The must-read stories and debate in health policy and leadership.
Robert Francis QC’s 2013 report into the Stafford hospital scandal found that leaders had lost sight of patient care in their obsession to hit financial targets and become a foundation trust.
The top barrister said in a previous report that finance had become master of patient care, not its servant.
One trust director fears the NHS is now heading back into Mid Staffs territory, as the centre orders trusts to hold down workforce numbers to balance the books. “The tone of the conversation has become intimidating”, they said.
Board papers and senior sources in some areas speak of a “national expectation” to hold staffing flat in 2023-24.
Local leaders complain of mixed messaging from NHS England, which is telling trusts to save on workforce costs while simultaneously increasing numbers in priority areas like mental health and maternity.
The staffing drive comes as the centre grapples with a £3bn deficit but NHSE is also said to be focused on the service’s productivity conundrum – more money and staff, but less activity.
Whatever the explanation, it’s clear that the days of “money being no object” are well and truly over – once again, cash is king.
Feeling the squeeze
Staffing agencies adhering to NHS rules say they are being “squeezed” and “pushed out” of the market due to tight price caps.
The warning comes after NHS England published price caps for 2023-24, which has kept rates the same from the previous year, despite a high rate of inflation.
Representing several agencies, the Recruitment and Employment Confederation has accused the NHS of not “grasping the impact” of the cost-of-living crisis, or why staff choose to work for agencies.
REC deputy chief executive Kate Shoesmith told HSJ: “Commercial framework providers do their best to support the NHS but they are being squeezed, given high inflation rates.
“A lack of movement on pay caps may eventually shrink the framework and thereby force NHS trusts to pay more for emergency staff and go ‘off framework’.”
Ms Shoesmith believes staffing supply has got worse, not better, since agency price caps were introduced nearly a decade ago.
She added: “It has got to be the time for all the relevant bodies to work on this together.”
NHS Professionals, which supplies bank staff to around 100 trusts, agrees and there was some consternation when the 2023-24 rates were revealed.
There could be more pushback soon.
Also on hsj.co.uk today
In The Download, Nick Carding explains why shared care records are essential if integrated care systems are to deliver better care for patients. And in Comment, Lisa Weaks says charities overcome organisational barriers to embed their services, develop imaginative and proactive solutions to local issues and are extremely effective at reaching the community’s most vulnerable members.
