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

Third quarter update

Another year, another big provider deficit.

NHS Improvement’s latest forecast for 2018-19 suggests a year-end deficit of £661m, against the planned £394m.

And the forecast would have been worse, at £917m, were it not for a fortunate accounting adjustment relating to two Carillion hospitals which have been brought on to the government’s books as “part-donated assets”.

The actual year-to-date position after the third quarter suggests a slight improvement on 2017-18, but significant deterioration on 2016-17.

It’s all a far cry from what Ian Dalton and NHS Improvement committed to back in February 2018, when the regulator said it would deliver a breakeven position for the sector.

While the drive for integration is clearly a major factor in Simon Stevens’ looming takeover of NHSI, the failure to make better progress in clearing the deficit was surely also a factor in Mr Dalton’s imminent exit.

New chief in town

The Nursing and Midwifery Council’s new chief executive Andrea Sutcliffe has set out her vision for the regulator and is determined to ensure the NMC takes a more nuanced view of care failures involving nurses.

In particular, her comments around highlighting wider issues is a welcome step given the repeated failures of all regulators to spot and take action on systemic issues. For too long, professional regulators have been too individualistic in their approach, with doctors and nurses finding themselves crushed by a system that ignores the environment they were forced to work in.

All power to Ms Sutcliffe’s elbow as she looks to transform the NMC.