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

Regionalised spread

Coronavirus spread appears to be persisting at a higher rate in parts of the north of England – prompting warnings that the mortality gap between those more and less deprived will get bigger.

Figures seen by HSJ indicate the covid-19 hospital admission rate in the North West is falling far more slowly than elsewhere, and has been higher than all other NHS regions for nearly three weeks.

The number of new daily cases in North West hospitals (the total of patients who are admitted with confirmed covid-19, and patients testing positive for covid once in hospital) has been around 175 since the beginning of May, and the rate per 100,000 people just below 20.

Hospital admissions peaked only a few days later in the North West than in London, but its rolling-average rate of admissions has now been running higher than London’s since 21 April, and has been diverging while other regions fall.

If it continues it will prove correct those who believe the inequality impact of the virus will get greater as it spreads further, even at the now lower run-rate. West Yorkshire and Harrogate leaders have set out what they are trying to do about it.

The political challenge is that local leaders in areas with more visible spread and impact are proving more wary about loosening the lockdown and changing the message.

Manchester and Liverpool mayors, Andy Burnham and Steve Rotherham, this evening called for government to publish regionalised reports of the covid-19 “R” reproduction rate. Further results from local infection surveys are expected later this week from the Office of National Statistics, but it’s not known whether they will be localised.

Releasing this information would remove the uncertainty, but may also add fuel to the calls for regionalised policy on lockdown. 

Ticked off on testing

The UK Statistics Authority has given the health and social care secretary a ticking off over government’s reporting of covid-19 test numbers and called for greater transparency on how they present the data.

The watchdog’s intervention follows HSJ’s revelations that the government changed the way it counted the number of covid-19 tests in order to hit its target of 100,000 tests per day by the end of April.

UKSA Sir David Norgrove on Monday wrote to health and social care secretary Matt Hancock to outline the concerns.

The letter said: “We urge government to update the covid-19 national testing strategy to show more clearly how targets are being defined, measured and reported.”

As officials move on to trying to implement a “test and trace” model rapidly in a high pressure politicised environment, by mid May, can the temptation for more dodgy counting be resisted?