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

Amid political discontent and many negative headlines, it is easy to overlook the remarkable work carried out in the last six months to dramatically expand the UK’s covid-19 testing capacity.

Starting from a dismal capacity of just 6,000 tests in mid-March, the UK can now process around 250,000 tests daily (excluding antibody tests) – placing her firmly among the leading nations in this field.

But, this expansion would be dwarfed if the government achieves its strategy – revealed by HSJ – to carry out 10 million daily tests.

The aspiration, which was mentioned by NHS Digital executive director Ben Davison during a board meeting, sounds – at best – extremely unlikely to be achieved. Hopefully, it will never be needed if a vaccine can be developed and rolled out in time.

During his comments to the board about NHS Test and Trace, Mr Davison also highlighted a “lack of stable operating model” and a “volatility” in the service’s leadership, with new personnel arriving frequently.

This is not surprising to hear given the newness of the organisation and the pressure it is under to deliver its targets, but it confirms the narrative that the service currently is anything but “world beating”.

Discharging the duty of care

There are growing concerns among senior consultants about hospital discharge guidance that was issued by the Department of Health and Social Care at the end of August.

Very strict discharge rules which were developed in March, when there were fears the NHS would become overwhelmed with covid cases, have been kept in place despite the coronavirus death rate rapidly falling.

Two leading medics, who both have worked as the national clinical directors for older people, said the guidance, if implemented as read, could increase readmissions, disabilities and even deaths.

Alongside this, patient leaflets have been developed that ask families to help care for people who have been newly discharged, including helping them get washed, dressed and fed. It even asks school children to let their school know if they have such caring responsibilities.

The charity, The Patients Association, said this guidance was an admission from the government that it does not have the resources to offer care to all those that need it.

The discharge guidance was quietly released on a Friday afternoon but expect its consequences to be much more attention grabbing.