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

The rapidly spreading omicron variant is a nightmare for the NHS, arriving just before the NHS’s busiest period and potentially driving a wave of admissions and staff absence.

But the extent of its threat does not end there. Its increased ability to infect those with two vaccine shots or less risks undermining the NHS’s covid infection prevention and control measures.

NHS England IPC lead Mark Wilcox told local clinical leaders on a webinar this week the NHS had been “lulled” into a sense of security over the summer by the levels of immunity created by the vaccination programme.

Omicron is set to burst that bubble, he suggested, and would mean IPC measures would have to be applied with an “assiduous attention to detail” if the service was to avoid a dramatic increase in hospital-acquired covid infections.

With patient-to-patient infection the commonest route of covid spread in hospitals, Dr Wilcox said the NHS would have to be more robust with those being cared for who declined to wear a mask for non-clinical reasons.

“There’s a difference between [it] not being possible [to wear a mask] and not being liked — one is acceptable and the other needs to be addressed,” he said.

A more varied CV

The NHS in London is often (rightly) criticised for being overfocussed on its big-brand teaching hospitals, meaning community, primary and mental health services can be overlooked.

Current regional director Sir David Sloman came to the job following a long stint at one of those hospitals, but his (temporary) successor has a more varied background.

Andrew Ridley has led Central London Community Healthcare Trust for the past five years and his organisation operates in most corners of the capital, following years of gradual expansion.

This will give him insights into how the different integrated care systems are working that few other provider chief executives will have.

Well-regarded in the system, Mr Ridley has run a region before — the south back when there were just four sub-national tiers above all the clinical commissioning groups and trusts.

He also spent five years in leadership positions at Tower Hamlets Primary Care Trust, and was part of the team that took it from typical inner-London dysfunction to one of the best-regarded primary care systems in the capital.