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

The NHS often talks about the economies of scale; however, a major provider within the independent sector has recently learnt of the benefits a smaller service can have.

Independent mental health provider St Andrew’s Healthcare runs a children’s and adolescent inpatient service in Northamptonshire. This service was rated “inadequate” in June 2019 and placed into special measures. The provider has also received poor Care Quality Commission ratings for its women’s service earlier this year.

Since then, the provider has reduced the number of beds within its unit from 90 to 30 and has moved the unit to a new building. This comes as part of a wider plan, announced by CEO Katie Fisher, last year to downsize services, to help mitigate serious quality issues.

Following an inspection this year the CAMHS unit was taken out of special measures and rated requires improvement. Although there is a lot of work still to do, says the CQC, the service seems to have improved considerably.

Of course, this won’t all be down to size — the provider also overturned the hospital’s leadership team.

Time will tell if this leads to further improvements within the service.

Four in five systems see covid rise

New data analysed by HSJ shows that the number of covid-positive patients in hospital has risen in 80 per cent of England’s health systems as Christmas nears.

The figures show that the virus is taking a toll on the NHS in nearly all areas. Official local data published by NHS England yesterday shows that for the NHS’ 42 health systems (integrated care systems and sustainability and transformation partnerships), 34 saw the number of covid patients in hospital grow in the week to 15 December, and 37 saw the number of new covid cases in hospital (admissions and diagnosed in hospital) grow in the week to 13 December (Sunday).

For the full data on systems and acute hospital trusts, read Dave West’s story.