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

NHS England’s national clinical director for elective care starkly outlined the conditions the NHS is working under when addressing the Future Surgery 2021 conference on Tuesday.

Stella Vig’s comments, as we reported yesterday, will likely resonate with local managers and clinical staff alike.

She warned: “People talk about the NHS claps, well, now we’re getting the NHS slaps. People are no longer tolerant about what we are doing and they want their treatment because they are getting sicker waiting.”

Miss Vig also pointed out that, of equal concern, was how exhausted, mentally and physically, staff were. The desire to work additional shifts has dissipated. There is simply nothing left in the tank.

Another major challenge the service faces in efforts to tackle the waiting list backlog is validating the waiting list. In a figure which lays bare the clean-up task ahead, Miss Vig suggested around a fifth of patients on the list could be there due to “inaccuracies or duplications”.

She said: “First of all we actually now know who is on the waiting list. For years and years and years [the patient tracking list] has been full of errors. Those waiting lists are still not completely clean, but they’re as clean as they can be… Probably 20 per cent of waiting lists are actually inaccurate and are double counts.”

The government’s elective recovery plan is due this month – and as Miss Vig’s comment suggests it has much to address. You can read more about what the plan means for trusts in this week’s Recovery Watch newsletter, due out today at 5pm. You can sign up for this expert briefing here.  

Conflict is close to home

Details of the dispute between Chelsea and Westminster Hospital Foundation Trust and an integrated care system are not yet forthcoming except that £400,000 has been put aside for its resolution.

Commissioners in the ICS have issued a formal contract challenge to the London provider – which is led by the ICS’ interim chief executive.

The FT’s chief executive Lesley Watts is interim CEO of the North West London integrated care system, which covers the same footprint as the clinical commissioning group and is due to take over its role in April.

North West London CCG said it would not comment on the dispute but CWHFT, which operates from two major hospital sites in the patch, disclosed in its annual accounts that £400,000 had to be set aside for the resolution of the dispute.

A spokeswoman for the FT said that because the £400,000 case was “still being disputed” it could not comment. The accounts said it “relate[s] to challenges on activity recording and charging that it has not been possible to settle by reference to the contract, under which the trust has been entitled to income”.