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

Some good news?

The latest workforce data has revealed a rare glimmer of good news about nurse staffing levels, with the number of nurses working in mental health and community sectors showing year on year growth for the first time in almost a decade.

At the same time, the number of adult nurses continues to rise, reaching record levels of 182,000 in October 2018 – the highest level since 2009.

So, finally some positive news on workforce growth at a time when shortages are all we seem to hear about.

The level of nurse vacancies in the NHS is still at more than 40,000. But - counterintuitively - this is also good news. Bear with us: Alongside the record levels of recruitment, it means providers are being upfront about their needs. In the past, trusts predicted fewer staff were needed, ignorant of real growing demand and complexity.

A significant point to note – these increases in nurse staffing levels are still being dwarfed by those increases in demand both inside and outside hospitals. So, you will be unsurprised to hear, while the numbers are welcome, they are not enough.

Plan B for Bedford

When Luton and Dunstable Hospitals Foundation Trust first announced it was acquiring Bedford Hospital Trust in September 2017, it raised some eyebrows – not least because it said the merger would be done and dusted in six months.

Fast forward 17 months and it is still dragging on, with the acquisition having been pushed back twice over funding.

Luton and Dunstable has asked for £150m of capital ahead of acquiring its smaller neighbour. NHS England told it in December that it had failed in its latest sustainability and transformation partnership bid for funding.

A spokeswoman told HSJ that NHS England and NHS Improvement were “exploring other opportunities for capital funding for this particular merger project”. Without it, the whole merger may be doomed.

And a trust board paper revealed it was already making plans in case the merger does not go ahead.

It leaves the future of the Bedford trust unclear - it long ago said it was not sustainable alone. Is it time for the region, now formally an integrated care system, to scramble together a plan B?