Daily Insight: Insular and in the spotlight

A major trust’s leadership style has been described as “insular” by other NHS organisations in an assessment which has emerged amid growing national scrutiny of its performance.

Feedback from other NHS agencies as part of oversight of University Hospitals Birmingham Foundation Trust in the spring, seen by HSJ, says that despite making some improvements, “an insular [leadership] style has perpetuated” and greater progress is needed to embed true and sustainable system working.

It adds that the scale of the challenge facing UHB has stretched the team, with a lack of development of the leadership model. However, it does note that the board has achieved a level of resilience despite covid pressure.

It comes as several senior sources have told HSJ of growing concerns within NHS England and the Department of Health and Social Care about the trust’s performance, and the ability of its current leaders to tackle such problems.

Alongside significant cancer and elective backlogs, UHB has major emergency department performance problems, with repeated requests from the DHSC to improve in recent months, as well as large numbers of long ambulance handover delays – a major national priority. 

HSJ also understands the trust has failed to recruit a permanent chair in the past year, despite two attempts.

Time to make his Mark

“The most challenged organisations across the NHS” will soon be familiar, if they weren’t already, with a new face.

Ahead of a hugely pressured winter, Mark Radford has been hired by NHSE “to work closely with national and regional directors, providers, [integrated care boards] and other partners, including the [Care Quality Commission] and government”, according to an internal announcement. 

Mr Radford is currently chief nurse of Health Education England and a deputy chief nursing officer. He now becomes national director for intensive support and will report to NHSE chief operating officer Sir David Sloman.

Professor Radford will remain a deputy CNO under the arrangement, which comes in advance of the formal merger of NHSE and HEE, expected to be completed in April. He will also remain chief nurse of HEE until the merger is complete.

A new workforce directorate in NHSE, run by current HEE chief Navina Evans, will combine HEE functions and NHSE’s current “people” directorate. A design for this structure is said to be close to complete.