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

In a few years’ time we will likely see a deterioration in the “cancer outcomes” for the UK because of the delays in treatment and diagnosis this March, April and May.

The term “cancer outcomes” means more people will have died than would otherwise, and others will have died sooner – lives lost and lives cut short.

That’s not to point the finger - decisions had to be taken on what to suspend and what to keep running as covid-19 in hospitals peaked.

But if urgent treatments for cancer dropped 60 per cent then the rest of the picture on cancer is probably even worse.

We can only hope NHS England’s odd reluctance to disclose how many patients got a deferred referral in this period, or even where its new “cancer surgery hubs” are up and running, is coyness rather than it not actually knowing.

There is optimistic talk near the top of the NHS office of the elective waiting list not building up an insurmountable backlog (as appears numerically inevitable) - on the prediction that for some time people won’t want to be referred into potentially dangerous hospitals. And indeed referrals were so restricted during March and April that the total list has fallen and the recovery of referral rates so far appears slow.

This seems unlikely with cancer.

How quickly services can be restored to anything like pre-pandemic levels remains to be seen.

And on emergency care…

“So on these data the 2014 NHS Five Year Forward View  is delivered. Right?”

So asked one Twitter health policy wag of the news that May saw emergency department attendances and admissions down by about 40 and 30 per cent respectively.

That was a little up from April - the month most affected by the covid peak and lockdown measures - but still leaves a long way back up to normal.

PHE data today also shows attendances up to last week at about 80 per cent of normal, and flattening off rather than still growing. While some are worried about those still not coming in, some ED doctors are happy with the lower activity, and feel they are seeing those they need to.

Over in the ambulance service, May data shows there’s been a significant uptick in “see and treat” - services dealing with patients at the scene rather than conveying them to hospital - another long-term ambition for service reform.

As with planned care, the million dollar question is whether a big chunk of demand will stay away for good, or otherwise, how quickly will it return?