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

NHS England is rapidly increasing its requirement of trusts. According to latest guidance, trusts are now expected to carry out internal investigations each time a patient is suspected of contracting covid while in hospital.

They must also use nationally reported data to analyse local infection rates and review them on a daily basis.

It might come as a surprise to some that full investigations were not carried out before, but it is clear the centre is particularly concerned about spread of the virus within clinical settings.

Regional teams and integrated care systems can also expect to play a bigger part in the control of the virus; “outlier” trusts will be subject to regional investigation.

An area NHS England is less firm on is staff testing – non-symptomatic staff should only be tested if they have been working in situations where this is “an untoward incident or outbreak of high prevalence”.

This is despite growing pressure, including from the Labour party, for routine regular testing of NHS staff.

Lessons still not learned

Today HSJ revealed that the NHS has kept secret dozens of external reviews of failings in local services – covering possible premature deaths, unnecessary and harmful operations, and rows among doctors putting patients at risk.

This unwillingness to share findings goes against Bill Kirkup’s recommendations following the Morecambe Bay scandal in 2015. 

His review said that trusts should “report openly” all external investigations into clinical services, governance or other aspects of their operations, including notifying the Care Quality Commission.

Today’s HSJ story shows that at least 70 external reviews by medical royal colleges were carried out from 2016 to 2019, across 47 trusts, according to information provided by NHS trusts.

More than 60 of these have never been published – contrary to national guidance – while several have not even been shared with the CQC and other regulators. These include reviews which uncovered serious failings.