The must-read stories and debate in health policy and leadership.
You would have thought that collation of different overtime rates for consultants covering strikes across England – the better to help trusts know what to pay their senior medics – would have been in place ages ago.
Certainly before three bouts of industrial action by junior doctors had taken place.
Nevertheless, only now is NHS England responding to “concerns” from trust leaders and trying to collect the data to inform whatever action it decides to take.
What this reveals is that NHSE and by extension, health and social care secretary Steve Barclay and chancellor Jeremy Hunt do not actually know how much the strikes are costing the service to cover.
Three strikes in, and with widespread confusion as to whether providers should pay the British Medical Association’s significantly higher “rate card” or not, central policy remains unclear.
Why not a national policy? Because the different deal consultants get across the country varies dramatically. One senior leader told Daily Insight that trying to address it was “opening a huge can of worms”, which might lead to significantly higher costs.
With more junior doctor strikes announced for next month, the issue is a live one.
Whether trusts can expect consultants to accept one overtime rate for strike cover (the BMA-set one) and a lower one for regular overtime also remains to be seen.
Pipelines, not targets
The government’s drive to build 40 “new hospitals” by 2030 has seen multiple twists and turns over the years, including over what schemes count towards the total, and the order of builds.
The head of this national programme has now set out her vision for how new hospitals should be built in the future.
Natalie Forrest exclusively told HSJ she wants to move beyond political commitments and targets, such as the “40 by 2030”, being the driving force.
Instead, she would like to see the NHS create its own structured pipeline of hospitals that need replacing, and tick them off as it works through the list.
“There shouldn’t be a special group that are getting rebuilt, and everyone else has to watch from the sidelines,” she said.
It comes after Mr Barclay announced a rolling programme of capital investment in the NHS beyond 2030, although the details of how this will work are yet unclear.
Ms Forrest said: “What we don’t want is for us to have to stop building hospitals because it’s not on anyone’s political agenda. It should be what we do. That’s why it needs to be driven by the NHS.”
Also on hsj.co.uk today
Amanda Pritchard’s speech at the NHS Confederation was full of positive thinking, but empty of priorities, in contrast to a recent report that clearly spells out what ails the NHS and how to remedy it, writes Steve Black. And in Comment, Julia Chain says that aftershocks from the pandemic are standing in the way of some people trying to have a baby.
