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

Even in times of covid-19 the “50,000 more nurses” pledge is causing trouble for the government. Very senior sources close to the People Plan have shared with HSJ concerns that the first year of the workforce strategy has been “written off” because of pressure the pandemic has put on international recruitment.

Countries, including India and the Philippines, where the NHS recruits most of its international staff, have over recent months put measures in place, including preventing staff from resigning and not issuing exit visas to protect their own workforce.

One chief executive described how some staff recruited by their trust have been unable to tender resignations while others are now without work abroad and waiting to travel over, prompting concerns they might fall into hardship.

It might sound obvious that a global pandemic makes it more difficult for healthcare professionals to travel freely, but the 50k nurses ambition relied on five years of steady recruitment, with overseas staff the biggest contribution overall. The impact of covid-19 will force Health Education England, NHS England and the government to heavily backload staffing plans to hit the target on time.

App seeks good PR

The significance of the contact tracing app rose to a new high this week after HSJ revealed users will be told to self-isolate after a “high-risk” contact with a covid-19 patient, even if they themselves do not have any symptoms.

This marks a change from previous guidance about the app, which – according to the NHS’ own website – stated self-isolation may not be needed if a person is asymptomatic.

The definition of a “high-risk” contact has not yet been set out, but seems likely to include things like being close to someone for a period of time – something which frequently occurs in the NHS.

Thankfully, testing chief John Newton indicated the impact of this on NHS absence rates would be low, but trust executives may still feel nervousness until Professor Newton’s prediction is confirmed.

That same nervousness could also apply to members of the public, who may opt against downloading the app in the fear it will greatly increase the prospect of fortnight’s isolation.

Professor Newton told a webinar of local NHS leaders that a “huge communications exercise” is needed from the government in the next two weeks about the issue. Hopefully, any lessons learned from the controversial communications around testing previously will help in this regard.