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

The overall waiting list’s modest increase to just under 7.6 million is bad optics for ministers but NHS leaders are likely to be more concerned by the long waiters.  

The number of 65-week waiters has risen back to more than 50,000, ending a stretch of six consecutive months when the cohort was falling, NHS England’s monthly data shows.

The 65-week breach group – the cohort system leaders have pledged to clear by September after missing an initial pledge to do so by March – rose by around 1,400 between March and April. The overall list nudged up by 34,000 to just under 7.6 million cases, according to the official data.

The overall list is longer than it was in January 2023 when the prime minister pledged it would be reducing by this stage. Rishi Sunak conceded that the target would be missed earlier this year.

The rise in waiters came against a backdrop of record demand pressure on the service, with statistics published today also showing accident and emergency in England were hit by their busiest ever month in May – with around 2.4 million attendances.

But with a five-day junior doctors’ strike looming at the end of June it does not feel like life is going to get any easier any time soon. 

A second chance for community care?

The NHS can succeed where it failed in the past to shift more care into the community, the NHSE chief executive has claimed. 

Speaking at ConfedExpo this week, Amanda Pritchard said that by incentivising community services, the NHS could improve patient care, shift demand away from the acute sector, and deliver better value for money.

Ms Pritchard acknowledged many in the audience would be thinking: “We’ve heard this before. We tried it, it didn’t stick”, before adding: “You know what? You’re right.”

However, she claimed that the service’s radical shift to system working had created opportunities to make the reforms possible, with a move from “adversarial relationships to unity of purpose and trust”.

She added she was “under no illusions” that some systems “still aren’t there”, and said “through the NHS oversight framework we need to, and will, make it much clearer who is responsible and accountable for what” to provide a “basis for mature relationships”.

The other key “opportunities” for change, said Ms Pritchard, were presented by the long-term workforce plan and the greater use of technology, especially the NHS App.

Ms Pritchard also said: “Our ambition is to be the fastest improving health system in the world, so improvement has to be everyone’s business.”

Also on hsj.co.uk

In The Integrator, Dave West looks at that declaration by Ms Pritchard that NHSE will seek to overhaul contracting to incentivise more care in primary and community care. And we report that the creation of a new community and mental health trust has been delayed for a second time.