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

Last week NHS England boss Amanda Pritchard set out plans to ramp up the health service’s autumn booster vaccine programme.

But now NHS staff working on the vaccine programme are voicing concerns that the needles they have been given are “not fit for purpose” – and could place vaccinators and members of the public at risk.

Issues relate to the SpikeVax vaccine produced by Moderna – the first to target both the original and the omicron strain of the virus. It is due to play a key role in the NHS’s autumn covid vaccination booster programme.

Staff forum messages seen by HSJ reveal widespread concerns about the syringes, variously described as bendy, flimsy and poorly designed.

One pharmacist said: “Our problem is that it is very hard to remove bubbles from syringes. We are wasting a lot of time and doses on this.”

“They just are not fit for purpose and as such we are not using them and are using the original needles until a solution is found,” another manager added.

The UK Health Security Agency, which procures the needles, said it was monitoring the situation. In the meantime, staff have been told to use alternatives.

Region’s integration question

With integration the buzzword in the NHS, look to Somerset for a sense of where the health service might – very slowly – be heading.

From April  there will only be one NHS trust in the entire integrated care system, which will run acute, community, mental health and a significant slice of the county’s primary care services.

Throw in the fact that Somerset County Council and the county’s four district councils are all merging to form a new unitary authority, and suddenly there are very few organisations to squabble over money.

It’s no wonder that Somerset and Yeovil foundation trusts chief Peter Lewis – whose two organisations are merging – believes “different solutions” will be open to the ICS compared to many other health economies.

However, Mr Lewis told HSJ their ability to fully unlock the potential benefits will be limited without national changes to GP contracts and funding streams.

He said current funding mechanisms meant objectives are not always aligned across the services that would benefit from integration and cash streams should be consolidated.

Making such changes would be a big ask given the NHS’s present challenges, but it’s surely a debate that is needed.

Also on hsj.co.uk today

In an opinion piece, Sally Gainsbury and Polly Mitchell highlight the need to tackle the “first come, first served” reality in the health service. And this week’s edition of our Health Check podcast asks why cash levels are three times higher than before the pandemic and whether this money will help trusts cope with final pressures.