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

The shadow health and social care secretary Wes Streeting has “total confidence” in NHS England chief executive Amanda Pritchard, he has told HSJ during a wide-ranging and exclusive interview.

This contrasted sharply with his reported confidence in NHSE chair Richard Meddings, whom the Guardian said on Monday he was “poised to axe”. Labour will look to replace him with a “party loyalist”, the paper reported. 

Mr Streeting declined to comment to HSJ on Mr Medding’s future, despite his ringing endorsement for Ms Pritchard. 

“I’m not… getting into the business of being judge, jury and executioner on individuals who don’t have the opportunity to speak back for themselves,” he said.

Other topics he covered included:

  • Committing to a larger share of the NHS budget going on primary and community services by the end of a first term;
  • Stating that trust CEOs had told him that increasing funding of the acute sector would “be the worst thing” he could do;
  • Arguing that the perception of frontline staff that the service had too many inefficient managers “needed to be addressed”; and
  • Expressing the desire to be health secretary for the entire first term of a Labour government.

Read our interview with more here.

Grating expectations

NHS trusts nationwide are intensifying efforts to achieve substantial efficiency savings, according to an investigation by HSJ.

For example, The Queen Elizabeth Hospital King’s Lynn plans to launch a £30m cost improvement programme in 2024-25, equivalent to 9 per cent of its total expenditure, a significant increase from the £10m saved the previous year.

Facing a projected £3bn deficit among local healthcare organisations, NHSE has imposed new targets for trusts and commissioners. Portsmouth Hospitals and Isle of Wight must aim for savings of 7 per cent and 8 per cent respectively, while Oxford University Hospitals and the consortium overseeing Hull University Teaching Hospitals and Northern Lincolnshire and Goole set a challenging 6 per cent target, described as their most ambitious to date.

East Kent Hospitals, which grappled with a deficit exceeding £100m last year, aims to save £49m, roughly 5 per cent of its costs, surpassing the £13m saved in 2023-24.

In one instance, a Northern trust executive, preferring anonymity, disclosed being offered additional funding to raise their efficiency target to what they deemed an “excessive” level.

Pre-covid, NHS providers aimed for annual savings averaging 4 per cent, often falling short. Now, with temporary financial measures waning, trusts face renewed pressure.

Also on hsj.co.uk

In his final North by North West, Lawrence Dunhill says the array of providers in Cheshire and Mersey is gradually being whittled down as system leaders push for consolidation. And our mythbuster Steve Black reveals the three things that he says matter more than increased NHS funding.