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

The NHS is extremely anxious about the potential impact of omicron on its hospitals, GPs and community services.

Even if it is milder than its forebears, the fear is the rapid spread will mean a lot of people need hospital care for their infection, albeit a smaller proportion of those who were hospitalised by the delta or alpha variants.

So, this week the NHS centre held calls with local and regional leadership to tell them to start planning for a surge in admissions and mass casualty events in January.

This means identifying areas of hard-standing where they could set up “field hospitals”. This could come with army support, though the NHS has yet to formally ask for this. It also means checking space in mortuaries and identifying non-clinical areas that could be turned into extra ward space.

However, this plan for “lots of little Nightingales” has drawn scorn from local NHS chiefs who point out they are struggling to staff the beds they have now, let alone additional bedspace in car parks and canteens. And that’s before the expected surge of omicron leaves as many as one in three NHS staff self-isolating with the bug.

With any luck, this will all be for nought and merely contingency planning that never gets used. However, as Professor Chris Whitty said to MPs the other week, we have not had a lot of luck so far in this pandemic. For now these remain merely desktop plans. Long may they remain thus.

London feels the heat as absences rocket

Two thousand more NHS staff in London have gone absent due to covid in the past two days, according to internal NHS figures seen by HSJ.

The number of covid-linked absences reported on Tuesday was 6,799, a sharp rise on the figure from two days earlier – 4,700 – and on 14 December when it was 3,375.

Covid had pushed the total staff absences for any reason in the city on Tuesday to 13,653, estimated to be just over 6 per cent of the workforce. The rate will be much higher in particular staff groups, teams, trusts, or providers like GP practices.

The Royal College of Physicians claimed that “more than one in 10 doctors are off work, one in 24 due to covid. In London these figures increase to one in seven off work and one in 13 [respectively].”