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

Staff like porters and cleaners played an important part in the NHS’s battle against covid – and some lost their lives – so one might assume they would share in the Agenda for Change lump sum of at least £1,655 paid to most NHS staff; which ministers said was in recognition of efforts during the pandemic.

However, those low-paid groups have had the most difficulty accessing it. While full NHS AfC employees got it in their pay packets last summer, those working for social enterprises, private firms and trust subsidiary companies — who tend to be support staff — had to wait until last month for their eligibility to be confirmed. Not all will have qualified because of the requirement their pay was “dynamically linked” to Agenda for Change. 

Now another group has been left out in the cold – staff at Barts Health Trust who moved from Serco to the trust a few weeks after 31 March 2023 – the date to qualify for the bonus. NHS England has been blamed for refusing Barts’ submission to be allowed to pay staff who had no control over the date their employment transferred, which in turn cited the terms set in government guidance. 

Staff not on AfC employed by some facilities companies are also ineligible.

It’s left many of the lowest paid staff without a bonus enjoyed by their peers whom they may have worked shoulder-to-shoulder with throughout covid.

Unintended consequences

Trusts could be exposed to increased negligence claims because of updated NHSE guidance for a serious spinal condition, a royal college has claimed.

The guidance issued by NHSE’s Getting It Right First Time programme said emergency MRIs for suspected cauda equina syndrome should be taken within four hours of requests to radiology. Where this is not possible, standard operating procedures involving local spinal and radiology services should be in place for urgent out-of-hours scanning.

However, the Royal College of Emergency Medicine, understood to be the only clinical body not to endorse the guidance, said in a statement last month that “few EDs, outside of tertiary centres, have access to 24/7 MRI scanning”.

Adrian Boyle, RCEM president, said: “The GIRFT pathway advocates a substantial, but unquantified increase in MRI scanning. By setting this standard of care without the increase in scan availability, this may have the unintended consequence of increasing litigation costs”.

NHSE said the GIRFT guidance has been endorsed by 11 clinical and patient bodies, including the Royal College of Radiologists and the Spinal Injuries Association. It added the guidance has been “positively received” since it was released last year.

Also on today

In the north, Richard Barker, NHSE regional director for the North East and Yorkshire and the North West, has announced he is retiring after four decades in the health service. In the south, it has emerged Ashford and St Peters Foundation Trust chief executive Julie Smith left the role suddenly early last month, saying she wanted to focus more on her family and education. And, in the capital, this fortnight’s London Eye examines some of the big impending changes facing services and their providers.