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

Next week’s rail strikes will “probably end up killing people”, a senior NHS leader has told HSJ.

The source, who is closely involved in southern England’s emergency and urgent care services, told HSJ: “Next week’s rail strikes will probably end up killing people because they’ll prevent ambulance trust staff getting to work.”

Ambulance trusts are already experiencing high demand amid soaring temperatures and continuing problems with lengthy handovers at the accident and emergency departments. Fears are now growing that next week’s rail strikes will push services to breaking point as many ambulance staff travel to work by public transport.

Both London Ambulance Service Trust and South Central Ambulance Service Foundation Trust have moved to “Reap 4”, the highest level of alert, meaning they are under extreme pressure. 

Some acute trusts are also experiencing very high numbers of patients at A&E. Frimley Health FT has asked patients to consider alternatives after volumes at both its main sites – Wexham Park in Slough and Frimley Park – increased.

The trust’s new electronic patient record went live last weekend at a time when the trust expected relatively low levels of demand. The new EPR is said to be working well but the trust had anticipated its teams would work slightly slower than usual in the go-live period.

Only in the NHS

The outgoing CEO of an acute trust has said the system of board chairs in the NHS is “weird” and in any other industry would be seen as “mad”. 

Christine Allen of West Hertfordshire Teaching Hospitals Trust said she had been “lucky” with the chairs she had worked with but she knew of other people who had not been.

“You have someone on a part-time basis who has generally not got NHS experience as your boss. That is weird and in any other industry it would be a mad idea.”

She continued: “You have a couple of types of chairs. There are chairs who want to be chief exec – that never works. You have to be very clear about what is operational, and what is more strategic…

In a wide-ranging interview with HSJ, Ms Allen called for better support for healthcare leaders, particularly when it comes to the relationship between chiefs and chairs, as she prepares to retire.

She has led her trust since 2019, having been the fifth chief to be appointed to the trust in as many years. She announced her retirement earlier this year and is due to leave this month.

Also on hsj.co.uk today

Catch up with our extensive coverage from the NHS Confederation conference, where NHS England’s chief operating officer Sir David Sloman has said the proportion of the NHS budget being spent on regulation has “gone too far” and needs to be shifted to frontline services. At the same event, an integrated care system chair has said systems will still face “short-sighted” competitive behaviour from trusts.