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


How to produce a 10 year plan in three months? Not with a potentially unwieldy “NHS Assembly”, it seems.

The assembly concept – first floated to HSJ a year ago by Simon Stevens – resurfaced in May, when NHS England and NHS Improvement said it would be used to “help codesign the proposed upcoming NHS 10 year plan”.

It would contain, they said, “among others, national clinical, patient and staff organisations; the voluntary, community and social enterprise sector; the NHS arm’s length bodies; and frontline leaders from integrated care systems, sustainability and transformation partnerships, trusts, clinical commissioning groups, and local authorities”.

Once the funding to underwrite the plan was confirmed last month by the prime minister, officials started chewing over quite how that would work.

Not very well, they clearly decided. And they were probably correct.

The assembly, under reviewed plans, will be assembled after the plan is produced – in November.

Government has been fairly clear it wants the “front line” and clinicians in some way involved in developing the long term plan. There’s a clear case for patient groups to be involved too, and lots of influential people would like to see the plan taken as an opportunity to involve the masses in a debate about why the things they love about the NHS may need to change, and how the relationship needs to change to help it survive and thrive.

The decision has been made that doing an “assembly” would be too big, tricky, and subject to mass lobbying to carry off properly in the available time.

NHS England and government, in discussions with some external forces, are now coming up with their favoured alternative process.

If the assembly is ultimately convened it will likely have a place for those who are heavily involved in the process of developing the plan.

Council stumps up

There has been a huge amount of controversy about dozens of NHS trusts transferring their non-clinical staff into subsidiary companies, especially among unions and opposition politicians.

Feelings have flowed so strongly in Wigan, that the Labour-run council has now offered £2m to persuade Wrightington, Wigan and Leigh Foundation Trust to abandon its well advanced plans.

The offer matches the amount that the trust expected the subsidiary to save in 2018-19, without which it risked missing its control total and gaining access to £8m of “provider sustainability funding”.

The council seems to have recognised that an £8m loss to the trust would mean an £8m loss to the overall health and social care economy.

Male, pale and stale

The NHS leaders of today are less likely to be “male, pale and stale” – with many more women in the top job and a small (but hopefully growing) number of BME chief executives.

But what are the skills needed to lead organisations in the complex world of today’s NHS?

Are the chief executives running mental health, ambulance and community trusts more likely to develop and model these behaviours than their counterparts in acute trusts? And do women chief executives display some of these skills more often than men?

HSJ asked some of our top 50 chief executives these questions in a roundtable debate sponsored by Korn Ferry – and what they do to inspire and motivate their staff at such a tough time.