potential threat to the programme.

The agreement is for major capital works in the New Hospital Programme, which has faced significant delays since being set up to deliver 40 projects by 2030.

The government claimed the original Conservative plan was unrealistic and further shifted timelines last month –  with nearly half now starting construction after that date.

NHSE said the Hospital 2.0 framework agreement would cover hospital building, refurbishment and ancillary works – including design – for schemes.

The contract notice said: “NHSE is seeking expressions of interest from suppliers with suitable major project experience, capacity and the capability to deliver complex hospital build and refurbishment construction works.”

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Source: HSJ, 17 February 2025

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NHSE launches ‘sprint’ in bid to hit waiting list target

NHS England has told trusts to begin a “sprint” exercise in a bid to hit its politically critical waiting list target by March.

HSJ understands “tens of millions of pounds” is likely to be made available to trusts to fund extra elective work.

The pot was still being finalised as of last week, with the money due to be released from contingency funds within NHSE’s existing budget.

Some trust leaders were given assurances about indicative allocations last week and told to use it as soon as possible. A formal briefing from NHSE leaders is scheduled for next week.

Progress on increasing the proportion of patients waiting under 18 weeks from referral to first treatment stalled in the most recent reporting period. It remained at 61.8% in November – the same level as in October and September.

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Source: HSJ, 21 January 2026

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NHSE issues fire risk warning over ‘corridor care’

NHS England has warned trusts not to compromise on fire safety when using corridor spaces to treat patients, amid growing pressure to accommodate more patients.

It comes as emergency departments face increasing pressure from national and regional officials to find more space for patients this winter – even when they are deemed full to capacity – to reduce ambulance handover delays.

The guidance, issued earlier this month, says trusts should complete new fire safety risk assessments before bringing any new part of a hospital into use for patient care, or extending the capacity of an existing area. It also said trusts have a legal duty to ensure escape routes are kept clear.

It added: “As we continue to find extra capacity in the estate by newly using, or re-using, parts of hospitals for patient treatment or care, or increasing the capacity of existing areas, we would like to remind you of how any change of use of areas may affect fire safety requirements.

“Under no circumstances must fire compliance be compromised on sites which have been changed.”

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Source: HSJ, 29 November 2022

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NHSE investigates concerns over-65s have received ineffective flu jab

NHS England is investigating a “potential serious incident” in its flu programme following concerns that people aged 65 and over are being given a vaccination jab known to be ineffective for this age group.

Details of the investigation were set out in a letter by NHS England’s South East regional team. The letter, seen by HSJ, said: “The NHS regional direct commissioning team are investigating reported administration of QIVe flu vaccine to patients aged 65 years or older by a number of primary care providers (primary care and pharmacy) across the region. QIVe is not recommended for use in this age group due to its poor effectiveness.”

It said officials were contacting practices and pharmacists directly where there was a record of QIVe vaccine having been given to the older age cohort to identify whether this is a recording coding error, or a genuine administration of QIVe. Initial investigations “suggest a mixture of both”, it said.

The letter added: “If any patient 65 or over has received QIVe, we will be asking the practice or pharmacist to treat this as an incident. Patients will need to be contacted, informed of the error, its potential implications and offered the opportunity to receive a vaccine which is appropriate for their age group."

It is unclear how many patients have been given the wrong jab.

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Source: HSJ, 8 November 2022

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NHSE intervenes over ‘fear and bullying’ in surgery department

Nearly a dozen junior doctors have been relocated from a London hospital’s general surgery department by NHS England, after concerns about a culture of fear, poor support, and reports of bullying. 

NHSE has withdrawn 11 surgical foundation year trainees from Barnet Hospital, in north London, after a review uncovered concerns regarding staff behaviour and safety.

The General Medical Council has opened a case into the hospital’s department, which is run by the Royal Free London Foundation Trust, and the trainees have been placed elsewhere in the trust.

Colin Melville, the GMC’s medical director and director of education and standards, told HSJ: “Doctors in training in the department reported a culture of fear, worry, and feeling unsupported and unable to raise concerns in the appropriate manner.

“There are also concerns over their supervision, bullying, and undermining behaviours in the department, as well as doctors’ physical and mental wellbeing.

“Because of the [trust’s] failure to meet the high standards we require, we stand firmly with NHSE workforce, training, and education London’s decision to relocate the 11 trainees, [to] where they can work and learn in a supportive environment.

“This action is necessary not only to ensure their safety, but to protect the public as well.”

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Source: HSJ, 18 April 2024

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NHSE intervenes at governance crisis trust

NHS England has formally intervened over governance failures at a trust whose chair resigned after “exceeding her authority” by suspending its chief executive.

NHS England told East Kent Hospitals University Foundation Trust it was taking action because of “leadership and board instability and the impact of recent events on the working relationship between the wider board members and the council of governors”.

It was “imperative that a strong and stable board and executive leadership team [are] in place… to set direction, manage and respond to the range and scale of the issues currently faced”, according to a letter on Tuesday from regional director Anne Eden.

NHSE told the trust to “ensure that the board is equipped with the right leadership skills, experience and capacity to oversee all elements of organisational governance, financial delivery, quality of care and operational delivery”.

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Source: HSJ, 29 April 2026

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NHSE home birth proposals spark major safety fears

NHS England is considering allowing midwives to “withdraw” services from women deemed to be giving birth at home against professional advice, HSJ has learned.

The Royal College of Midwives has warned that if this advice is introduced, it risks “push[ing] women towards giving birth entirely alone, [presenting] far greater risk to mother and baby”.

The disagreement comes as NHS services urgently seek clarity from system leaders on how they should best support home births and some high-risk pregnancies.

However, the advice would also cover how services should respond to other care and treatment requests that are considered “highly unsafe or unreasonable”.

NHS England’s discussions about the potential new advice were revealed in a letter responding to a coroner’s Prevention of Future Deaths report.

The letter is dated 24 December, but it was only published last month, and HSJ understands a definitive decision about the advice has not yet been made.

The letter said: “We will build on work already started, looking to clarify whether NHS health professionals providing maternity services may withdraw midwifery services from women birthing at home against professional advice and/or from women making requests with regards to care/treatment that are considered highly unsafe or unreasonable.”

It added: “In developing [better home birth resources], NHSE and its partners will consider the ethical responsibility and proportionality of offering women an NHS home birth, while taking into account that women have a legal right to choose what healthcare they receive.

“In addition, some women who cannot be supported to birth at home due to the level of risk may choose to give birth unassisted, which carries a higher risk.”

The report prompted chief midwifery officer Kate Brintworth to order all trusts to “urgently” review the safety of home birth services in November.

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Source: HSJ, 28 April 2026

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NHSE funding policy risks ‘levelling down’ maternity safety, warns hospital chief

 

Glen Burley, an acute trust chief executive has said NHS England risks ‘levelling down’ safety in some maternity services by ‘disproportionately’ directing additional funding to struggling trusts.

This comes after NHS England said the funding prioritised the trusts which needed the most support to meet the essential actions in the Ockenden Report, where in March, NHSE invited trusts to bid for a share of £96m extra funding for maternity services. 

A spokeswoman for NHS England has said: “The NHS made an additional £96m investment in maternity services following the Ockenden Review, the majority of which will bolster the workforce by funding an additional 1,200 midwives and 100 obstetricians. While the funding for additional workforce is for all NHS trusts, it is right that those who most need the support are prioritised.”

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Source: HSJ, 02 September 2021

 

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NHSE failing to hold trusts to account on inequalities

NHS England ‘lacks a clear vision’ on a key part of its health inequalities agenda and is not holding trusts to account for delivering an ‘inclusive recovery’, a study by the King’s Fund has concluded.

The think-tank’s report, which represents one of the most comprehensive analyses on the subject to date, said system leaders had not made the case for change “strongly or clearly enough to convince clinicians and other staff to consider inequalities” when tackling elective backlogs.

The think-tank said it had undertaken the research to investigate to what extent local NHS organisations had taken an “inclusive approach” to managing waiting lists, as NHS England had ordered them to do in August 2020.

The research team said in a statement alongside the report: “There has been a lack of a clear vision from national leaders on why inclusive recovery is important for delivering better and fairer services for patients and the public.

“The report calls on the government to pay greater attention to inclusive recovery to ensure progress is made so that patients can be treated fairly, no matter their background.”

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Source: HSJ, 8 November 2023

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NHSE expects to declare victory on number one target

NHS England bosses are predicting they will get close enough to hitting 65% against the 18-week standard by March to declare victory against their main performance objective for this year, HSJ  has learned.

This would mark a significant improvement, around 2.5 percentage points, from the 61.5% for December, the most recent official data. Performance has flatlined at around this mark for the past six months.

Senior figures cautioned they still had a difficult task balancing activity and finances in the final weeks of 2025-26, but they are increasingly optimistic about success against the government’s priority NHS target.

Official figures for January, to be published on Thursday, will give a first indication of the impact of a £120m “elective sprint” funded by NHS England at late notice, for the final months of the year.

One senior national figure told HSJ it was “a tricky time with final sprints to the line on elective, urgent and emergency care, and the money. But the fact that we are still in the running for all three feels very positive and motivational”.

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Source: HSJ, 10 March 2026

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NHSE expands overseas recruitment drive

NHS England has expanded its drive to increase overseas recruitment, introducing funding for trusts to hire more types of health professionals from abroad.

Employers are now able to use national NHS England funding to recruit physiotherapists, therapeutic radiographers and operating department practitioners from overseas.

Until now, within allied health professionals, the scheme has only covered diagnostic radiographers, occupational therapists and podiatrists. None of the professions are on the government’s shortage occupation list.

NHSE said it decided to expand the AHP scheme to more staff groups where it had decided there were NHS shortages, and others where it had identified there was global availability of staff. For example, it said other groups such as prosthetics professionals still could not be recruited from abroad as there is limited international supply. 

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Source: HSJ, 30 May 2023

 

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NHSE estimates mortality rate for autistic people is 51% higher

Autistic people in England who do not also have a learning disability are approximately 51% more likely to die in a single year compared to the general population, according to a leaked document which estimates the mortality rate for the first time.

According to an internal NHS England document, seen by HSJ, the standardised mortality rate between April 2020 and March 2021 was 16.6 deaths per 10,000 for people with autism and no learning disability compared to 11 deaths per 10,000 for the general population. 

NHSE also determined life expectancy for this group to be 75 years – 5.4 years less than the general population.

Dominic Slowie, former national clinical director for learning disability, told HSJ that because of the different ways autism presents itself, it can be difficult to pinpoint causes of premature mortality. 

“In some cases, people with autism who are severely disabled and can’t communicate their needs in a conventional way are going to have premature mortality for the same reasons that people with a learning disability do, because people do not really understand the level of their need or do not investigate their need in a reasonably adjusted way,” he said.

“While, if someone is presenting atypically in their communication, we mustn’t make presumptions – we must make reasonable adjustments to ensure they are investigated and diagnosed in the same way.”

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Source: HSJ, 13 December 2022

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NHSE drops tech target

NHS England has revealed it is no longer planning to meet a long-term plan maternity digitisation target, because of a change of approach.

Under the heading of “empowering people”, the 2019 long-term plan promised to extend digital access to maternity records to the whole country by 2023-24. This was in addition to digitising the so-called red book, which is used to track the health of babies and young children.

It followed a recommendation in the 2016 Better Births report, led by former health minister Baroness Julia Cumberlege and commissioned by NHS England. It was intended to reduce bureaucracy and improve safety, as well as provide parents with better information.

However, a paper prepared by chief nursing officer Ruth May for NHSE’s October board meeting said while the organisation “remains committed” to digitising the records, meeting the 2024 deadline would be a challenge due to “varying levels of digital maturity and change capacity across maternity services”.

In response, Royal College of Obstetricians and Gynaecologists president Edward Morris told HSJ: “While we recognise the enormous pressures that maternity services are currently facing, we are disappointed that NHSE is no longer on track to meet the target to digitise maternity records by 2024.

“This programme of digitisation will help realise our ambition for more effective use of data collected during pregnancy, to help identify and prevent the future onset of disease and improve outcomes for women and their babies.

“If digital maternity records are to become part of the wider shift to electronic patient records, it is vital that this information is still accessible to both women and healthcare professionals as an important tool for shared decision making.”

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Source:  HSJ, 11 October 2022

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NHSE drive on follow-ups only delivers marginal reduction

NHS England’s drive to encourage patient-initiated appointments is only having a marginal impact on reducing overall outpatient follow-ups, a major study suggests.

NHS England currently has a target to have 5% of outpatients on patient-initiated follow-up pathways, and hopes this can be increased substantially in future years.

The headline finding in a study by the Nuffield Trust think tank, which analysed almost 60 million cases, was that for every 5% on PIFU pathways, this roughly corresponded to 2% fewer outpatient follow-up attendances overall.

It suggests PIFU implementation would need to be dramatically expanded to get anywhere close to a 25% reduction in total follow-up activity, which NHSE had previously targeted by March 2023. As previously reported, there has been little to no reduction so far.

Chris Sherlaw-Johnson, senior fellow at the Nuffield Trust, said: “As few patients are currently on PIFU pathways at present, it’s not going to have that noticeable impact on the overall number of follow ups.”

He also stressed it was not clear whether the reduction was caused by the genuine elimination of unnecessary follow-ups or if patients were not returning for care despite needing it.

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Source: HSJ, 25 January 2024

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NHSE director: It could take a year for cancer services to return to normal

NHS England’s cancer director has said it could take another year for the level of cancer treatments and diagnosis carried out to return to normal, after being impeded by COVID-19.

National cancer director Dame Cally Palmer told HSJ’s national cancer forum event last week that activity over the past 12 months had been 89% of the previous year, but the service was committed to getting “fully reset” to 2019 levels by March 2022.

She shared information showing that, by December 2020, the amount of treatment being carried out following an urgent referral, for most cancers, exceeded December 2019 levels, but that there are still significant treatment backlogs.

And, for lung cancer patients, the number of treatments carried out in December 2020 was only 73% of that a year earlier — a decrease from September and October 2020 levels — as covid pressures rose during the third wave. Lung cancer is one of the most amenable to treatment if picked up early.

Other areas of diagnostics and treatment have also been severely impeded because of requirements to change practice to reduce the risk of spreading covid, particularly to vulnerable patients.

Dame Cally, also chief executive of the Royal Marsden Foundation Trust, said the service was committed to returning to at least normal levels of activity across the board by March next year.

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Source: HSJ, 12 March 2021

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NHSE director vows to ‘turn off’ funding for wasteful IT systems

NHS England will intensify its crackdown on wasteful technology spending next year as part of “radically different” approach to funding, a national director has said.

Alex Crossley, NHSE’s director of transformation, finance and delivery, said the NHS needs to be “more disciplined” with its approach to technology funding and that he would be “turning funding off” when productivity gains are not achieved.

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Source: HSJ, 5 December 2025

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NHSE director resigns, claiming politicians wanted ‘change at the top’

Claire Murdoch, NHS England’s national mental health director for the last nine years, has today resigned “with immediate effect”.

In her resignation letter to Sir Jim Mackey, seen by HSJ, Ms Murdoch said it had become “common knowledge that change at the top is wanted” and that she “could no long lead the sector when the political leadership don’t want to engage with me”.

Ms Murdoch wrote in her letter, which is attached to this article, that since it was ”apparently widely already known” that ministers wanted change that ”I cannot continue to do the job in the way it deserves to be done and it’s best you quickly find someone that you and the political leadership can have confidence in.”

Ms Murdoch’s letter also raises concerns about mental health spending and described maintaining its share of NHS funding as “critical”. She said it “…fell last year and will again this year. It likely will continue to do so over the next 3 years. I hope I am wrong.” HSJ reported earlier this year the proportion the NHS spends on mental health was this year cut for the first time in several years. 

Ms Murdoch said tackling inequalities and reducing the premature mortality of people with serious mental illness remains an area that we have sadly made “insufficient progress on”. More needs to be done she said, “much of which does not require additional investment …. but much of which, absolutely does”.

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Source: HSJ, 11 September 2025

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NHSE director demands maternity consultants work nights

The deputy chair of NHS England has said it should be as ‘demanding’ of medical cover in obstetrics and neonatal care as it is for emergency departments, to improve safety in the wake of repeated care scandals.

Sir Andrew Morris, who was the long-serving chief executive officer of the well-regarded Frimley Health Foundation Trust, said the service would “expect a consultant to be on duty in an emergency department [from] 8am till 10pm, or midnight, seven days a week”.

Speaking at NHS England’s public board meeting yesterday, Sir Andrew said: “We haven’t set that similar expectation out for [maternity care]. I know we’re saying we’re expecting that two ward rounds are undertaken, each day, seven days a week, but that is very different to the service I think is appropriate for this type of semi-emergency operation, that most trusts run.

“I’d like us to be as demanding of organisations [in relation to obstetrics and neonatal] as we are for the emergency department.”

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Source: HSJ, 1 December 2022

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NHSE director calls out trust over ‘speak English’ rule

An ‘outstanding’ London trust has come under fire for asking staff to communicate ‘only in English’ when around other people.

A document published under the ‘trust values’ section of Homerton University Hospital Foundation Trust’s website, says: “I will only communicate in English in the presence of others.”

The document has been widely shared on social media in the last 24 hours, with many criticising the trust for its wording. The document itself is dated 2014, but was reposted by the trust in 2019, and remained on its website as of midday today.

NHS England’s director of equality – medical workforce, Partha Kar, who is also NHSE’s diabetes lead, questioned the document on Twitter. He also said: “I am not aware of any NHS England ‘diktat’ suggesting we must all only speak in English to uphold NHS values.”

It follows a separate notice being posted on Twitter yesterday signed simply by “Matron”, by a doctor who claimed her friend saw it at her “hospital placement”. It seemingly threatened staff with “disciplinary action” if they spoke any other language other than English.

It reads: “English is the only language to be spoken in the ward area – this includes the kitchen. Disciplinary action will be taken against staff who do not comply, including agency and bank.”

The documents have prompted a backlash on Twitter, with many criticising them and raising concerns about racism and inclusivity of staff. NHSE’s chief nursing officer, Ruth May, has publicly queried where the document is from.

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Source: HSJ, 16 March 2022

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NHSE director admits ‘huge cost’ to cutting ambulance delays

Reductions in the number of long ambulance delays have come at a “huge cost” as hospitals are having to take in more emergency patients than they have space for, NHS England’s urgent care director has said.

Sarah-Jane Marsh told NHS England’s board meeting on Thursday that emergency departments and hospital wards are now taking more “risk” by taking extra patients in a bid to get ambulances back on the road quicker.

This year, many fewer hours have been lost to ambulance delays, although the total number of delays of more than 60 minutes is approaching the same as last winter. Emergency department waits in November and December were better than last year, although still much worse than pre-covid and a long way below targets. 

But Ms Marsh said the improvement was a result of hospitals agreeing to take more patients into EDs and acute wards, even when they did not have space or staff to properly care for them.

She said: “It’s come at a huge cost. Some of the things we have achieved are because we have moved pressures around in the system.

“We have moved risk out of people’s houses and from the back of ambulances, and in some cases we’ve moved that into emergency departments [and] wards, that have had to take the pressure of taking additional patients.

“Next year one of our learnings is that we need to have a really big focus on what is happening inside our hospitals [so] we decongest some very crowded areas.”

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Source: HSJ, 1 February 2024

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NHSE director ‘shocked’ by lack of weekend working

The national director for mental health has said she was shocked to discover how many ward managers do not work at weekends, adding this could contribute to abuse and poor care going undetected.

Asked at the NHS Providers conference about recent reports into care scandals, NHS England’s director for mental health Claire Murdoch said it was crucial to listen to frontline staff, such as healthcare assistants, who spend most of their time with patients.

But she added: “[It’s also] making sure your ward managers do work of a night and at the weekend.

“I’ve been a bit shocked to hear that we’ve moved with agenda for change and quite often ward managers are Monday to Friday people.”

Her comments come amid a string of high-profile care scandals, such as at the Edenfield Centre in Greater Manchester, as well as an ongoing debate around seven-day working across the NHS.

It is understood Ms Murdoch is concerned managers are spending too much time on bureaucratic tasks, which typically happen during Monday to Friday shifts, meaning they are then not working night or weekend shifts.

In September, the national director ordered all trusts to carry out safety reviews, warning in a letter they should leave “no stone unturned” in seeking to eradicate and prevent poor care. She also urged all boards to urgently review safeguarding of care in their organisations, and identify any immediate issues requiring action now.

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Source: HSJ, 15 November 2022

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NHSE director ‘concerned by 20% nursing gap’ amid push to tackle poor culture

NHS England’s national mental health director admitted she was ‘concerned’ that 20% of mental health nurse roles were unfilled and about the impact this could have on a nationwide push to improve safety and tackle closed cultures.

Claire Murdoch was speaking to HSJ a year on from a series of high-profile documentaries exposing abuse and poor care at mental health trusts. In their wake, Ms Murdoch urged providers to urgently review safeguarding, while a separate three-year quality programme was also launched to look at closed cultures and improve safety.

Now in the middle of that programme, Ms Murdoch stressed that stability in staffing is “vital” to developing safe and therapeutic care, but that many services across the country are struggling with significant nursing vacancies. 

She said: “The bit that absolutely we need to acknowledge [around changing cultures] is there are some significant workforce and staffing challenges, which I’m concerned about, with a 20%t vacancy of qualified registered mental health nurses nationally.

“There are new support roles, psychology assistant roles, physician associates – there are all sorts coming into being in inpatient care, but a lot of services are still struggling with staffing".

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Source: HSJ, 21 September 2023

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NHSE desire to please government forcing finance chiefs to agree undeliverable plans

One of the NHS’s foremost finance figures has joined the chorus of senior healthcare leaders raising serious concerns about the damaging effect of the way the service’s annual planning round is conducted. 

Hardev Virdee is the group finance officer of Barts Health Trust, the junior vice president of the Chartered Institute of Public Finance and Accountancy, and the chair of the NHS National Finance Academy.

In an interview with HSJ, he said:

  • The planning process was undermining the credibility of both the financial plans it produced and the senior NHS finance staff involved.
  • This “erosion of credibility” had grown over the last five years.
  • NHS England’s main goal was to produce financial plans that were acceptable to government, rather than being sustainable or credible.
  • The process means finance directors and boards are increasingly having to “consider unethical options”.
  • The pressure felt by many senior NHS finance professionals is seriously affecting their morale, causing some to leave the sector, and discouraging others from taking on the most senior and toughest jobs.

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Source: HSJ, 4 November 2024

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NHSE declares emergency over IV shortage

NHS England has declared a national emergency over shortage of feed for babies and disabled patients, with some patients being told to go to Accident & Emergency (A&E) departments.  Hundreds of NHS patients, including children, who depend on intravenous (IV) nutrition, have been experiencing delays in deliveries.

It follows an inspection by watchdogs which found manufacturers were failing to meet safety standards, and the presence of potentially fatal bacteria. The NHS National Patient Safety Director, Aiden Fowler, has written to all NHS hospital trusts, and affected patients, warning that the incident has been designated as an emergency incident, under the Civil Contingencies Act, at the highest level. 

British manufacturer Calea had already said the shortages could last up to four weeks. But the letter warns that the crisis could last far longer, outlining plans to ration the product to those most in need. 

Parents said the situation was “terrifying” with some told to go to A&E if vulnerable children were left too long without being fed. 

Hospitals have now been asked to review all patients receiving such IV feed to ensure only those deemed at high-risk are allocated the supplies, which are tailored to meet specific individual needs. Others will be allocated standard bags of nutrition, with extra supplements. 

In the letters from Dr Fowler, disclosed by the Health Service Journal, he warns that the NHS is facing a “difficult balance” between the risks caused by the shortages, and the dangers of allowing production to continue, without safety improvements. 

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Source: The Telegraph, 13 August 2019

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NHSE cuts elective targets and admits PM’s waiting list pledge under threat

NHS England has reduced its elective activity target for the service because of the impact of junior doctors’ strike, and acknowledged the service may not hit the prime minister’s pledge to reduce waiting lists before the next general election if the industrial action continues.

NHSE has agreed a deal with ministers which will see the “value based” elective activity target set for the service reduced for 2023-24 from 107 per cent of pre-pandemic levels to 105 per cent (See explainer box on value-based targets below).

Trust finance bosses were briefed by NHSE chief finance officer Julian Kelly this morning (Wednesday 12 July) on the eve of junior doctors’ longest strike action to date.

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Source: HSJ, 12 July 2023

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