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

Hancock’s clear blue water

Matt Hancock is still developing his position as new health and social care secretary and used the NHS Providers conference to put more clear blue water between him and former secretary of state Jeremy Hunt.

Asked by Chris Hopson to define his role, Mr Hancock made a very pointed reference to Mr Hunt’s time in Victoria Street saying he had no interest in spending Mondays delving into the details of individual trusts – something Mr Hunt considered a core part of being health secretary.

Mr Hancock instead wants to be an “executive chairman”, setting system direction and leaving the day to day business to Simon Stevens. Whether this slightly hands off approach will survive the winter remains to be seen.

Elsewhere in his video interview, Mr Hancock signalled areas of frustration that he wants to see tackled.

Most interesting among these were his warning that agency staff in the NHS should prepare themselves for another crackdown. Mr Hancock said he believed having an agency worker alongside a substantive member of staff could be demoralising for the staff with more responsibility but earning far less.

What he did not mention was that often agency and substantive staff are the same people at different times of the week, that many agency staff do these shifts on top of their substantive position. As such, the discussions about agency are effectively an extension of the pay debate.

Nurses don’t tend to get rich from this work and medics who do so command significant agency prices because there are not many of them and they are required. Not using them precipitates an even less fun conversation for a minister over whether to downgrade a small hospital.

In one recent employment tribunal, a trust in an isolated area would have been looking at £200,000 a year for one locum, and this affected the amount the substantive member of staff wanted for the role.

Staff wellbeing is one of Mr Hancock’s key priorities, so how succcessful he will be in reconciling these agendas is not clear.

He also told the conference that in preparation for winter, trusts will be expected to hold back elective capacity upfront and to then bring it forward if possible.

Mr Hancock continued his push to improve technology and criticised the “fetish” of piloting everything in the NHS instead of rolling out changes in waves that you alter and update based on the evidence.

Of course, this may work in business and non-safety critical areas, but as many in the NHS will know all too well, when you’re playing with patients’ lives its better to be right but slow than fast and wrong.