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

Coronavirus update

NHS England set out a six-week action plan and priority areas for the restart of a raft of non-coronavirus services on Wednesday.

The tone of the orders was understandably cautious. Hospitals were told to “release and redeploy” capacity back from being ready for covid-19 patients, to space suitable for other care, “over the next six weeks”.

But it warned it would be “prudent [to] retain extra capacity that has been brought on line — including access to independent hospitals and Nightingale hospitals”.

This is partly because the service must remain braced, the letter says, for a rebound in emergency admissions, which have fallen drastically in recent weeks, and also because the threat of another covid surge remains.

The first peak is passing, but the threat remains high and the service on high alert. 

Looking specifically at the capital, the NHS in London is heading for major reorganisations born from lessons already learned from the pandemic. It is clear the health service cannot be in this position again, where either it must set up from scratch a critical care unit in a conference centre or have patients dying in corridors for want of a ventilator.

That conference centre critical care unit, the Nightingale, will have a role to play in the coming reorganisation, its chief executive said this week. It will care for the covid patients while London’s trusts reorganise themselves to provide covid-free sites. And it will provide an insurance policy, a tested model that can be scaled up should the cases started to climb again. But above all, it has to be temporary.

Turning to finances, NHS England and Improvement last month set out new guidance for paying suppliers and services during the pandemic. It highlighted that suppliers were at risk with the associated economic downturn so reliable payment times for services and goods were vital to keep the procurement machine moving.

A month later, the regulator has doubled down on this advice, strongly advising trusts and commissioning groups to pay invoices in seven days of receipt. In peacetime, the target for invoice payment is 30 days and many trusts have, historically, failed to hit that objective. 

With finance teams reorganised to focus on cash flow among other areas, can the NHS meet this stricter deadline?