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

In his leader article, HSJ editor Alastair McLellan notes that the test and trace programme is a key factor in ensuring care levels are manageable, that a second peak is guarded against and that the economy is restarted successfully.

The rapid scaling of testing capacity is a testament to the hard – and largely unrecognised — work of civil and public servants, particularly those in the Office of Life Sciences, he writes.

“Insiders readily admit in hindsight that the ‘100,000 tests’ target was ‘ridiculous’ but say that without a goal of some sort it would have been hard to create the environment in which both NHS and other actors ‘achieved more than they thought was possible’.”

The ambitious scale of the programme means it has emerged as rather “clunky” but that ambition was necessary to drive its multiple creators to achieve the impossible. Another upside is that the UK will now join many Asian countries in having a dedicated agency or department responsible for combating pandemic threats – which are only likely to increase in coming years. 

Another concern is using spare testing capacity in the most effective way, he says. “There are growing calls for all health and social care staff to be tested on a regular basis. There is some logic to this, as it is already known that asymptomatic staff are behind many outbreaks.

“However, as prevalence falls, the relative impact of false negative and false positive tests increases. As a positive test could lead to entire departments having to self-isolate – as happened in Morecambe Bay – false positives could be disastrous. False negatives, for the obvious reason, could also cause chaos.” Read the article here.

The other NHS waiting list

Throughout the pandemic, the government has attempted to gain the public’s confidence in the idea that when it came down to cash the NHS would get “whatever it needs”.

However, in at least one sense, that does not appear to be the case.

HSJ has discovered, through conversation with several senior sources, that trusts are still waiting for capital funds needed to make their hospitals covid ready.

Modular wards are among some of the projects we’ve been told are on hold, even as lockdown measures begin to ease. While the NHS says these bids are being considered, anxiety is mounting. As one source in the North of England bluntly told us, as they try to ready for winter as well, “we can’t wait any longer”.