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

The seriousness of a trust potentially losing a significant number of midwives ahead of the government’s mandatory covid vaccination deadline was made plain by its chief executive earlier this week.

Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals Trust, said maternity services could be restricted due to a high midwifery vacancy rate and a large number of workers still unvaccinated against coronavirus.

It is a troubling situation for one of the country’s largest maternity services providers as it redoubles its efforts to encourage staff to take up the covid jab before 3 February and 30 March respectively.

Of the trust’s 7,550 staff, about 1,300 – or 17.4 per cent – do not have a vaccination recorded against them. However, the trust hopes a “significant number” of them have had their jabs elsewhere.

Mr Trainer said: “The current numbers, as they are, would pose us quite a significant operational problem for women whose births are booked in from April, which is why we’re having [to put in] such an effort to try and turn that around.

“There’s no easy answer to this other than start training some more midwives five years ago, and it’s a bit late for that.”

Indeed.

Emergency for emergency departments

People will be waking up this morning to more stark figures which lay bare the “appalling” situation in emergency departments.

Data seen by HSJ suggests that 12-hour waits for ward beds averaged at more than 400 per day at the start of the new year – and this is likely to be an underestimate of the official figures released by NHS England this morning.

The leaked data, from “situation reports” from NHS trusts, also indicate that ‘trolley waits’ jumped significantly from November to December.

The Royal College of Emergency Medicine has described the situation in EDs as “appalling” and admitted “it’s difficult to see hope at the moment” amid this sustained pressure.

NHS England said it is “working closely with colleagues in social care” to get people out of hospital safely to free up more bed capacity. It comes as trusts fall well short of an NHSE target on reducing delayed discharges.

Also on hsj.co.uk today

In a double helping of our expert briefings, Recovery Watch says NHS England wielding an axe to quality targets risks normalising poor care, while London Eye examines a mild sense of optimism among the capital’s acute health leaders.