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

While the South West region was the least affected by covid-19 in terms of hospital deaths, the impact on clinical services has been more consistent with the rest of England.

Diagnostic and theatre capacity has been severely reduced, while cancer treatment and some urgent elective work has been transferred to covid-19-clean facilities. Such facilities include many private hospitals, which struck a deal with NHS England in March to put almost all its capacity at the NHS’ disposal.

As the dust from covid-19 starts to settle, local health chiefs are keen to maintain access to the private sector’s capacity while restoring elective services carefully.

In Devon, senior leaders told HSJ they were making a “strong case” for the national deal to be extended. The county’s sustainability and transformation lead Philippa Slinger said keeping the deal in place was necessary in order for the NHS to “offer any reasonable activity of non-covid-19 related care”.

NHS Providers echoed this. Its chief executive Chris Hopson today warned of a “real risk” of health services being overwhelmed this winter if the government makes the “wrong decisions on funding NHS capacity for the rest of the year”.

On Monday afternoon, NHS England’s Sir Simon Stevens and Amanda Pritchard confirmed they wanted independent sector beds on stream — although adding that the nature of the deal will change quite a lot — and said discussions were active with government about it (a similar ask is outstanding about paying for keeping the empty Nightingale hospitals going, they indicated).

Clearly the Treasury will have to decide whether to foot the bill — along with other asks, such as capital for its own new beds — and decisions are expected in the coming days.

Facing up to BAME needs

The Black Lives Matter movement and covid-19 have put “pressure” on white leaders to act on inequality and discrimination in the NHS, according to trust chief Navina Evans.

Dr Evans, who is set to become Health Education England’s new chief executive in the autumn, also told HSJ the health service must stop looking for reasons not to confront the issues faced by black, Asian and minority ethnic people.

It comes as events in recent weeks and months, including the killing of George Floyd in the US, have sparked anti-racism protests in the UK and across the world.