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

International finance

Both the contenders for prime minister (and indeed the present incumbent) insist that the UK will open for business post-Brexit.

One NHS trust is already expanding its international ambitions.

Great Ormond Street Hospital is planning to increase its revenue for overseas private patients by 10 per cent in each of the next two years. In 2018-19 it had income of £62.3m from this source – not bad for a trust with a total annual turnover of £500m.

The only trouble is that overseas patients sometimes forget to pay their bills. The trust is now owed close to £50m and its debtor days total (the average number of days required for a company to receive payment) has ballooned from 120 to 243.

Chief executive Matthew Shaw has had to resort to visiting embassies and politely asking when their compatriots might pay up. The trust has also had to set the debt-collectors on Libya.

The trust is now hoping to expand its work into Russia and China – two countries not unfamiliar with complicated (and problematic) financial arrangements. 

Re-boot and re-stock

Simon Stevens issued a stark warning this week that if government does not re-boot the NHS no-deal Brexit contingency plans sharpish, the service and its suppliers will not be ready should the UK crash out of the EU on 31 October.

The NHS boss told MPs the government needed to “push the button on those additional contracts” for transporting and storing vital medical consumables, goods and drugs designed to protect the NHS in the event of a no-deal Brexit in October “within the next several days or weeks”.

He stopped short of saying the varied and complex set out time-consuming actions needed to be done before the conclusion of the Conservative leadership battle on 23 July, but you could sense he was rather keen to get things moving before then.

Not least because a no-deal Brexit in winter would also be a far more challenging prospect than one in spring for which the system prepared for previously.

The service is busier and consumes more drugs, not least flu vaccines, in winter than in spring, Mr Stevens said. To further compound problems, warehouse capacity is also harder to come by in the run-up to Christmas than in spring, and doubtless more expensive.

The costs of re-booting and refreshing the plans will no doubt spiral. But the prospect of disrupted supply chains resulting in patients not getting potentially life-saving drugs is infinitely worse.