The must-read stories and debate in health policy and leadership.

Most data on hospital discharges is biased against social care and is “useless”, a former chief executive of NHS England has said.

Sir David Nicholson said “almost all” of the data around delayed discharges “is designed to show how bad social care is”.

Sir David, who was chief executive of the NHS from 2006 to 2013, and of NHSE until 2014, added that data on the numbers of patients who “no longer meet the criteria to reside” is “wholly useless” when trying to improve operational performance.

NHSE said the data is being used to inform actions to improve patient flow.

Data published by NHSE shows around one in eight hospital patients are waiting to be discharged – and this proportion has been roughly the same for several months and up from the start of the year.

Delayed discharges are a key factor behind the high levels of occupancy at many hospitals and the resulting long waits for emergency care.

PFI problems

After being outlawed in 2018, private finance initiatives continue to cast a long shadow in the NHS.

Although some schemes have been successful, too many NHS trusts have fallen victim to eyewatering costs, dodgy buildings or both.

Just ask Tees, Esk and Wear Foundation Trust.

The mental health trust needed court action to terminate its contract with PFI company Three Valleys Healthcare Limited after multiple building defects and fire safety concerns were flagged at Roseberry Park Hospital in Middlesbrough.

Four years on, the trust continues to have to fork out thousands of pounds in legal fees, with HSJ yesterday revealing the company’s liquidators have launched legal action against TEWFT.

The liquidators claim the trust owes the company compensation after the contract termination, which TEWFT denies.

In its annual report the trust said it would “rebut” liability associated with the PFI contract, but acknowledged there was a “potential liability”.

The amount sought by liquidators runs to millions of pounds, HSJ understands.

With the trust’s PFI deal with the company described as “extremely complex”, it’s clear that the main winners of this sorry tale will be the lawyers.

Time will tell what the cost to this trust and the NHS overall was.

Also on hsj.co.uk today

In London Eye this week, Ben Clover looks at the multiple reasons why this winter is going to be punishingly hard for the NHS, including the prospect of ambulance and nursing strikes, and the many people arriving at accident and emergency because they can’t get through to 999. And in comment, Peter Walsh, Joanne Hughes and James Titcombe say millions of pounds in litigation payouts could be saved if people were empowered early on to have their care needs met.