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

The first job of a trust is surely to ensure the safety of its staff and patients. This includes clinical safety but also environmental safety and minimising the risk from the estate.

Yet Frimley Health Foundation Trust – and potentially other trusts – is being penalised for needing to carry out repairs which will affect the amount of elective work it can do in 2022-23. Frimley will miss the 104 per cent target (based on 2019-20) levels for several reasons – one of which is closure of theatres while work to their roofs are carried out.

The sort of concrete used in the roofs is recognised as a safety risk and a number of trusts face multimillion pound bills each year as they shore them up. This work inevitably leads to disruption to the normal business of hospitals but is surely better than having the roof cave in or facilities having to be closed at short notice: the Queen Elizabeth Hospitals King’s Lynn FT had to close its critical care unit for three weeks last year because of the danger that the roof would collapse.

Given that, NHS England’s insistence on hitting the 104 per cent target in all circumstances seems perverse.

Annnd… relax?

The pressure from the top to relax covid visiting restrictions may be growing but at a local level some clinical leaders are resisting. 

In recent weeks, ministers, NHSE and some patient groups have been calling for more relaxed rules, with health and social care secretary Sajid Javid reportedly planning to “name and shame” trusts not implementing the changes. 

But an NHSE online meeting for clinical leaders on Friday was told that while “a great number of trusts have returned to previous visiting policies… we know there are trusts which haven’t implemented this fully”.

And several people attending the event, posting anonymously, appeared to challenge the current guidance and pressure to permit visiting.

One said: “It is very difficult to safely return to pre-covid visiting as some hospital’s estate can’t safely support visitors in already over-crowded [emergency departments] and increasingly busy [outpatient departments].” Read our full story here.

Also on today

In the latest edition of North by North West, Lawrence Dunhill looks at a potentially tricky leadership issue at one integrated care board, and in The Primer we offer a rapid-fire guide to health coverage elsewhere, including stories on the real picture of nursing supply and demand, racism faced by GPs and the pandemic’s effect on delaying the start of cancer treatment for thousands of people.