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

The handling of media requests by the health service – rigid at the best of times – has been tightened substantially over the last year.

NHS England imposed a command and control structure at the start of the pandemic which meant requests and answers to questions all had to run past them, with a central team in London determining much of what could be said.

HSJ has frequently heard private frustrations around this, and concerns that local organisations were struggling to get timely messages out to the public. But naturally, there is a reluctance to put those sorts of sentiments on the record.

However, in a setpiece interview about wider issues, Sir Richard Leese, the chair of Greater Manchester Health and Social Care Partnership and leader of Manchester City Council, was asked how he was working with the NHS generally.

Without hesitation, he said: “NHS England’s approach to communications is truly dreadful. They don’t like telling people things.

“We took the view that having a fully informed public might have helped us tackle covid, but that’s not the view we got from NHSE.”

This was refuted by NHSE, whose medical director Professor Steve Powis tried to rubbish the claims as “obviously not correct”. It also provided a list of around 80 media requests in the north west that were approved during a key period last autumn.

However, Sir Richard’s comments appear to have tapped a well of frustration among our readers, with dozens of comments expressing support for him.

One reader, who said he is a trust chief executive, said: “The man is bang on. I had to seek permission from national comms to even break wind during the first and second waves, and the lack of respect for local judgement produced tears of frustration at times.”

Another said: “Despite NHSE denials, Sir Richard is right. Comms professionals in trusts and CCGs were tied in knots in having to go up and down the line for approval from NHSE, which damaged our relationships with local media and our local authority comms partners. Lessons need to be learned.”

Image problem

England doesn’t have nearly as many scanners per head as its European neighbours. When the kit is there, trusts are often short on the staff needed to operate it. And these shortages can be deadly. Coroners, who write to organisations when an inquest reveals other patients might be at risk, have been warning the NHS about the risks of low-imaging capacity for years, an HSJ investigation has revealed.

By digging through three years of Regulation 28 reports – where a coroner deems that action must be taken to prevent future deaths – HSJ has found almost a dozen examples highlighting dangerous equipment and staffing shortages. And many more reports revealed other problems: delayed reporting of results, poorly kept notes and software issues, to name just a few.

Although almost half of the reports concerned deaths at a single site – Tameside General Hospital in Greater Manchester – this is very much a national problem. The Royal College of Radiologists has been warning about staffing pressures in England for years. And without enough staff to perform scans and interpret the results, scanning equipment is useless. It takes time and concerted financial investment to build a more resilient and sustainable workforce.

When asked about the coroners’ reports, NHS England said it’s bought a raft of new equipment since 2019. But it didn’t say a word about staffing.