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

If there is one word which stands out from the Care Quality Commission’s report on the William Harvey Hospital in Ashford, Kent, it is “assure”.

Six times in the report on medical wards the CQC says East Kent Hospitals University Foundation Trust was not able to assure itself of elements of infection protection and control such as cleaning and PPE training. There were similar issues raised when it inspected the emergency department.

But if the trust does not have processes to assure itself, then what chance does it have of assuring the CQC it has got a handle on problems? The answer is probably zilch and one of the most devastating lines in the report was that the trust “could not provide assurance as to who was the executive lead for infection prevention and control”.

The long list of failings came after the trust had already been warned about hygiene by the CQC, whose chief inspector of hospitals, Professor Ted Baker, said it was “extremely disappointing” that not enough work had been done since then.

The trust has had a torrid time over the last two years and faces an ongoing investigation into maternity services. NHS England and Improvement may well be looking for much greater assurance that things are improving going forward than this report offers.

Over to you…

NHS England’s deputy chief has said system leaders will take a more localised approach to the second wave of covid and promised to “trust our local leaders to do the right thing”.

Speaking to the NHS Providers conference on Wednesday morning,  Amanda Pritchard commended the actions of regional NHS leaders in their preparation for winter, whom she indicated would now be more involved in big decisions about balancing services.

Stating that a second spike, however, presented “a different challenge” compared to April where there was a “blanket national response”, she said the NHS now had “the ability to think much more locally, much more regionally”.

Ms Pritchard added: “Different places will have different ways of responding to that three-sided pressure [covid, other winter pressures, restoring non-covid services]. Certainly up in the north where we have got peaks of covid… they are already implementing their plans for mutual aid, for moving work around between different organisations to try to protect elective care, and make sure they also have the capacity to support [covid patients].

“Areas in the south are yet to really experience any of that pressure yet but they are ready to do so. It’s back to the heart of collaborative working and supporting each other and, honestly, let’s trust our local leaders to do the right thing.”