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

NHS England is seeking “an ambitious and inspiring leader” to be its next chief operating officer. The successful candidate will have no shortage of tasks on their to-do list, with core responsibilities including operational delivery by the NHS in England, leading the oversight and delivery of the long-term plan, and supporting the development of integrated care systems.

The job description and person specification published alongside the ad sheds some light on the sort of person NHSE is looking for. Unsurprisingly, it wants somebody with “recent experience as a CEO of an NHS trust or NHS foundation trust or comparable organisation”.

Amanda Pritchard — who held the role before her promotion to NHSE CEO this summer — used to lead Guy’s and St Thomas’ Foundation Trust, while current interim COO Mark Cubbon is a former Portsmouth Hospital Trust chief executive.

Other “essential capabilities and experience” called for include: a “strong personal commitment to driving improvements in quality and efficiency and delivering transformative change for patients”; a “highly developed political antennae with sufficient EQ to be able to read and understand the motivations of individuals and groups”; and “vigilance in scanning the external environment to anticipate sector and talent threats and opportunities”. The job advert adds that if this could also be somebody who “suspends ego”, that would be great.

The advert promises “delivering the role of NHS [COO] for our NHS will indeed truly be a career-defining experience” (but, should it fall short, the salary of between £161,601 and £191,900 ought to go some way towards offsetting the disappointment).

A crumbling service

“There are many services hanging on by fingernails,” was the response of one HSJ reader to the news that Nottingham University Hospitals has had to restrict chemotherapy treatments because of staff shortages.

It may be true that the NHS’ resources are depleted and the legacy of covid is often being felt in terms of vacancies and staff sickness, but this measure by NUH is deeply worrying and feels like a line in the sand.

The trust has apologised for the “concern and upset” this decision has caused and emphasised a “small number” of patients would be affected and that service limitations would be in place for as short a time as possible.

The public may now be used to news of operations and tests being cancelled, but cancer treatment is another, more troubling level. Being forced to restrict chemotherapy access even to a small number of patients highlights just how pressured this major East Midland acute trust is at the moment.

And this isn’t the only challenge for NUH to contend with; a bad Care Quality Commission report, warnings about poor accident and emergency provision, culture and maternity services, its board (minus its substantive chief executive Tracy Taylor who is off long-term sick), has a huge amount of work to do.