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

There is a real risk that NHS England’s ambitions to develop an omniscient HR, payroll, finance and procurement system could descend into an omnishambles.

That’s the considered opinion of government watchdog the Infrastructure Project Authority. This week it emerged the IPA had rated NHSE’s all-encompassing Integrated Single Financial Environment as “red”, meaning “successful delivery of the project appears to be unachievable”.

This is a blow for the new, all-encompassing project to replace two finance and HR systems, which has seen development delayed by covid. Its predecessor, also called ISFE and run by NHS Shared Business Services, was due to come out of service in April this year but it has been extended to March 2024 so that its service life ends when the new ISFE comes online.

There is now a big question mark over that plan thanks to the IPA, which reports to the Treasury and Cabinet Office and oversees the compendium of its 185 most complex and significant projects.

The IPA said the new ISFE would have been rated “amber/green” (“successful delivery appears probable”) were it not for some areas “that need to be urgently addressed to achieve delivery”.

And what are those areas that must be addressed, and right quick? There is scant detail as yet but the IPA said they relate to “access to sufficient resource in some key areas such as commercial strategy and project management support”.

Commercial strategy and project management would seem to be rather pivotal. There are fewer than three years before this system is due to come online. Can NHSE find sufficient resources to bolster these functions in time?

If you have an inkling of an answer to that question, or any more details about this seemingly faltering scheme, please do contact us in confidence.

Most difficult period yet

The January to March wave of the pandemic hit the NHS so hard that some may have thought the worst had passed.

However, with covid admission and infection rates rising again, against a backdrop of “unprecedented” emergency pressures and attempts to keep electives on track, NHSE Midlands has warned services could face their most difficult period since last spring.

Although covid-19 deaths and admissions are not yet near levels of the January peak, it is all the surrounding pressures on top of covid which trusts are having to grapple with.

In a letter sent today from NHSE Midlands, local trust leaders were told the region needed to trigger surge capacity for ICU. This appears an attempt to even out the pressures between areas that are experiencing higher admissions, due to lower vaccination rates.

Rising admissions to hospitals in Birmingham have hit headlines in the last two weeks, with the chief executive of Sandwell and West Birmingham Trust warning they were linked to “vaccine hesitancy”.

All trusts will be expected to have 100 per cent capacity for both adult and paediatric care going forward.