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In the early days of the covid pandemic, NHS organisations rushed to make changes to services for commendable reasons – protecting patients, creating pathways which were likely to be covid-free and matching staff resources to demand.

More than five months on from lockdown, some of those changes could start to be reversed in the next few weeks. But some services which have been centralised or downgraded look set to continue in their new forms until next year.

That may represent cautiousness on the part of the NHS in not rushing to return to normal when a second wave of covid could be pending but it is causing concern.

Where accident and emergency departments have been temporarily downgraded, they have often been under long-term threat and, in some cases, have seen earlier emergency changes without public consultation. Campaigners fear that the latest changes could become embedded and hard to reverse.

In some cases, trusts are setting out what conditions need to be met before changes can be made: in others there is no clear map of how this could happen. Expect these to become a hot issue as the months go by.

Uptake uptick?

Health Education England have organised a little additional incentive for NHS trusts to have their staff take up learning disability nurse apprenticeships.

The education body will give employers £3,900 per apprentice on top of the £8,300 for general nursing apprenticeships announced earlier this month.

Learning disability nursing has been one of the worst suffering specialties in terms of workforce numbers across the sector and figures do not appear to be recovering.

This latest carrot has been made in the hope to boost numbers of clinicians trained in treating and supporting people learning disabilities. Expanding this specialist workforce has long been identified as key to improving the quality of services across the board.

The question now is will providers take the bait and push for more LD apprentices?