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

There’s no doubt that everyone in and around the NHS pulled together around covid – and the government’s “covid bonus” was meant to reward them for that (and put an end to a series of damaging strikes).

Unfortunately, the bonus has shown up how far the NHS is from one big happy family. Social enterprises – many of whom were spun off from the NHS over a decade ago but provided NHS services – were excluded, as were staff working in trusts’ subsidiary companies and also those working for independent providers who paid Agenda for Change rates.

Then the Department of Health and Social Care backtracked and said that such bodies could apply for funding to make payments to members. But the criteria – which were published last week – seem onerous. To qualify, staff must have Agenda for Change terms and conditions with no deviation. And their employers need to have been in financial dire straits at some point in the last 18 months or so.

The issue seems far from buried: some union members are striking in protest while bodies like Social Enterprise UK are calling for equal treatment with NHS bodies, who were given the bonus money without question.

Same day, different results

Leaked data has shown that a third of acute trusts are doing proportionately less of their emergency activity in “same day” services.

This is despite “same day emergency care” (SDEC) services being central to NHS England’s urgent care recovery plan.

The data reveals for the first time how trusts’ SDEC services are performing.

It shows that while there was a small increase in SDEC use across the country in the last year, at 40 trusts there was a relative drop.

Several trusts said the data did not capture the full range of their SDEC activities. More standardised SDEC performance data is expected next year.

NHSE said it remains committed to expanding SDEC services. 

Also on today

The NHS should focus less on buying big IT systems and more on standards, interoperability and design, according to Mike Bracken, the architect of an acclaimed major UK government digital transformation, who is interviewed in this week’s The Download. And in Comment, Dr Charlotte Augst and Paul Corrigan explore the stark reality of the current healthcare challenges, dissecting policy failures and proposing how to reshape patient-professional interactions.