Daily Insight: A complete one-eighty

Rehab plans retracted

In late May, NHS England/Improvement announced the “first” Seacole Centre in Surrey to care for patients recovering from coronavirus.

And although it was never described as a full national strategy, the implication was that more units could be created in other parts of the country.

In the North West region, for example, NHSE/I asked leaders to draw up proposals for up to 900 recovery beds dispersed across multiple localities, to replace, for a potential future peak, the “unsuitable” and largely unused Nightingale facility in central Manchester. 

It was suggested capital funding was available to build new modular units or repurpose existing buildings.

The idea was to have the units in place in time for winter and any potential second surge of covid cases. However, the lack of any formal plan and the tight timescales involved made some leaders doubt whether the idea was realistic. 

As it turns out, they were right to be sceptical. 

HSJ has learned that capital bids for new Seacole units have now been rejected by national leaders, with funding seemingly knocked back by government.

Instead, NHSE/I said: “Work with local NHS and social care providers suggests that these expanded rehab services can largely be provided in existing physical facilities as well as people’s own homes, so government has not allocated extra capital in-year for this purpose.”

It said there is £500m of additional revenue funding to help do this, along with other post-discharge care.

Whether this will be enough to cope with winter remains to be seen, but there’s no doubt some local leaders would have preferred the security of knowing there was always going to be spare bed capacity.

One trust director in the North West said: “These new units made absolute sense with our A&E issues every winter, social care even more fragile than usual, and covid coming on top.

“But they’ve done a complete one-eighty [degree turn] now. It’s wasted loads of effort, planning and thinking, with no plan B.”

Ministers to be marked

Patients are now accustomed to seeing purple-branded signs dotted around trusts and on the walls in GP surgeries explaining just what the Care Quality Commission thinks of the provider’s performance.

Yesterday the Commons health and social care committee raised the tantalising prospect of something similar gracing the desks of government ministers, or the foyer at Skipton House.

Jeremy Hunt’s committee is setting up an independent panel of experts to scrutinise the government’s work and publish reports grading their efforts with the same ratings used by the CQC (outstanding, good, requires improvement and inadequate).

The first policy area to fall into the sights of the new expert panel is maternity services. The committee will assemble its first panel in the autumn.

The select committee announcement made no mention of whether a minister would be put into special measures, but the inquiry will be one to follow closely, nevertheless, after serious problems in Shropshire and Kent — against a history of safety problems in that service area.