Daily Insight: Relationship woes

A governance review of the Cornwall and Isles of Scilly Integrated Care Board has identified some familiar-sounding issues.

“Difficult relationships” with partners, the lack of an “integrated view of performance”, and missing consensus on progress and accountability were just some of the problems identified by reviewers PwC.

The findings will come as little surprise to observers of Cornwall’s NHS, which has been dogged by leadership turbulence and poor performance against key targets for the last few years.

So, what next for this beleaguered integrated care system?

Daily Insight hears the report has been given a lukewarm reception by ICB chiefs, although it has provided a framework to sharpen leaders’ focus.

More than 30 recommendations were made, which the ICB intends to deliver on – but several of the problems in Cornwall run deeper than issues picked up in a governance review.

A severe shortage of care home beds, not enough social care staff, outdated facilities, the increased pressures in summer brought by tourists, a high proportion of elderly patients and deprived areas – these are all the symptoms of Cornwall’s health and care troubles.

Ultimately, these problems will require changes at national – as well as local – level.

The deal is in the details

A deal between South East Coast Ambulance Service and the GMB union means many union staff will work on ambulances and in control rooms during next Wednesday’s strikes.

Others may be asked to come off the picket line if operational pressures escalate under the deal, details of which have been seen by HSJ. 

Some other trusts are hoping to conclude negotiations shortly, but for several – such as in the North West and London – it is thought no strike “derogations” (exceptions) have so far been agreed, and managers are concerned that unions are resistant. Trusts have been pushing for more cover on strike days – especially around category 2 calls.

In the South East, the GMB is the only union striking – both Unison and Unite failed to get 50 per cent of members voting in their ballots – but GMB has the largest ambulance membership and is particularly strong in the emergency operations centre (which takes and triages calls, and manages responses).