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

What does industrial action mean for the PM’s pledge to reduce the NHS waiting list by next year? That depends on who you ask.

During an exclusive HSJ interview on Monday, health and social care secretary Steve Barclay rejected the suggestion that the pledge could not be met unless pay disputes were settled.

But NHS England’s finance chief was less convinced when he spoke to us on Wednesday. Asked if the NHS could still meet the PM’s pledge, Julian Kelly told HSJ: “We will keep looking at where we get to with total waiting list size. That is going to depend upon what happens in terms of further industrial action… I think that is one for us to keep looking at as we think about planning into 2024 and 2025.”

On the available evidence, Mr Kelly’s would appear the more plausible position. Indeed, the strikes have already forced NHSE to water down a key elective activity target, as we revealed yesterday. 

NHSE has agreed a deal with ministers that will see the “value-based” elective activity target set for the service reduced for 2023-24 from 107 per cent of pre-pandemic levels to 105 per cent.

HSJ understands trusts will be handed a £360m bailout to cover the financial impact of April’s junior doctors’ strike. However, conversations are still understood to be ongoing on compensation for the strikes which took, or are due to take, place after April.

Truth management

An ambulance trust withheld details of care failings from coroners in a number of deaths, a review has found.

North East Ambulance Service was found by an NHSE commissioned investigation to have delayed telling coroners about care failings, omitting key details from reports before eventually disclosing them later on.

The review, which looked at four cases in the 12 months to December 2019, ordered NEAS to make improvements to how it discloses information. NEAS has pledged to do so, and has apologised to the families involved.

In one case, NEAS had not informed the coroner about an investigation into the death of 17-year-old Quinn Beadle in December 2018. An initial report found that the first paramedic to respond should have attempted “full advanced life support” for Quinn, but did not do so.

However, this report was altered to omit these details, following orders from a NEAS “strategy group” which disagreed with the outcome. Quinn’s mother has called NHSE’s review a “whitewash” and called into question the suitability of Dame Marianne Griffiths to lead the review.

In another case, NEAS delayed reaching a man with chronic obstructive pulmonary disease whose oxygen supply had failed as the crew stopped – unnecessarily – to refuel. The man was found dead at home and although NEAS responded to the incident within national guidelines, the family say he could still be alive if reached sooner. Again, NEAS ordered a statement to the coroner from a paramedic to be changed to omit any details of the delay.

While the information was eventually disclosed to coroners, the report criticised the trust for its lack of transparency and how it then dealt with the family’s concerns.

Also on today

Expanding on the lead story above, Recovery Watch looks at NHSE’s “inevitable” watering down of its elective activity targets just a few months into the year. And in Comment, Kate Shoesmith says agency staff deserve more respect than the NHS workforce plan shows them.