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

Storage space

Those feeling their cupboards are long overdue a declutter should perhaps take pity on the approximately 35 trusts which have been left with the unenviable task of finding somewhere to store their clinical waste, including human remains, for up to a fortnight.

Extra containers for temporary storage of anatomical, hazardous and other forms of waste have been installed at hospitals across England, as part of a national incident response ordered by NHS chiefs.

Proposed temporary storage receptacles include compactors, skips, and trailers, although the guidance adds anatomical waste should be stored in refrigerated units at a hospital’s mortuary if it is unlikely to be collected within 24 hours.

HSJ also understands NHS chiefs have initiated the NHS Emergency Preparedness Resilience and Response – which is used for major incidents.

The situation comes after scandal-hit Healthcare Environmental Services stopped collecting waste last Thursday, the day after the company was told it would lose its contract for all waste management services within the Scottish NHS.

The contractor is subject to legal action from the Environment Agency after it was found to have stockpiled up to five times the permitted amount of clinical waste at its depots this summer. 

Service gaps

HSJ’s latest analysis of the state of crisis services for patients with learning disabilities and autism probably comes as no surprise to those familiar with the performance of the national transforming care programme.

According to information obtained under freedom of information requests, almost half of clinical commissioning groups have no short term crisis accommodation designed to help patients with learning disabilities and autism avoid admission to inpatient units.

Equally as worrying, a third of commissioners said they did not have enhanced community services for children with learning disabilities and autism.

The findings come after some high profile scandals within “institution” type inpatient units, which have placed more urgency on NHS England to hit its targets for closing 35 to 50 per cent of inpatient learning disability beds and move patients into the community.

Speaking of that target, HSJ understands only 20 per cent of beds have been closed nationally as of November 2018. 

Why has the transforming care programme failed to meet its requirements? Norman Lamb, who was a health minister in the coalition government, pointed out local authorities are set to take on a considerable financial burden when a patient is transferred out of an inpatient unit, potentially creating a “perverse incentive” to keep patients where they are.