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

Covid vaccination is not the only priority for the NHS this winter: it also has the ambitious target of vaccinating 85 per cent of staff involved in direct patient care against flu. And that looks as if it might be quite a challenge.

By the end of October less than two out of five eligible staff had been vaccinated, according to returns from 80 per cent of trusts. That was well behind last year, when more than half had been vaccinated by the same point. Trusts were quick to disown the figures and insist their positions were better than reported (despite the figures apparently being submitted by them in the first place).

This low uptake presents the NHS with several issues. It will have to work hard to recover the ground lost – not easy when it is also trying to give staff covid booster jabs and help the national covid vaccination programme.

More staff will be vulnerable to flu should there be a bad outbreak this winter, potentially adding to rota gaps. And, in a year when the NHS is trying to persuade the public of the merits of vaccination, it may make this task even harder.

London’s bright lights

Another of the top seats at NHS England jobs is to be filled by one of London’s long-serving leaders.

Sir David Sloman has been appointed NHSE’s chief operating officer on an interim basis, after a recruitment process failed to make a substantive appointment.

Multiple senior sources confirmed Sir David is expected to take over the national COO job from Mark Cubbon, who has filled the role on an interim basis since Amanda Pritchard vacated it to become chief executive in August.

Sir David has been NHSE’s regional director for London since 2019, and before that was a hospital chief executive in north London for 18 years.

The move means that three of NHSE’s most senior executives — chief executive, medical director and chief operating officer — had long recent spells at large London teaching hospitals.

Ms Pritchard was previously chief executive of Guy’s and St Thomas’ FT, while Sir David and Professor Stephen Powis, who is medical director, were at the Royal Free London for many years.

Mr Cubbon was chief executive of Portsmouth Hospital Trust before joining NHSE as deputy COO and director for long-term plan delivery in spring this year.