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Major survey reveals ‘best and worst’ A&Es for patient satisfaction

A survey of almost 50,000 patients by the Care Quality Commission (CQC) found people’s experiences of emergency departments improved in 2020, compared to the last time the poll was conducted in 2018.

On a scale of one to 10, the regulator found 33% of patients scored their overall experience as 10, compared to 29% in 2018. Eighty-eight per cent of patients scored their care at six or higher, compared to 85% three years ago.

However, overall satisfaction levels declined at around 20 providers. 

Ted Baker, CQC’s chief inspector of hospitals, said: “This year’s survey shows some encouraging improvements with trust and confidence in clinicians, perceptions of cleanliness and overall experience all performing better than in previous years…

“However, the scope for further improvement remains. Access to emotional support, help with pain relief and information provided at discharge were all areas where some people surveyed were less positive.”

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Source: HSJ, 16 September 2021

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Major study will use philosophical expertise to highlight patient voices in healthcare research and practice

A new six-year study, which aims to prevent the ‘silencing’ of patient voices and improve patient trust in the healthcare system, is due to begin thanks to a major funding award

Researchers at the University of Nottingham, University of Bristol and University of Birmingham have received a £2.6M Wellcome Discovery Grant for the 'Epistemic Injustice in Healthcare (EPIC)’ project. The study will use philosophical expertise to explore forms of 'silencing'.

Patients regularly report that their testimonies and perspectives are ignored, dismissed or explained away by the healthcare profession. These experiences are injustices because they are unfair and harmful - and philosophers call them ‘epistemic injustices’ because they jeopardise patient care and undermine trust in healthcare staff and systems.

By studying these epistemic injustices, EPIC will find ways to correct them and improve the relationship between patients and healthcare practitioners.

"Patients have long reported feeling ignored, dismissed, or silenced in ways that jeopardise their care and intensify their suffering. The challenge is to understand how this silencing happens and what can be done about it, in ways that can help patients and healthcare practitioners alike. The NHS is right to seek 'patient perspectives' and listen to 'patient voices'. Project EPIC will help them to do that better by fully diagnosing the causes of that silencing." Dr Ian James Kidd, EPIC Co-Investigator & Assistant Professor in the Department of Philosophy.

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Source: University of Nottingham

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Major spikes in hospital-acquired covid infections at two trusts

A spike in hospital acquired Covid-19 has been observed in two acute trusts, The Royal Wolverhampton Trust and Yeovil District Hospital Foundation Trust. 

According to NHS England, it is can be considered hospital acquired if covid infections are diagnosed eight days or more after admission. Data suggests The Royal Wolverhampton Trust had a weekly average of 25 probable hospital-acquired covid infections in mid-August and a spike at the start of August for Yeovil District Hospital Foundation Trust. 

Infection Prevention Society president Jennie Wilson said "Infection prevention and control teams are totally aware it’s a problem and they strive to do their best to keep it under control. It’s hugely challenging but [staff] are doing their best."

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Source: HSJ, 25 August 2021

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Major scaling back of infection control measures announced

A significant relaxation of infection control guidance has been announced in a bid to free up more capacity to tackle substantial waiting lists and demand for emergency care.

New guidance issued jointly by the Department of Heath and Social Care, the UK Health Security Agency, NHS England and health bodies in the devolved nations, recommends the relaxation of isolation requirements for inpatients who either test positive for Covid-19 or are considered close contacts of people with the virus.

The isolation period for inpatients with Covid-19 can now be reduced from 10 days to seven if they have two negative lateral flow tests. The tests must be taken on two consecutive days from day six of the isolation period onwards, and the patient must also “[show] clinical improvement”.

A letter from NHSE released to trust chiefs, sent last Thursday, also recommends the “[return] of pre-pandemic physical distancing in all areas,” including emergency departments, ambulances and “all primary care, inpatient and outpatient settings.”

It also recommends the returning to pre-pandemic cleaning procedures outside Covid-19 areas.

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Source: HSJ, 19 April 2022

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Major NHS trust downgraded by care watchdog amid safety fears

One of the largest hospital trusts in England has been downgraded by the care watchdog amid safety fears and criticism that bosses did not act on staff concerns.

The Care Quality Commission (CQC) said it found bedpans covered in faeces, urine and hair during 10 visits to wards at University Hospitals Birmingham Trust in June.

Staff in A&E told inspectors they were put under pressure to nurse patients in corridors. At one stage 20 ambulances were queuing outside Heartlands Hospital with patients waiting outside.

The CQC said staff felt “disconnected from leaders” who didn’t show an understanding of the pressures they were under.

Consultants to the regulator staff were experiencing fatigue and they felt executives at the trust “were no longer interested in staff welfare”.

In its inspection report, the CQC said staff did not always clean equipment and said labels for when items were last cleaned were being applied incorrectly.

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Source: The Independent, 8 October 2021

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Major law firm faces court over withheld contracts in landmark NHS whistleblowing case

A law firm that routinely advises health service bosses faces claims it withheld evidence in a landmark NHS whistleblowing case.

A judge has called for full evidence disclosure to assess claims that healthcare specialist firm Hill Dickinson acted fraudulently in a dispute over a lack of legal protection for NHS doctors in whistleblowing claims.

The firm will now have to account for its actions in litigation that saw more than 50,000 doctors below consultant level in England deprived of legal whistleblowing protections, according to the junior medic at the centre of it, Chris Day. The case also had implications for 865,000 agency workers across other sectors – including construction.

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Source: ByLine Times, 9 February 2023

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Major incident declared at hospital over cyber issue

A major incident has been declared at a hospital "for cyber security reasons".

In a statement on their website, Wirral University Teaching Hospital said the ongoing incident at the Trust is likely to impact performance at Arrowe Park Hospital in Wirral.

The hospital has asked people to only attend the hospital if they have "a genuine emergency".

“The Trust business continuity processes are in place and our focus remains on maintaining patient safety," a hospital spokesperson said.

The statement added: “However, this issue is likely to result in longer waits in the emergency department and assessment areas.

“Please only attend the emergency department if you have a genuine emergency.

“If it’s not an emergency, please visit 111, use a walk-in centre, an urgent treatment centre, a GP or pharmacist."

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Source: BBC News, 26 November 2024

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Major HRT supplier sanctioned after whistleblowers raise concerns over patient safety

A major UK supplier of menopause drug HRT has been sanctioned after whistleblowers claimed patients were being put at risk, it has emerged.

A group of employees from Theramex, which supplies HRT treatments to millions of patients in the UK, wrote a letter to the pharmaceutical regulator Association of the British Pharmaceutical Industry over allegations the company was not following regulatory standards and may “jeopardise” patient safety.

The whistleblowers claimed some products featured inaccurate prescribing information and failed to highlight common side effects. They claimed they had been forced to contact the regulator after their attempts to raise issues internally were brushed off.

The company has now admitted it breached regulatory codes, amounting to “bringing discredit upon, and reducing confidence in the pharmaceutical industry”, according to an interim case report from the ABPI. It also failed to maintain high standards and provide accurate and up-to-date prescribing information, the report said.

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Source: The Independent, 21 July 2025

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Major healthcare equipment firm on brink of failure

A major supplier of healthcare equipment to people who are being discharged from hospital or need support in their own homes, is on the brink of going bust.

NRS Healthcare, which works with the NHS and about 40 councils in England and Northern Ireland, is expected to run out of cash by the end of the week, the BBC understands.

The government said it was working with local authorities to minimise "any potential disruption" and find alternative suppliers.

In a letter, sent to the government early in July and seen by the BBC, councils warned of "a devastating impact" and "risk to life" and asked for a short-term loan for NRS while new arrangements were put in place.

It is believed no loan was offered, but most councils have now managed to get plans in place to keep services running.

Council leaders and social services bosses have since confirmed they are "exploring all options to maintain services, including alternative providers and local solutions".

"We are committed to ensuring that services remain as reliable as possible, especially to those people with the highest levels of need during this period of uncertainty," said the Local Government Association, which represents councils in England, in a joint statement with the Association of Directors of Adult Social Services.

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Source: BBC News, 30 July 2025

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Major German research funder launches audit of clinical trial portfolio

German public research funder Deutsche Forschungsgemeinschaft (DFG) is conducting an audit of the clinical trials it has supported in the past. The audit was announced in response to a request from TranspariMED asking DFG for a list of all its trials completed between 2009 and 2017, to which DFG replied that it currently has no such comprehensive dataset.

DFG stated that it is "currently preparing an evaluation of its clinical trials programme. In the framework of this evaluation the data you requested will be collected and analysed, as the outcomes of trials supported by DFG is of high interest including for DFG itself."

TranspariMED, an organisation which aims to end evidence distortion in medicine, sees this development as a good opportunity for DFG to check whether and when clinical trials were registered and their results made public.

Previous research has shown that nearly a third of German academic trials never make their results public.

This not only wastes public money, but also harms patients because it leaves gaps in the evidence base on the efficacy and safety of drugs, medical devices, and non-drug treatments.

Due to gaps in German law, there is still no legal obligation to make the results of many German clinical trials public.

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Source: TranspariMed, 20 December 2022

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Major failings found after surgeon harmed women

A former NHS gynaecologist's risky practices and shortcuts contributed to women suffering severe physical harm, a long-awaited report into his care has found.

Daniel Hay joined the University Hospitals of Derby and Burton (UHDB) NHS Foundation Trust in 2005, and operated on hundreds of women before retiring in 2020.

A report - which scrutinised Mr Hay's care between 2015 and 2018 - was commissioned after concerns were raised by colleagues, and found failings in his practices, how he was managed and added only "good fortune prevented further harm".

The report was commissioned by the Gynaecology Review Steering Group, which included representations from NHS England, UHDB, and the Derby and Derbyshire clinical commissioning group.

As part of the report, the panel contacted 325 women who had been treated by Mr Hay between 2015 and 2018, asking them to share their experiences.

In addition to the 325 patients, 58 women had already been reviewed in an earlier assessment carried out in 2019.

In Wednesday's report, the steering group panel identified two women as suffering "severe physical harm", with three sustaining "moderate physical harm" under Mr Hay's care.

Among the issues identified were women who had a hysterectomy - a surgical procedure that removes the womb - with some patients made to feel like it was their "only option" when less invasive options may have been available.

This "adversely affected" the mental health of women who dreamed of starting families but were unable to do so, affecting their relationships and jobs.

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Source: BBC News, 1 October 2025

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Major diagnostics review kicked into long grass

There are “no plans to publish” a much-anticipated NHS England review of diagnostic services that had been expected this month, a government source has told HSJ.

The review on diagnostics and community diagnostic centres, a follow-up to Sir Mike Richards’ report in 2020, was due this month ahead of the budget on 30 October, senior figures familiar with the report said.

The original report prompted ministers to pledge £2.3bn worth of funding which involved the development of over 160 CDCs – a key recommendation from the report. But cash for the programme runs out in March 2025.

Diagnostic leaders had been hopeful the follow-up report, which was being overseen by NHSE, would provide fresh funding and focus for the CDCs programme.

However, HSJ understands the review is now unlikely to be published in full and will instead be subsumed into the government’s “10-year health plan”.

A government source told HSJ this week: “There are no plans to publish a second report into diagnostics by [Sir Mike].”

“To develop the 10-year health plan we are going to listen to the public and the people who work in the NHS, because patients and staff must feel the difference in their daily lives. We will announce further details later this year.”

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Source: HSJ, 4 October 2024

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Major delays for new NHS England covid service

A key expansion of services for patients recovering from coronavirus has been delayed by several months, HSJ has learned.

In July, NHS England hailed a “ground breaking” new service with the launch of a website with information for patients on how to recover from covid following hospital discharge. It promised a second phase of the service would allow patients to be connected with health professionals for more tailored support, to be launched “later this summer”.

But in a memo sent to professional bodies on 30 October, NHSE said the national roll-out was delayed until at least January 2021, with no date confirmed for the launch beyond that.

Documents on the website itself said a “first cohort of patients from Leicester will begin to work through the programme” in November, with a further rollout scheduled for early December, followed by a “refresh” in January 2021 and a “full national rollout accessible across the country” at an unspecified date beyond that.

The second phase is seen as vital for ensuring that people with covid receive personalised support to help them recover from its debilitating effects, especially as a separate face-to-face rehabilitation programme was scrapped due to costs.

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Source: HSJ, 16 November 2020

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Major COVID-19 booster trial looks at how best to improve immunity against coronavirus in vulnerable people

Researchers have launched a major clinical trial investigating whether people on long-term immune-suppressing medicines can mount a more robust immune response to COVID-19 booster jabs by interrupting their treatment.

The VROOM trial will have implications for people on immune-suppressing medicines, who are among the millions of clinically vulnerable patients advised to ‘shield’ during the pandemic. The study is funded by an NIHR and the Medical Research Council (MRC) partnership, and led by a team at the University of Nottingham.

Approximately 1.3 million people in the UK are prescribed the immune-suppressing drug methotrexate for inflammatory conditions such as rheumatoid arthritis, and skin conditions such as psoriasis. Many of them were among the 2.2 million clinically extremely vulnerable people advised to shield during the first phase of the pandemic, depending on specialist advice and on their risk factors.

While methotrexate is effective at controlling these conditions and has emerged as first line therapy for many illnesses, it reduces the body’s ability to generate robust responses to flu and pneumonia vaccines.

Researchers will recruit 560 patients currently taking methotrexate, to investigate whether taking a two week break in this drug immediately after they receive the COVID-19 booster jab improves their immune response to vaccination, while preventing flare-ups of their long-term illness. The study will take between one to two years to complete. All participants will have had the Pfizer-BioNTech vaccine as their third jab, as part of the national vaccination programme against COVID-19.

Professor Andy Ustianowski, NIHR Clinical Lead for the COVID-19 Vaccination Programme and Joint National Infection Specialty Lead, said: “Although the vaccine rollout has saved many lives and helped drive down the effects of the pandemic, there are still groups of vulnerable people who can’t always mount robust immunity against the virus. "

“It’s important to establish if people can safely improve protection from their booster jabs by taking a break from their immune-supressing medicines, and this pivotal study will help develop our understanding of immune responses in people taking this widely prescribed medicine."

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Source: NIHR, 12 November 2021

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Major concerns over quality of care for those dying at home

A lack of face-to-face appointments during the coronavirus pandemic has significantly worsened the palliative care being provided to people at the end of their life, according to a survey of specialists.

The research, which the Association of Palliative Medicine and end of life charity Marie Curie shared exclusively with HSJ, found 95% of respondents said their ability to provide good quality end-of-life care had been affected because patients had not received their “usual contact” such as visits from GPs or social care staff. Three-quarters said this had a “great” or “massive” impact.

Significantly higher numbers of people have died at home since the start of the coronavirus pandemic, compared to previous years.

Two-thirds of respondents said health professionals had missed opportunities to refer patients into palliative care and, once they had done, four fifths thought they had not done so in a “timely manner.”

Dr Iain Lawrie, president of APM, said a lack of face-to-face appointments meant “red flags” about patients’ conditions were missed, as these clues are easier to gather in person.

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Source: HSJ, 16 December 2020

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Major concerns over funding and staffing of new ‘long covid’ clinics

There are serious concerns over the funding and staffing numbers available for new ‘long-covid’ clinics, while patient groups ‘remain in the dark’ over their locations.

Last month, NHS England announced there would be 40 clinics around the country, to start opening at the end of November, with £10m of funding to cover set-up and operational costs until March 2021.

But several speakers at HSJ’s inaugural virtual respiratory forum last week said there were still uncertainties and concerns about the capacity to provide the clinics.

Dr Jon Bennet, a respiratory consultant and chair of the British Thoracic Society, said staffing the respiratory rehabilitation services within the clinics would be challenging, as “there isn’t at the moment sufficient capacity”.

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Source: HSJ, 29 November 2020

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Major AI project paused over patient data concerns

NHS England has paused a major AI project after concerns were raised about how the primary care records of 57 million people were used to train it.

The Joint General Practice IT Committee (JGPITC) – a collaboration between the Royal College of General Practitioners and the British Medical Association – wrote to NHSE last month to question the lawfulness of the Foresight AI project.

Foresight is the result of a data sharing agreement between NHSE and a consortium of researchers brought together by the British Heart Foundation. It will be used to predict potential future outcomes for patients that could be used to identify opportunities for early intervention.

In its letter, the JGPITC said it was “very surprised and extremely concerned” to learn of the project, which used the GPES Data for Pandemic Planning and Research dataset to train the AI model.

The committee said it had “serious concerns about the lawfulness of the data use for this project” and the “apparent absence of strict governance arrangements”.

An NHSE spokesperson said: “Maintaining patient privacy is central to this project and we are grateful to the Joint GP IT Committee for raising its concerns and meeting with us to discuss the strict governance and controls in place to ensure patients’ data remains secure.”

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Source: HSJ, 4 June 2025

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Major acute tells staff to work despite isolation guidance

A major hospital trust has told staff they should attend work even if a household member is showing covid-19 symptoms, contrary to national guidance.

Newcastle Upon Tyne Hospitals Foundation Trust’s occupational health department has told staff who had reported having family members with covid-19 symptoms they were still expected to attend work.

In the email exchanges seen by HSJ, some as recently as a couple of days ago, the trust’s occupational health department was clear there was an NUTH policy agreement with Public Health England.

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Source: HSJ, 1 April 2020

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Major A&E shake-up plans to be rolled out in coming weeks

Pilots for a new urgent care model requiring walk-in patients to book slots in emergency departments are expected to be rolled out in at least one site in every health system in the coming weeks, HSJ has learned.

The move comes amid concerns from trust managers who warned some 111 providers’ systems were too “risk averse” and were sending too many patients who could have been treated in other care settings to hospitals.

Local managers believe NHS 111 not directing enough people to alternative services was a cause of a major incident at Gloucestershire Hospitals Foundation Trust’s emergency services earlier this month, HSJ understands. And trust leaders in other parts of the country are understood to have similar concerns.

Trials of 111 First have already been publicly confirmed at Portsmouth Hospitals Trust, Royal Cornwall Trust, Newcastle Hospitals FT and Blackpool Hospitals FT. HSJ also understands five London sites, one for each integrated care system in the capital, are also running trials.

These “early adopter” trusts have been given autonomy to trial different models for “111 First”. Most EDs at these sites still treat “walk-in patients” as normal. But in Portsmouth, patients with minor injuries who turn up at ED without calling ahead have, on three different days, been instead told to call 111 following assessments.

NHS England said further trials will take place in the Midlands and East of England, but the specific trusts undertaking these trials have not been decided yet.

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Source: HSJ, 2 September 2020

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Maine hospital under fire for threatening to sue family of teenager who shared patient safety concerns online

A not-for-profit health system in Maine has threatened legal action against a 15-year-old boy for shedding light on alleged patient safety issues in the paediatric ward of one of its hospitals.

Samson Cournane, a student at the University of Maine, started a petition (Patient Safety in Maine Matters) advocating for an investigation into Northern Light Eastern Maine Medical Center last year, claiming conditions at the hospital were unsafe.

Mr Cournane’s mother, Dr Anne Yered, had previously been fired from the hospital after reportedly voicing safety concerns to the hospital’s CEO and president in 2020.

In the petition, Mr Cournane said his mother was threatened by hospital staff after raising concerns, with one hospital manager going so far as to show up in her backyard to confront her. Dr Yered subsequently claimed she was wrongfully terminated.

Mr Cournane then began pushing for an investigation into the hospital, outlining problems in the petition, which was addressed to US Representative Jared Golden. He alleged that the medical director of the paediatric intensive care unit (ICU) — a former colleague of his mother’s — finished just one year of a three-year critical care fellowship, and implied other hospital employees may be scared to come forward with safety concerns.

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Source: The Independent, 4 September 2023

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Main hospital corridor turned into ‘makeshift ward’

The main corridor of an acute hospital has been closed to patients and staff and turned into a ‘makeshift ward’, in what sources describe as an ‘absolutely unprecedented’ situation.

The move by Aintree Hospital comes after staff clashed with paramedics last week about whether ambulance patients could be brought into the crowded emergency department.

One staff member, who wished to remain anonymous, said: “It’s exceptional for this to happen, but I can see it happening more over winter. It’s a rock and a hard place… either you wait in the ambulance if the queue is too long, or you wait in the main hospital corridor. Neither option is ideal.”

Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: “Across the country, the urgent and emergency care system is in unprecedented crisis. Emergency medicine teams and our paramedic colleagues are doing their very best to deliver effective care in exceptionally difficult circumstances. Circumstances like these require ICB leaders to engage, take control of the situation and accept their responsibility. This will both help to de-escalate the situation and ensure the right decision is made for the patients, the ED teams and ambulance crews."

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Source: HSJ, 19 October 2022 (paywalled)

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Mackey: regulation of NHS managers ‘is coming’

A national NHS leader has said regulation of managers ‘is coming’, and the service should ‘just go with it and make it as effective’ as possible.

Sir Jim Mackey, national director for elective recovery and the chief executive of Northumbria Healthcare Foundation Trust, also told HSJ that regulation could offer better “protection” for management staff if implemented properly.

NHS England is considering additional regulation of NHS management after being asked to “revisit” the idea by health and social care secretary Steve Barclay in the wake of the murder of babies by nurse Lucy Letby at the Countess of Chester Hospital.

In an interview with HSJ, Sir Jim said: “Honestly, I think it’s coming. So we just need to go with it and make it as effective as it can be. It’s completely understandable in the current context for politicians and the public to want people in these positions to be regulated.”

He continued: “There’s potentially some protection for people in being regulated in an effective way, as well as [being subject to] clear rules, clear processes. If somebody makes an allegation and it’s found to be wrong [and] you’ve been through a thorough regulatory process, it’s going to help you to move on and put it behind you.”

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Source: HSJ, 18 September 2023

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Mackey: Cyber attack risk ‘dramatically accelerating’

Sir Jim Mackey has warned NHS leaders that cyber security is a “dramatically” bigger threat than it was just a few weeks ago, due to rapidly changing tech.

At today’s public board meeting, the NHS England chief executive said the service needed to do “basic things” to safeguard against a “risk environment [that] has now changed really dramatically”. 

At the same meeting, NHSE’s tech committee chair Mark Bailie said the NHS’s sprawling and patchily-updated information systems were “a direct patient safety issue”.

The non-executive director previously told the March public board meeting that the cyber threat was a major area of weakness. Since then, it was revealed that patient data from UK Biobank – a government-supported research database – was available to buy on Chinese auction sites.

The NHS’s suppliers are particularly vulnerable, with a lack of multifactor authentication at the Synnovis pathology provider, allowing the fatal attack in 2024.

An NHSE risk assessment published last night increased its recorded risk level for cyber security to the highest possible - 25 out of 25 – with a likelihood level of “frequent” and impact of “catastrophic”.

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Source:: HSJ, 4 June 2026

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Mackey reveals PFI revival plan

NHS England has confirmed plans to introduce a mechanism to allow private finance investment into health service infrastructure within months.

Sir Jim Mackey confirmed today he wanted government to “introduce an off–balance sheet capital investment mechanism”. It is part of a “100 day plan” for his first few months as NHSE CEO, published today.

HSJ understands discussions between NHSE and the Treasury over how this would be used and what form it would take are ongoing. Government is due to publish a new infrastructure strategy in coming weeks; whole 10 Year Health Plan drafts have included proposals for more social investment.

A move to revive off-balance sheet capital would pave the way for private investment to be once again used to build NHS hospitals, after the previous Labour government used private finance initiatives to invest widely in health service buildings in the late 1990s and 2000s.

Under the arrangements, the private sector builds and maintains an asset in exchange for annual payments from the public sector over the course of the contract. Because the private sector bore the up-front construction costs, this did not count as government borrowing.

However the model was criticised heavily over value for money concerns, and was banned by former chancellor Philip Hammond in 2018.

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Source: HSJ, 11 June 2025

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Mackey demands sign-off on disruptive tech deployments

Sir Jim Mackey and other national leaders are concerned that the disruption to appointments which often follows electronic patient record deployment will capsize elective performance, particularly during the busy winter period.

Several senior sources have confirmed to HSJ that NHS England’s transformation directorate is now required to make a recommendation on the readiness of trust and contractor teams, before Sir Jim makes the final decision.

One senior figure at the centre told HSJ: “While electronic records can have huge benefits, the reality is we as a system need to pull our fingers out, invest in the training, job planning and process re-engineering, and make sure we’re really seeing and feeling the benefit, not a productivity loss. And suppliers need to help make that true.”

A hospital CEO said Sir Jim had been “exceptionally clear that there can be no drop-off in activity or reporting” and that there was an “expectation of business as usual regardless of go-live”.

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Source: HSJ, 16 October 2025

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