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

In an apparently unprecedented move, NHS England has asked all acute trusts to audit their medical staff to better understand the specific workforce gaps the health service is facing.

NHSE said this exercise was linked to getting elective work back on track, amid concerns staff shortages in certain trusts and systems are holding back service recovery.

In a letter sent by NHS national director Pauline Philip, trusts were told the centre would use the data to identify action that could be taken to “maximise” workforce availability.

There has been speculation this could mean staff are moved around the system or services are redesigned, such as asking services where medical gaps mean they are no longer sustainable to merge.

But other theories include that it could be used as evidence to take to the Treasury to bid for more funding for workforce in the spending review or even to target further private sector support.

The precise motives remain unclear, but this exercise reveals quite how dire the situation is when it comes to oversight of workforce supply.

But, with Health Education England also undertaking its own scoping work to gain a better understanding of long-term workforce demands, the NHS workforce is now firmly in the spotlight.

On the naughty step

It’s one thing to be placed in NHS England’s “recovery support programme” — the latest iteration of the special measures regime — but four health systems now hold the unfortunate accolade of being placed on the regulator’s naughty step before even officially coming into existence.

The four integrated care systems — Devon; Lincolnshire; Norfolk and Waveney; and Shropshire, Telford and Wrekin — have been deemed to require “intensive mandated support”. This is despite ICSs having not yet been made statutory. 

Devon in particular will likely be keen to shake the label quickly, having a long history of regulatory oversight and previously been part of the “success regime” (2015’s version of special measures). 

Alongside the ICSs, 16 trusts have also been placed in the programme. Twelve of these were already subject to the old special measures regime.

The four new joiners are:  University Hospitals of Morecambe Bay Foundation TrustHillingdon Hospitals FTMedway FT; and University Hospitals Plymouth Trust. HSJ has previously reported on the problems facing the four providers.