Daily Insight: They want millions but Saj offers change

It was arguably brave of Sajid Javid to make a sweeping hour-long speech about health and care reform, without any real new reform announcements, to a sector which is already somewhat tired of hearing about how a wide array of reforms might solve its growing problems – the biggest being a lack of staff.

The health and care secretary then capped it all off by saying that the workforce plan he has commissioned will not actually receive any new funding above current spending plans. Thereby dashing most of his audience’s hopes of some staffing solutions, having elevated them just slightly above the gutter only a few weeks ago.

It did however fit with one of Saj’s core messages on Tuesday: a clear statement that while he knows there are severe cost pressures in health and care from multimorbidity and innovations and so on, he doesn’t think the NHS can go looking for extra funding growth.

So instead, he looks to reform. The trouble is, health and care leaders and managers have been pulling many reform levers for years, especially around integration and collaboration.

Mr Javid’s most eye-catching and disruptive ideas – creating “academy trusts” and overhauling general practice employment – were excised from the speech, or smoothed out so they fit in with the current direction of change, though we can expect them to return one day soon.

Still not sorry

Things will always go wrong in the NHS.

But when they do, leaders need to investigate properly, accept what’s happened, apologise and put robust actions in place to address the problems.

After the fallout from Mid Staffs and other scandals, most organisations do try to take this approach. But some are still stuck in the dark old days of dismiss and deny.

The response from The Christie Foundation Trust in January to an external review into bullying and cultural concerns was particularly jarring.

Despite the review vindicating many of the concerns raised by whistleblowers, the trust issued a bullish response listing numerous “inaccuracies” and characterising the concerns as being limited to a “small number of staff who are dissatisfied or aggrieved”. It did not thank the staff for raising the issues, nor apologise for the experiences they had.

However, HSJ has now learned that NHSE is trying to ensure the trust issues a public apology.

At a meeting with some of the whistleblowers on 11 February, David Levy, regional director for NHSE North West, said he was “shocked” and “frankly a bit angry” at the trust’s response, saying it reflected badly on the organisation, HSJ understands.

Regional director Amanda Doyle is understood to have said she was “absolutely surprised” and “the way they responded actually gave credence to some of the findings in the report… they were defensive and dismissive”.

They said they were in ongoing discussions about ensuring an apology, and the implementation of an action plan.

A month on from that meeting, there has still been no apology from The Christie, which refused to comment when approached by HSJ.