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

Getting people who are medically fit to discharge out of hospital has been a Gordian knot for NHS managers for decades.

But once again the pandemic has given new impetus to finding solutions for a problem which affects patient flow throughout the hospital – and ultimately leaves ambulances queuing outside accident and emergency.

The NHS England demand to discharge at least half of patients who are medically fit to leave comes with the promise of money attached – both to assist with discharges to everything from social care beds to hotels and with virtual wards, which might avoid the need for admission in the first place.

A new national taskforce bringing together the NHS and local and national government will focus on the action needed to drive progress.

It will be led by Sarah-Jane Marsh, chief executive of Birmingham Women’s and Children’s Hospitals Foundation Trust. But although there is pressure to do as much as possible by Christmas, there does not seem to be a date by which half of the relevant patients should be discharged.

Releasing some of these beds will undoubtedly help the NHS cope with covid cases and relieve pressure on other parts of hospitals and the ambulance services. But where people still need a care home bed or support in their own home – or in a hotel room – will the staff be available to provide this, given the issues social care faces?

Omicron marches on the capital

Omicron was on course to be the dominant variant in London yesterday, according to the capital’s public health director Kevin Fenton.

The highly transmissable omicron variant has taken the greatest hold in the city, with admissions of covid positive patients to hospitals there having risen by 30 per cent.

In the seven days to 11 December, 981 covid patients were admitted to hospitals in the capital, the highest total since late February.

In most London boroughs, at least 30 per cent of their over-12 population have not received a single covid vaccination.

Covid admissions are now rising in all seven English regions. Nationally, the seven day total has reached 5,219, a return to the level seen a month ago. The week on week increase of 12 per cent is the steepest since late October.