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

Planning guidance and allocations

You’ve enjoyed the long-term plan, now get stuck in the short term clamour. A more fullsome version of the planning guidance – expanding on the pre-Christmas preview – has been published this afternoon by NHS England and NHS Improvement, as have five-year commissioning allocations. Follow for full details soon.

Not FITting in

Cancer screening was something of a lightning rod for controversy in 2018, particularly after the NHS and Public Health England unearthed what they thought was a major crisis in their breast screening programme. 

And 2019 hasn’t exactly got off to a great start, either. This week, HSJ reported the long awaited new technology for the bowel cancer screening programme has again failed to materialise.

If trial data is right, faecal testing should increase the rate at which people take part in screening. This, in turn, should mean the NHS diagnoses more cancers sooner, a priority of the long-term plan.

The national screening committee first said in 2015 that having FIT in England’s national screening programme would be a good idea. The government tried, but failed, to get the necessary kit and software in 2016. It had hoped a second procurement attempt would have borne fruit in time to start rolling out the new test in the autumn.

Alas, the contracts have yet to be completed and the diagnostic tools yet to be distributed, although NHS England is confident it will have everything signed and sealed by the end of the financial year.

But all the recent noise around screening means the National Audit Office is looking into all the national screening programmes, including bowel cancer, while former national cancer director, Sir Mike Richards, is leading a review of all the national cancer screening programmes.

The auditors are scrutinising programme governance and management, as well as IT systems, and will be reporting in “early 2019”. Sir Mike is looking into all aspects, and will be making recommendations for the NHS to overhaul their screening programmes.

Whether they cast eyes over FIT procurement remains to be seen, but screening controversies are unlikely to go away in the near future.