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We’re always looking ahead at HSJ, well nearly always, and thus we give you two new op-eds considering what life looks like for NHS leaders on the other side of the general election.

Not to preempt anything - the polls are narrowing, so we’re told - and a lot of this might look surprisingly similar whether it’s Conservatives or Labour in charge.

In the first of a new weekly column from our comment editor Andy Cowper, he outlines the huge challenge the health sector faces in getting government to listen to it and take seriously its challenges, chiefly the funding predicament.

Meanwhile, senior bureau chief Dave West argues there is a signficant risk for the NHS of tumbling into another top-down structural reorganisation, the Tories having said they are open to major change in their manifesto. 

U-turn if you want to

The latest mea culpa from NHS Improvement today, which acknowledges it got its advice wrong over implementation of new agency tax rules. Somewhat curiously it comes two months after the new rule came into force. 

NHS Improvement said: “Our priority is to help encourage NHS providers to ensure that agency staff pay the correct tax. Today we have published updated guidance on the IR35 rules, which amends our previous guidance to trusts and ensures that there is no ambiguity in what trusts are expected to do.

“Trusts should not assume that all agency staff will fall inside IR35; they need to assess whether or not the IR35 rules apply on a case by case basis.

“Our updated guidance encourages trusts to seek expert advice or approach HMRC in cases of ambiguity. We hope this will contribute towards trusts taking steps to ensure that agency staff pay the right amount of tax and the same amount as NHS staff doing exactly the same job.”