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Working from home has been a hot topic since Jacob Rees-Mogg started leaving missives on civil servants’ desks saying he was sorry to have missed them. So NHS England is rather late to the party in telling staff they will normally be expected to work at least two days a week at their “contractual office base” from April.

Managers in Partnership was annoyed that no consultation took place before this was announced although NHSE now plans to work with unions on implementation – which should allay fears around areas such as clinical vulnerability and disabled employees.

But staff are still likely to have qualms – varying from longer commutes for those who have moved out of London to who will walk the lockdown dog. HSJ’s comments section has buzzed with those pointing out office space has been reduced, teams may be spread over multiple sites and the pointlessness of travelling to simply sit on Teams calls which could be done in the comfort of their own homes.

Life for many has changed irrevocably over the last four years – often in a way they regard as positive. NHSE may need to find a fudge to keep everyone happy.

Gap year

Speaking to HSJ at the conclusion of the 2023-24 planning round, NHS finance boss Julian Kelly said he had “more confidence” in the health service’s spending plans than he had in the previous 12 months.

As the end of the financial year draws near that optimism may have been misplaced.

NHS trusts and commissioners are on course for a major deficit this year, according to analysis of board papers.

Even after NHSE injected £800m into the system back in November, the final deficit could be as high as £1.5bn – three times the year-end deficit in 2022-23.

HSJ collated figures for 33 integrated care systems and found 13 have now formally admitted they will miss the financial plans they drew up at the start of the year.

This has seen some areas revise their deficits upwards significantly and others move from forecasting a balanced budget to predicting major deficits.

Blame for the eye-watering financial gap cannot be laid at the BMA junior doctors’ committee: these figures largely exclude the costs of industrial action in December and January. If the Treasury doesn’t step in, the number could rise further.

Also on today

In Following the Money, Henry Anderson reveals the full list of NHS funding pots that have been left vulnerable in the wake of November’s financial reset. And we report a patient safety commissioner’s comments that senior leaders are resorting to “ticking the duty of candour box” instead of developing a “just and learning” culture in their organisations because their bandwidth is full.