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

Amid the clapping for frontline health and care staff, spare a thought for NHS estates staff who have pulled out the stops to create space for the safe care of both covid-19 and non-covid-19 patients.

From the delightful job of increasing mortuary space to installing security fencing around oxygen tanks outside hospitals, the pandemic has thrown up some tough challenges.

But are they about to be given their hardest nut to crack yet?

At a webinar last week the NHS’ head of estates – Simon Corben – said the health service needs to renew efforts to reduce its non-clinical space.

Currently, it is estimated around 30 per cent of the NHS estate is non-clinical space. But Mr Corben believes this needs to be reduced to as low as 15 per cent, with the freed-up space repurposed for surge capacity in the event of a second covid-19 wave or severe winter pressures.

Achieving this in the next few months would take the heroics to a new level, and it is hard to see enough space being freed up this quickly, despite mountains being moved across the NHS in recent months.

But, with plenty of hospital building planned this decade, the pandemic has offered a timely reminder of the need for a rebalancing of clinical vs non-clinical space.

Seeing the contract home

NHS Digital is looking for a new external provider to “harden” the management of covid-19 home testing in order to make it “fully resilient, scalable and automated”.

The news comes as home testing is expected to be phased out for some groups and focused mostly on people needing elective procedures in hospitals.

It sounds like a positive step forward for the testing progamme, after home testing proved to be controversial, with concerns about speed and resilience.

There have also been concerns about many home tests not being returned, slow turnaround times and accuracy problems.

More than 20 unnamed companies are currently bidding for the job, which involves supporting the distribution of 30,000 covid-19 swab testing kits and – potentially – antibody tests to people’s homes.

The procurement follows NHS Digital’s appointment as technology delivery partner for the government’s test and trace service, excluding work on the delayed tracing app.

This includes a longer-term piece of work in which NHSD will provide a manual contact tracing system, which entails contacting people who have been around others with covid symptoms and advising them to isolate.

This programme has also been fraught with difficulties, with reports of software issues and tracers struggling to get data from people who have tested positive for covid.