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

‘Small p’ politics

Maybe post-corona it’ll be different, maybe rows about who gets vaccines will supplant it, but for the time being closing an A&E remains the most contentious thing the NHS can do.

The rows over downgrading an accident and emergency department go on for years and bring up the big underlying issues in an area: staff shortages, clinical safety and who is actually in charge.

Medics at Lancashire Teaching Hospitals Foundation Trust took the unusual step of writing to their clinical director, saying the trust had been placed under “external pressure which has resulted in an unsafe decision being taken to re-open the emergency department prematurely”.

The local MP has called for the unit in Chorley to be re-opened but the letter says the timing is particularly bad.

With the trust having a high number of covid inpatients and the health economy currently one of the worst-hit nationally, staff are already stretched. And lack of staff has been the reason for multiple temporary closures of the unit over the years. It was closed again at the start of the outbreak.

Of course, campaigners get suspicious that every temporary closure will end up being permanent.

But the people delivering the service have said it will be “unsafe” and the politicians should respect that, especially with covid rates the way they are in the county.