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

After stepping back from plans to cap public sector payments at £95,000, following backlash from unions, ministers have quietly tightened procedures around NHS payoffs instead.

Government guidance, published without announcement last month, has outlined the criteria public sector employers must consider when using special severance payments.

The rub is that all offers must have Treasury approval – either verbally or in writing – while exit packages above £100,000 will need ministerial say-so.

Government officials have stressed the need for special severance payments to be “value for money,” but it comes across as a direct response to shelving those legislation plans earlier on.

Right person for the role

The expected appointment of Dr Amanda Doyle as the regional director for the North West could signal a change in how NHS England is working.

Not only is she a clinician, but she is a long-serving GP and advocate for primary care.

And after practising for 20 years in one of the most deprived wards of the country in Blackpool, she will also be extremely well-informed when it comes to thinking about the underlying causes of ill-health.

Her appointment will be welcomed by many who believe the health system is overly focused on the acute sector and needs to pay far more attention to what’s happening outside the hospital walls.

From refugee to telemedicine pioneer

Dr Waheed Arian escaped from Afghanistan in 1999 and travelled to the UK, without his family, as a 15-year-old-refugee.

His remarkable journey over the following decades took him through numerous jobs, including a stint in Portobello Road Market, doing part-time A-levels and winning a place at Cambridge University to study medicine, and then working in the NHS as an A&E doctor and running a global telemedicine charity.

Dr Arian was also named as one of HSJ’s 2016 ‘rising stars’ and awarded a ‘highly commended’ by the judges.

Since then, his telemedicine charity has gone from strength to strength, becoming even more pertinent during the covid pandemic, when global health inequalities are more stark that ever.

On this week’s HSJ Health Check Podcast he reflects on how a dangerous bout of TB contracted as a child ignited his ambitions to become a doctor and how simplicity is often overlooked when launching a new digital venture.

We also discuss the impact on the NHS workforce’s mental health over the pandemic and how the NHS needs to quickly get better at looking after colleagues suffering from PTSD.

You can listen to HSJ Health Check here, or subscribe on Spotify, Apple Podcasts, Amazon Music, and all the other popular podcast platforms.