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

Pensions are back on the agenda as the government has confirmed it will go ahead with its intended reforms of the scheme later this year.

Following a major consultation by the Department of Health and Social Care, which ended in early January,  several of the changes that were originally proposed will go ahead as planned.

These include members’ contributions being based on actual pensionable pay, rather than whole-time equivalent pay, and a reduction in the total number of contribution tiers to create a “flatter” structure.

Individuals with pensionable earnings below £26,823 will see their contributions increase, and people earning more than £47,846 will see theirs reduce, while those who are in between could see theirs rise or fall depending on which tier they fall into.

The reforms will set in from October, six months later than originally planned, and be phased in over a two-year period.

It appears concerns raised over how the reforms would impact some staff members’ take-home pay were a factor in the government’s decision to delay.

While the changes have been welcomed, there are concerns about how they will affect lower and middle band NHS staff at a time when the cost of living is rising.

Out of order

Imagine the national outcry if cancer patients were being sent hundreds of miles for care – yet that’s exactly what’s continuing to happen in mental healthcare. And it’s getting worse.

Following a failure to eradicate ‘inappropriate’ out of area placements by April 2021, a key long-term plan target, HSJ  has now been told of national-level concerns over the practice.

Figures show the number of patients in inappropriate OAPs averaged between 600 and 700 in 2019, and after a drop caused by the pandemic in 2020, returned to similar levels through most of 2021.

Trudi Seneviratne of the Royal College of Psychiatrists said covid pressures combined with an underlying staff shortage have created a “perfect storm”, adding that some areas were seeing “unprecedented” numbers of patients sent out of area as a result. Affected trusts include Hertfordshire and Lancashire and South Cumbria.

So will the problem ever go away? Sussex Partnership FT’s chair Peter Molyneux told HSJ one possible move is for ICSs to lead on OAP solutions  by implementing ‘closer to home’ models as standard.

And Dr Adrian James of RCPsych said government needs to start taking mental health seriously, questioning its recent silence on investment in an accompanying editorial.