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

Most NHS workers are feeling understandably very anxious as 19 July approaches. A large part of this is, of course, down to the creeping covid admissions in various parts of the country. However, concerns have also been raised about infection control and public behaviour once ‘freedom day’ dawns.

Many trusts have taken matters into their own hands and HSJ has learned they will be “100 per cent insisting” members of the public continue to wear masks on their premises.

Many will also be going further and maintaining social distancing, flexible working for those who can and also operating a covid visiting policy in the case of Hull Teaching Hospitals.

As of yet there has been no clear message from the centre on this and Saffron Cordery, deputy chief executive of NHS Providers, has called for national guidance.

She raises the important point that without a “clear steer” it will simply be more difficult to manage patients and visitors who refuse to follow trusts’ policies.

HSJ has learned there could be an imminent announcement from the centre on just this, but until then local decisions will have to be made.

Tech confusion’s fatal consequences

“Widespread confusion” about equipment used in ventilation machines has been highlighted following the deaths of two people at London’s Nightingale Hospital at the beginning of the pandemic.

Investigations ahead of the inquests into the deaths of two men – Kishorkumar Patel and Kofi Aning – are ongoing but a coroner has described a “cluster” of incidents involving breathing system filters.

There is particular concern in intensive care settings – not limited to the Nightingale Hospitals. Thousands of critical care beds were created during the pandemic, with staff from other specialties brought in to help care for patients.

In a prevention of future deaths report, the coroner said both men were involved in serious incidents “in which the wrong filter was found to have been used within the breathing systems of their intensive care ventilator”.

However, full inquests are yet to take place and internal reviews by Barts Health Trust, which ran the Nightingale, have proved inconclusive.

Independent expert advice in the report, sent to the Royal College of Anaesthetists and the Faculty of Intensive Care Medicine, calls for the simplification of the classification and colour coding of the air filters.