Daily Insight: Running hot and cold

Splitting elective care and A&E between “hot” and “cold” sites to tackle waiting list backlogs is the conventional view promoted by NHS England.

But Glen Burley, who leads a “provider group” in the West Midlands, believes keeping ringfenced electives on the main hospital site delivers “optimal productivity”.

In an interview with HSJ, the respected CEO of George Eliot Hospital Trust, South Warwickshire Foundation Trust and Wye Valley Hospital Trust said this is a challenge he has set for George Eliot – which only has a single district general hospital.

He told HSJ the way the trust has started doing this is by being “really clear” about which parts of the hospital can and cannot be used, and having “clear ringfenced” areas for planned care.

A number of other trusts have implemented similar single-site split models, including North Devon Healthcare Trust, Croydon Health Services and Norfolk and Norwich University Hospitals FT.

Mr Burley believes patients in hospitals that use elective beds to manage urgent care can end up “in the wrong part of the hospital with the wrong teams and wrong skills”.

His trusts have also set “challenging milestones” to eliminate long waiters from the elective waiting list, with SWFT and GEH aiming to have no year-long waiters by July 2022. The national target for achieving this is March 2025.

It remains to be seen whether Mr Burley can achieve what he has set out to do and any possible impact on other areas of the hospital – but in the meanwhile, he says the response to the unconventional single-site split model has been mostly positive.

NHS suppliers seek Russian exit

Each day brings news of fresh monstrosities perpetrated against the Ukrainian people by the Russian military. Images from Mariupol’s devastated maternity hospital have been especially harrowing.

Companies around the world have been hastening to exit Russia since the invasion began, including NHS suppliers, and pressure is growing on those that have elected to continue operations in one form or another.

Former NHS England chief executive Lord Stevens of Birmingham told us: “The time for corporate fence-sitting and commercial fudging is long since passed. Companies – including those selling to the health sector anywhere else in the world – now have to make a clear-cut choice about whose side they’re on.”

Professional services firms like auditors and management consultants have been involved in Russia for the past 30 years, with some entering the market almost as soon as the Soviet Union fell. They have deep ties and significant operations there employing thousands of people.

But the highest profile firms are in the process of extricating themselves from the country, their continued operation there rendered untenable while the war continues. Some are severing ties completely, others are electing to see out their current contracts but will not take on new work.

By contrast, pharmaceutical firms that HSJ has spoken to are not leaving Russia. While decrying the war in Ukraine, they remain committed as they are “to providing essential health products to those in need” in the country, as one spokesperson told us.