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

Our analysis published yesterday reveals the amount of NHS elective work carried out by the private sector in early 2022 was lower in eight of the 10 largest specialties by volume than in a comparable period before the pandemic.

Problems getting more NHS-funded activity done in the private sector have been rumbling since covid arrived. And if it wasn’t for a remarkable doubling in the amount of NHS-funded ophthalmology being seen private, those numbers would look even worse.

We explore the reasons underpinning lagging private sector NHS-funded activity in this week’s edition of our expert briefing, Recovery Watch, titled “Why the NHS isn’t sending more patients private”.

And there are plenty of them. Private providers accuse NHS systems of “making it harder for patients to go private”, while some NHS sources have accused private providers of only being prepared to take on the low hanging fruit, and more interested in the more profitable self-pay work.

NHS England has long acknowledged that to hit the target of 130 per cent of pre-pandemic elective activity by 2024-25, it will need to make maximum use of the 8,000 beds, theatres and shiny kit in England’s private hospitals. The official data suggests there is plenty of room for improvement on this part of the mission.

Troubled trust needs continuity

The Care Quality Commission report on South East Coast Ambulance Service Foundation Trust makes grim reading – especially as part of it reads like a rerun of a 2017 report into the culture of the trust.

Bullying and harassment, inappropriate sexualised behaviour and a “command and control” mentality at the centre all featured in Professor Duncan Lewis’ independent review of the trust. Things seem to have improved under Daren Mochrie’s two year stint as chief executive but then declined under Philip Astle, who stepped down last month after a period of illness.

The CQC rated the trust “inadequate” for “well led”, with a disconnect between the frontline and the boardroom and staff feeling unable to raise issues for fear of reprisals. Will other leaders walk? There are some good people on the board but something has gone badly wrong – and it will be for new interim chief executive Siobhan Melia to figure out what that is and try to put it right.

When the time comes for a permanent chief executive, the need for someone who will stay for at least five years shines out. After an unsettled few years, SECAmb’s staff and the local population deserve more continuity and less scandal.

Also on today

Writing in our comment section, Phoebe Dunn talks about the need to recognise the differences in health of population and size of other challenges between ICSs, and in news we report that fewer than half of the stroke units in England have the recommended number of trained nurses – a drop of 10 percentage points in two years.