Daily Insight: A matter of life, death and the law

An acute trust CEO has warned that leaders could “end up in prison” because of unsafe hospitals after one of his main sites was “pushed to the extreme” during the latest nursing strike.

Matthew Hopkins, chief executive at Worcestershire Acute Hospitals Trust, criticised a lack of communication on 20 December when 18 people were brought into the hospital by the ambulance service, on top of 176 people already in an accident and emergency originally built for just 50.

Mr Hopkins told a board meeting that he and other accountable officers could face manslaughter charges if patients are put in danger by decisions made without senior colleagues elsewhere in the system. 

He said: “I wasn’t able to stop it because I wasn’t aware it was going to happen. I only found out when the divisional clinical director for the urgent care division informed me it had happened.”

After the incident, he wrote to Herefordshire and Worcestershire Integrated Care System to set out his concerns about a “lack of communication”.

He warned this was not a sustainable way of running acute hospitals and that it had impacted staff wellbeing, adding he was particularly concerned about the toll constant pressure is taking on urgent care leaders.

Don’t believe the hype

Official forecasters reckon that inflation, which peaked at 11 per cent this year, will begin to fall sharply next year.

But draft allocations seen by HSJ show that funding funnelled to ICSs – which account for most of NHS England’s budget – will continue to be eroded by rising prices.

ICSs are on course for a 3.3 per cent uplift next year, according to the document, including elective cash and a small pot of covid money that still remains.

London is to receive the lowest increase, at just 2.7 per cent, in contrast to the South West, which will get nearly 5 per cent.

The national rise is above the government’s preferred measure of public sector inflation – which economic commentators have criticised as “unlikely to be a good measure of cost pressures on services, with particular challenges around pay awards”.

The proposed increases will likely be outstripped by consumer price index inflation, which is predicted to be 5.5 per cent in 2023-24.

Against this mixed picture, the figures seen by HSJ suggest recent rhetoric on management cost-cutting has yet to translate into cash reductions: funding for integrated care board running costs will remain at the same level, at just over £1bn.