Daily Insight: A site for sore eyes

“Just give us a decision, either way.”

That’s the plea of one trust estates director waiting on a long-overdue replacement for a crumbling 1960s hospital. Staff at Harlow’s Princess Alexandra Hospital in Essex have to deal with outdated electrics, leaking theatres and overflowing sewage, but a replacement has been pushed back repeatedly and now could be as late as 2030.

In an interview with HSJ, the trust’s estates lead spelled out the day-to-day challenges of running modern health services at a site approaching the end of its life without knowing when a replacement will come. Despite positive noises from the new hospitals programme, the trust is still waiting for formal confirmation from the Treasury that it will get the £825m it needs for its new site.

Michael Meredith said the trust needed certainty and called for an “urgent decision” on funding. He said: “If you go back to risk-based decision making, am I managing a risk up to 2030, or am I managing a risk up to 2040? [Because] I would make very different decisions about how much money I would invest.”

“If we don’t get that [decision] in December, it makes it extraordinarily difficult for us to plan…”

Flower power

Can the NHS emulate the hardy arctic willow this winter? Survive, against all odds? NHS England certainly hopes so.

The health service has been instructed to run “Exercise Arctic Willow” over multiple days later this month; in a letter sent on Tuesday systems and trusts have been told they should prepare for extreme operational pressures, mixed together with potential staff strike action.

ICBs and trusts must use this planning exercise to test how they might respond if staff do decide to strike over the coming weeks; the first indication is likely to be from the Royal College of Nursing, whose ballot closes in a few days.

But, unlike its woody friend, the NHS has limited resources at its disposal if hundreds of staff do work to rule or stop working altogether – as one HSJ reader put it, “Exercise Cancel Operations”.

NHSE warned it was “vital” that local relationships between unions and staff are maintained and stressed pay negotiations “are for the government to lead on”. HSJ also understands engagement is being encouraged with staff members who were involved in the doctor strikes of 2015 and 2016.

Communication with staff and unions will be crucial – and arguably the only thing within the control of the NHS this winter.