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

In March, when NHS England announced its “unprecedented” deal to block book most of the private sector capacity it was pegged as a rescue package for the NHS, which was in the midst of battling covid-19. 

The deal, reported to cost around £400m a month, gave the NHS access to the majority of the private sector’s capacity from June to September. During this period, NHS England and Improvement charged NHS trusts with tackling the backlog of elective care activity which had built up as a result of covid-19.

How much of an impact did the deal with the private sector have on this feat? According to NHS data, leaked to HSJ, the impact was minimal.

Data showed just one third of the capacity across diagnostics, day case, chemotherapy and outpatients was used during the summer.

This is despite rocketing waiting lists for NHS operations over this period.

The big question is why didn’t the NHS use the available capacity? Theories, according to several NHS sources, are poor communication to local leaders over how to use the national route, poor working between private and NHS hospitals, and the NHS being slow to restart elective programmes.

At least 10 private providers were taken off the national contract due to “poor utilisation”, according to NHS England directors. HSJ understands these were largely London-based providers which, prior to the pandemic, did not carry out much NHS funded work. Was it thought that these providers were not value for money? This was the suggestion by some.

What was not advertised when the “unprecedented” contract was announced was how much it will have also benefited the independent sector, which initially would not have been able to carry out its own privately funded work.

Questions over how much private funded activity took place over summer, across private hospitals and NHS private wings, remain unanswered by NHS England.

As the country moves on from covid-19 the NHS is set to face some of the worst waiting times in recent history. With the national contract coming to an end further questions remain over how the NHS can maximise any available capacity from the private sector. 

GPs throw a jab at IT

The NHS doesn’t have the best track record for IT so there is a risk the covid-19 vaccination programme will be no exception to this.

Prominent GPs have raised concerns over the lack of information provided so far on how the IT will work for the local vaccine scheme. The concerns centre on how the “call and recall” systems will work, as NHS Digital has created a national system, while practices are expected to deliver their own.

While practices do have their own systems for the flu vaccination programme, the covid-19 jab has another layer as everyone needs to have two doses – meaning they can’t just use the same software.

Some practices are happy to handle the call and recall themselves, after mistakes were made by NHS England during the first wave of the pandemic – when patients were incorrectly told they needed to self-isolate.

However, others might not have the resources to run their own call and recall system, which could result in appointment backlog elsewhere in primary care.

Director of the primary care network at the NHS Confederation, Ruth Rankine, said the range of IT systems used in primary care will “need adapting to manage the [vaccine programme] efficiently.

She said: “NHS England needs to facilitate the deployment of efficient systems to support PCNs including, where necessary, adequate funding to support this ambition.”