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

Migration frustration

Analysis by HSJ has revealed thousands of NHS staff could be at risk of losing their right to work in the UK if the government was to tighten its immigration rules – something the Migration Advisory Commission is consulting on potentially doing.

The current lack of clarity on future migration plans is concerning experts and trusts alike, with worries staff at the lower end of the salary scale and not on the shortage occupation list could be affected.

In particular, the high number of physiotherapists not on the shortage occupation list and earning below £36,700 – a salary threshold suggested by centre right think tank the Centre for Social Justice – jumped out from the data.

Karen Middleton, chief executive of the Chartered Society of Physiotherapy, called on the government to either make sure salaries are increased so they meet future visa requirements or link a salary minimum to Agenda for Change.

These requirements – and the rhetoric around them – don’t just affect clinical staff but all members of a hospital’s team who ensure it runs safely and provides the best care to patients.

As someone who proclaims to love the NHS, Matt Hancock should be lobbying to ensure its current and future workers are protected from any tightening of immigration rules.

The Royal College of Emergency Medicine has far from given system leaders the green light to ditch the four-hour target – but pro-reformers will view comments made by its new president exclusively to HSJ as a significant step in the right direction.

Katherine Henderson, who took up the presidency this month, said the college could support replacing the four-hour target – but only if it was satisfied a replacement regime would demonstrably improve patient outcomes and cut bureaucracy for staff.

This contrasted with her predecessor, Taj Hassan, who warned in January that “scrapping the four-hour target will have a near catastrophic impact on patient safety”.