Daily Insight: Full-strength Coffey

How long Therese Coffey remains in power remains to be seen amid the leadership turmoil engulfing the government, but it hasn’t stopped her from making some significant decisions.

One of these was revealed by HSJ on Friday, when it emerged she has ordered a speeding-up of the merger between NHS England and NHS Digital.

Originally planned for completion at the end of this financial year, Ms Coffey has now ordered health chiefs to deliver the merger by early January – a deadline one source close to the process described as “challenging”.

The reason for the change appears to be a combination of bringing forward some savings, providing more certainty for staff and – perhaps – a desire by the new secretary of state to speed up the opportunities to make NHSE’s decision-making more digitally led.

But the project, led by NHSE’s chief delivery officer Mark Cubbon, will need to ramp up several gears to meet Ms Coffey’s deadline, and rushing through a complex merger of two bodies involving thousands of staff does not come with risk.

The NHS has already lost a lot of talent through previous restructures. It cannot afford to unnecessarily lose more this time.

A state of shock

The chief executive of the Care Quality Commission has called for “a long-term, sustainable funding solution” after the regulator revealed that a quarter of high-risk services it has inspected recently required enforcement action.

Speaking at the launch of the CQC’s annual State of Care report, Ian Trenholm said this level of intervention was a clear sign that “services are genuinely struggling to cope at the moment”.

Examples of action taken against NHS trusts in the last year included enforcement measures placed on Nottingham University Hospitals, University Hospitals Sussex, and Princess Alexandra Hospital.

The regulator turned to risk-based inspections during the pandemic, which it has described as an “appropriate and proportional” approach during continued pressures on the NHS.

In response to a question from HSJ about the robustness of the CQC’s inspection regime following further care quality and safety scandals, Mr Trenholm said observers should not focus solely on the ratings given to trusts by the CQC as there was a lot ”work going on in the background, whether that’s enforcement or otherwise”.

In the State of Care report, Mr Trenholm and CQC chair Ian Dilks wrote that the health and care system is “unable to operate effectively” following the pandemic, and without action “services will be further stretched and people will be at greater risk of harm”.