Managing doctors, doctors managing – Nuffield Trust, Dr Alison Powell, Professor Huw Davies
Good working relationships between doctors and managers are critical for the safety and quality of NHS care. Yet recent reports have referred to a ‘gulf’ between the two groups and to the growing risk of clinicians disengaging from management. This research uses a detailed survey of doctors and managers at board and middle-management levels of NHS acute trusts – along with interviews and a focus group – to understand their views on the current state of the doctor–manager relationship in the UK, the pressures it is coming under, how it has changed, and the outlook for the future.

Doctors and managers: a narrative literature review – Nuffield Trust, Dr Alison Powell, Professor Huw Davies
There has been a longstanding policy agenda to improve services and reform clinical work by improving the working relationships between doctors and managers. Although areas of tension between the two groups have always been present, these relationships have been severely tested in the past three decades, which have seen multiple initiatives around quality and safety, successive reorganisations and major restructuring against a background of significant technological, clinical, social and demographic change.

Diabetes UK nursing survey
Diabetes UK has published Diabetes specialist nursing 2016 workforce survey: a workforce in crisis.   This survey found that nearly four out of five Diabetes Specialist Nurses (78%) voiced concerns that their workload is having an impact on patient care and/or safety and almost four in ten respondents (39%) said they considered their current caseload ‘unmanageable’.

State of the NHS provider sector
NHS providers has published The state of the NHS provider sector. This report examines the state of the 238 hospital, mental health, community and ambulance NHS trusts in England. It examines how they are performing, the challenges they face and how they are responding. It combines analysis and commentary, published data and the views of NHS trust chairs and chief executives. It focuses on four key issues: quality and patient access, finance, workforce and transformation.

STP governance flaws causing ‘angst’ and may prevent NHS finance fix – NHE
NHS finance managers have significant doubt about the capability of STPs to be delivered because of concerns about leadership and finance, according to the latest NHS Financial Temperature Check from the Healthcare Financial Management Association (HFMA). The report found that nearly three-quarters of NHS finance managers are concerned…

NICE guidelines
NG58     Coexisting severe mental illness and substance misuse: community health and social care services
NG59     Low back pain and sciatica in over 16s: assessment and management
CG95      Chest pain of recent onset: assessment and diagnosis (Updated)
CG145    Spasticity in under 19s: management (Updated)

NIHR Signals
The National Institute for Health Research has published the following Signals.  Signals are summaries of recently published research.

• Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children
• Aortic valve implantation without open surgery has short term benefits
• How nurses support families of intensive care patients towards the end of life
• Fluoride-based treatments alone are not enough to stop tooth decay in young children
• Some treatments for abnormal cervical cells increase risk of preterm birth
• Exercise therapy may still improve balance when started a long time after a stroke

Provider bulletin: 30 November
This weekly newsletter is sent to NHS trust and foundation trust chairs, chief executives, finance, medical and nursing directors, and foundation trust board secretaries.

HSJ roundup: (contact the library for further details on any of these HSJ articles)

• High profile NHS ‘cyber attack’ may have ‘come from USB stick’  
  A high profile “cyber attack” on a foundation trust appears to have been the consequence of poor practice, rather than an intentional attack on the organisation, the director of a neighbouring trust has suggested.
• Regional leaders plan hospital contract shake-up
  Regional health leaders are drawing up plans to abandon payment by results based on national tariffs and move to a cost and risk based contract for acute providers, along with an STP-level control total.
• Cut locum rates or close services, Stevens tells trusts  
  Trust leaders have been told to close services that cannot be run without paying locum doctors a rate worth more than £150,000 a year.
• Health secretary says STPs unlikely to reduce nurse numbers  
  Jeremy Hunt has told HSJ he would be surprised if any sustainability and transformation plan areas managed to reduce their numbers of registered nurses.
• Hunt: Introducing NHS general management may have been a ‘mistake’  
  Introducing a general “manager class” in the NHS may have been “an historic mistake”, the health secretary has said today.