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

There is new uncertainty over the government promise to build 40 “new hospitals” by the end of the decade. This time, it is over who is in charge.

The government is advertising for a civil servant to permanently lead the ambitious programme, which has been hit by delays and rising costs since its inception five years ago.

Natalie Forrest, a senior NHS manager and nurse, has headed the New Hospital Programme as its senior responsible owner since 2021 on a secondment.

The Department of Health and Social Care said it always planned to substantively recruit to the role, and the time has now come. It is unclear whether Ms Forrest will be applying.

Whoever takes on the role will have significant challenges to face, including delivering on a political promise of 40 “hospitals” with the allocated money and stretched market capacity.

They also face the prospect of another shake-up under a new government, with Labour promising to review capital projects if they win the impending election.

External candidates are being offered between £97,000 and £162,000, with an application deadline of 21 January. 

Shots fired in the derogations battlefield

NHS England is facing allegations of succumbing to political pressure and attempting to undermine the ongoing junior doctors’ strike.

In a letter addressed to NHSE chief executive Amanda Pritchard, British Medical Association Council chair Professor Philip Banfield asserted that NHSE is weaponising the process for determining minimum service levels during the strike. The six-day strike, part of a 10-month campaign, is the longest in NHS history.

The BMA accused NHSE of not adhering to the voluntary agreement regarding “derogations,” which permit junior doctors to return to work in the case of safety concerns unrelated to industrial action. Allegedly, trusts are not providing necessary information, leading to the rejection of 20 derogation requests.

The BMA contends that NHSE’s change in attitude is driven by political motives rather than concerns for patient safety.

The letter calls for urgent intervention from Ms Pritchard to ensure the proper use of the derogations process, emphasising that it should be a last resort when alternative staffing strategies fail. The BMA outlines how the derogation process should work, including evidence from trusts that all other staffing sources have been exhausted.

Also on today

An acute trust is facing years of disruption after discovering parts of its building – including cladding – pose a potential fire safety risk. And the NHS has announced it will move to buying energy centrally in a bid to cut costs, although the deal will not be mandated for trusts.