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

Winter is coming

The government recently unveiled fresh plans to help tackle the pension crisis gripping the health service, but fears of its effect are still mounting as we head into winter. 

Most recently, the leader of the emergency medicine profession warned doctors would be cutting their hours, leaving emergency departments unable to fill shifts. 

Katherine Henderson, president of the Royal College of Emergency Medicine, said: “Given the sheer complexity of the scheme, and the confusion around what this additional flexibility means, we fear many consultants will ‘play it safe’ and continue to reduce their clinical commitments to avoid any financial risks this taxation issue brings.

“This means rota gaps will worsen as winter arrives, patient safety will be compromised and patient flow will worsen.”

This is a winter, of course, which may be preceded by a no-deal Brexit (with its potential impact on staffing, supplies, and social care).

It may also – more tantalisingly – be home to a general election, which will sharpen the focus on performance and care standards.

A survey by the RCEM, shared exclusively with HSJ, found more than three-quarters (77 per cent) of respondents were considering cutting down their clinical care commitments. Nearly everyone they asked (98 per cent) believed the current rules would have a detrimental effect on patient safety.

When approached about RCEM’s stark warning, the government stressed it has released “comprehensive” proposals to help senior clinicians manage their pensions more effectively with increased flexibility.

NHS England and Improvement, too, are still concerned and thought to be pushing government for further concessions; yet it’s hard to see anything making a difference for the winter coming.

Bennett’s back

David Bennett, the former boss of the competition regulator Monitor, has turned up as chair of Virgin Care, HSJ revealed on Friday after it was quietly posted on the company’s website.

Mr Bennett led Monitor for five years until the former foundation trust regulator joined with the Trust Development Authority to form NHS Improvement in 2015.

The former McKinsey director has taken over the role from Graham Eccles. Mr Eccles was chair for nearly a decade and has left to “explore new opportunities”, the company told HSJ. The progress of his replacement will no doubt be closely watched.

Mr Bennett, who was also an adviser to Tony Blair when he was prime minister, joined the company this month. Virgin Care provides a range of community, public health, primary care, and some specialist services for the NHS and local government.

During his time at Monitor, the organisation was due to be set up by the Health Act 2012 as a fully fledged competition regulator. Mr Bennett drew attention at the time for indicating the NHS could receive a similar approach to that which had earlier opened up public gas, electricity and telecommunications markets. 

Virgin Care tends to prefer to remain in the shadows whenever possible, so if Mr Bennett still holds such views they will probably be hoping he doesn’t shout them too loudly.

Mr Bennett was also involved in early negotiations over the 2014 Five Year Forward View and subsequent funding settlement.