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

Six more trusts have dropped into the “tier 1” group for the most challenged providers for their elective or cancer performance.

James Paget University Hospitals is now in tier 1 for both cancer and electives, having previously been in tier 2 for both categories.

Milton Keynes University Hospital, Lewisham and Greenwich and Portsmouth Hospitals University have been escalated to tier 1 for elective performance, while Liverpool Women’s Hospital and Northern Lincolnshire and Goole have been placed in tier 1 for cancer.

There are now 26 trusts in “tier 1” — the group of England’s most challenged providers, receiving extra assistance and oversight — for one or more of elective, cancer or diagnostics, up from 23 trusts in the last quarter of 2023–24.

But in better news, 12 trusts have been released from the tiering system — including two large providers that were previously in tier 1.

Newcastle upon Tyne Teaching Hospitals was in tier 1 for both cancer and electives, while University Hospitals Bristol and Weston was in tier 1 for cancer.

You can see the full lists of those in the tiering system and those de-escalated in our story here. 

About turn

General election season is hotting up and Labour has made some headlines already.

Shadow chancellor Rachel Reeves has U-turned plans to reintroduce the pensions lifetime allowance, which unions warned could trigger an “exodus” of senior clinicians, according to the Financial Times.

The about-turn was reported over the weekend as the proposal is expected to be dropped from the party’s election manifesto due to be published this week.

It comes after chancellor Jeremy Hunt abolished the allowance — the amount any individual can save into their pension across their lifetime before incurring tax — during his first Budget in early 2023.

The move was aimed at encouraging high earners, including senior NHS doctors and some managers, to return to the workforce or continue working. The allowance had been blamed for causing some to retire early or reduce their hours.

Ms Reeves vowed to reverse the change, which came into force last April, describing it as “the wrong priority, at the wrong time, for the wrong people”.

However, that has since changed.

Vishal Sharma, chair of the British Medical Association’s consultants committee, welcomed Labour’s move to scrap the plans.

Also on hsj.co.uk

Patient leadership champion David Gilbert offers his thoughts on the recent infected blood inquiry report, and our Mythbuster Steve Black explains why the NHS needs to make tough financial decisions now to create funds for crucial long-term improvements.