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

For those of us who live on the outside of the NHS it can be hard sometimes to remember that the health service is not a monolith. The revered blue and white logo is probably the most recognisable branding in the country alongside the venerable BBC but it is attached to a wide variety of organisations and institutions that the initiated know are quite distinct from one another.

At times those different components can come into conflict.

Yesterday, the NHS medical director Stephen Powis announced that NHS staff in areas of the country most hard pressed by covid will be soon routinely tested even when they do not have symptoms.

This is a welcome advance in a fight against a virus that spreads asymptomatically and has caused a sizeable number of nosocomial infections. But it does also present a bit of a challenge as to who will do the additional testing. This has brought the national testing service and the NHS to something of an impasse.

Logically one might expect the staff’s own trusts would do the tests but NHS labs have little by way of spare capacity to meet the additional burden.

Professor Powis instead said the tests would be carried out by the national test and trace service, which is famously presented under the NHS brand as NHS Test and Trace although it is actually a Department of Health and Social Care initiative.

But the test and trace system has barely any headroom to provide these tests. It could do it, but it would have to cut back on testing other groups who want tests, a source told us – mostly the general population or care home staff.

Calling for a champion

Government ministers have been accused of being “evasive” over a major report on patient safety.

Tory peer Baroness Julia Cumberlege, who chaired the Independent Medicines and Medical Devices Safety Review, said it is “not sustainable” for the government to delay its response any longer.

The review, which spoke to hundreds of women who suffered avoidable harm from surgical mesh implants, pregnancy tests and an anti-epileptic drug, criticised the NHS for a “a culture of dismissive and arrogant attitudes”, including the unacceptable labelling of many symptoms as “attributable to ‘women’s problems’”. In response, it called for an independent “patient safety commissioner” to be established.

In an exclusive interview with HSJ, Baroness Cumberlege said there is a “void” in the crowded field of regulators for a patient safety champion, and described feeling “diminished” by what women are still going through to get their concerns taken seriously.