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

Is anybody listening?

Many people including the health secretary have applauded the work of the Care Quality Commission in carrying out its new style local system reviews which have looked at how successfully, or not, NHS organisations, local authorities and care providers are working together in some areas.

Since the CQC is no longer funded directly by government grant, but primarily from fees levied on providers, it was clear from the outset that if these reviews were to continue then government would need to pay for them; and direct the CQC to carry out the work. Its current legislative basis does not allow it to review systems off its own back.

That it has had to stop this work is a surprising turn of events, given the widespread focus on system collaboration. Yet a CQC letter to Matt Hancock in November, asking about whether it should continue, received no reply. The CQC has thus been forced to disband its system review team and expert advisory group. There will be no further reviews unless the Department of Health and Social Care puts its hand in its pocket.

What is even more surprising is that a national regulator chief executive can be forced to write to the health secretary and receive no reply. This is either an oversight by civil servants or Mr Hancock is sending a not so subtle message about his view of the CQC and care regulation generally.

Would Simon Stevens receive such treatment? And what does it say about the position of the CQC that it has found itself having to complain to the Commons health and social care committee that it is being ignored by the secretary of state?

Another health check for screening

The latest in a series of investigations and inquiries into cancer screening has been published today.

This time it was the turn of the National Audit Office to examine well-established issues with IT infrastructure, dwindling uptake and impending changes to the bowel and cervical screening programmes.

Next in line will be the former clinical director for cancer, Sir Mike Richards, who has been charged with finding ways to improve the national cancer screening programmes.

He will suggest ways to improve delivery, increase uptake, learn lessons from last year’s scandals, “and modernise and expand diagnostic capacity”, according to the NHS long-term plan, which promised NHS England would “take forward the findings of the review”.

On the basis of the NAO’s work, and reports that came before it, it looks like it could be an extensive and expensive overhaul.