Dear secretary of state, 

Protocols for future announcements affecting NHS trusts

On Friday 5 June, two announcements on the use of face masks in hospitals and on visiting policy were made without proper consultation with, or notice to, NHS trust leaders. Both have a significant operational impact and have followed similar announcements where frontline leaders feel they have had no notice of, or input into, key decisions affecting their organisations, patients and staff, including:

• the original lockdown announcement of 23 March which contained instructions on which NHS staff should leave work immediately to go into isolation
• a series of tactical announcements changing the approach to testing NHS staff and patients during April
• the announcement of NHS test and trace on 27 May including the potential need to isolate whole teams of NHS staff with immediate effect if a team member was contacted by a contact tracer
• the announcement of a change in approach to shielding for shielded patients on 31 May.

In all of these cases, due to the lack of engagement and forewarning, these announcements were followed by a difficult period in which NHS frontline leaders had to seek rapid clarification so they could understand the impact of the proposed changes and implement them effectively.

As an example, detailed guidance on the use of face masks in hospitals was promised in the announcement on 5 June but trusts have only received this guidance today, 12 June, a week later, despite being asked to commence implementation on Monday 15 June. This is deeply frustrating.

Frontline NHS leaders are rightly expected to lead their 800,000 staff professionally and to ensure the provision of outstanding patient care. But this can only be done if they are properly consulted on decisions you want them to implement, they have timely notice of any major changes of policy, and detailed implementation guidance arrives when it is needed.

Trust leaders recognise that in the early days of the pandemic, decisions and announcements needed to be made at pace and they were happy to accept this. However, the NHS has now stabilised and trust leaders are therefore keen to return to normal protocols, unless there is an exceptional reason not to.

Could you therefore confirm that you are happy to do all you can to ensure that, as has usually been the case in the NHS:

• trust chief executives are properly consulted on the content of major changes and on the details of any announcement that affect them, including implementation date timing
• all trust chief executives have as much notice as possible of any announcement and, as a bare minimum, they are provided with a copy of the announcement at the same time it is made public, for example placed on a public website
• all trust chief executives are provided with Frequently Asked Questions and other supporting material as quickly as possible after any announcement to enable them to answer legitimate questions from staff, patients and local stakeholders
• any detailed guidance is made available in a sufficiently timely way to enable effective implementation within the announced implementation deadline.

Trust leaders also want much greater advance visibility of what is coming next operationally in the response to coronavirus. To give one obvious example, trusts know that they will need, at some point, to regularly test all their staff but are still completely unclear when this important change, with far reaching operational implications, will be made.

As ever we stand ready, as the membership organisation of NHS trusts with all 217 trusts in membership, to assist you in the task of involving trust leaders in these decisions.

We recognise that some of the detailed work here is the responsibility of arm's-length bodies and executive agencies within your Department’s area of responsibility so we have copied this letter to Sir Simon Stevens, Amanda Pritchard, Baroness Dido Harding and Duncan Selbie.

We are also releasing a copy of this letter to the media and our colleagues in similar primary care, social care, clinical and commissioning representative organisations.

Yours sincerely          

Chris Hopson                             Saffron Cordery
Chief Executive                          Deputy Chief Executive