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

The government appears to have seen off the threat of consultant strikes over December and January after the British Medical Association agreed to put a new pay offer to its members.

This would see an additional investment of around 3.5 per cent put into the pay scale structure for consultants, on top of the 6 per cent headline increase already implemented for 2023-24.

The offer will now be put to BMA members, with an agreement that no further strikes will be called during that consultation period.

There was no announcement on junior doctors, for whom leaders will hope a similar deal can be reached in the next fortnight.

As had been feared, however, the announcement has angered the Royal College of Nursing, which officially remains in dispute over the 5 per cent uplift given to nurses for this year.

Chief nurse Professor Nicola Ranger said: “Nursing staff will be appalled by this announcement and where it leaves them. The government has shown it has the political will to reform pay for some of the highest earners in the NHS – while our members are left with the lowest pay rise in the public sector.”

Further problems down the road appear likely.

Death by edict

Productivity is the flavour of the day, with Amanda Pritchard defending the service’s record while almost everyone else believes there’s a problem.

The health service faces historically stretching savings targets as it struggles to deliver more hospital activity, despite large staffing increases during the pandemic.

Despite this, HSJ has learned that an NHS England review of efficiency plans, announced last summer, never made it past the initial stages.

Jeremy Townsend, an NHSE non-exec, was set to lead an “efficiency stocktake” looking at the centre’s role in driving savings, in part driven by a perceived reputation for inefficiency among ministers.

Proposals for the work penned by the ex-Rentokill finance boss were obtained by HSJ.

They admit local leaders were likely “overwhelmed” by the number of edicts from head office, which is “very good at generating ideas” but does not have clear processes to evaluate efficiency programmes in a structured way.

Mr Townsend, who has since become interim CFO at Marks and Spencer, added that “a lot of the initiatives… lack the buy-in from frontline staff that is needed to make changes stick”.

The stocktake was delayed by the NHSE merger and then rolled into the chancellor’s review of public sector productivity.  

Also on hsj.co.uk today

Inadequate training for NHS managers highlights a pressing need for mandated and high-quality leadership training to enhance patient care, writes Anthony Painter. And in West Country Chronicle, Nick Carding’s FOI request reveals why the purchase of advice and guidance services by three clinical commissioning groups went so badly wrong.