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

The expiry date on some batches of the Pfizer covid vaccine supplies has been extended to 45 days, following concerns that large quantities would be wasted.

Last week, a leaked memo revealed large supplies delivered to local centres before Christmas had not been used and were set to reach their expiry date within two weeks.

But following negotiations with Pfizer and the Medicines and Healthcare products Regulatory Agency (MHRA), NHS England has told local leaders the shelf life for around 20 batches of Comirnaty [the brand name for the Pfizer vaccine] can be extended from 31 to 45 days.

The letter, signed by Dr Emily Lawson, who leads the vaccine programme, and Dr Jonathan Leach, the programme’s medical director, said Pfizer had indicated there was “no impact to product quality” by extending the shelf life by 14 days.

One well-placed source welcomed the shelf-life extension, saying it “should stop almost all wastage”.

It comes amid ongoing controversy over the lack of suitable vaccine supplies being sent to poorer countries. Whether Pfizer now looks at extending the shelf life for all its supplies to enable a better global supply remains to be seen.

Many managers are of little matter

Research finding no significant relationship between the number of managers or the amount spent on management and the quality of NHS hospital services unsurprisingly sparked a welter of reader comments below our story yesterday.

Researchers at the London School of Economics studied the performance of all 129 non-specialist acute trusts between 2012-13 and 2018-19.

They measured hospital performance on five indicators covering financial position, elective and emergency waiting times, level of admissions and mortality.

This was then compared to the number of managers each trust employed and the amount spent on management staff.

Reviewing the evidence they analysed, the LSE team state: “We find no evidence of an association between our measures of quantity of managerial input and quality of management… Furthermore, we find no associations between our measures of quantity of management input and five measures of hospital performance.”

They add: “This holds, irrespective of how we define managerial input, whether by number of managers or expenditure on management. These results are generally robust to how we account for variation between hospitals and within hospitals over time.”

One reader said: “At the operational coalface you’ll probably find management v stretched, but 1-2 steps removed you’ll find it better resourced.”

Another wrote: “Once you go beyond a certain number of managers you may get diminishing returns in the current environment, especially when managers have little influence on staffing levels. Even the manager who is smart at writing business cases for extra staff doesn’t get the reward as it has been government policy to cut the number of training places for most clinical staff groups.”

Also on today

Lawrence Dunhill examines the impact of omicron on hospitals in the North West in his latest column on the regional’s health economy, and Rob Findlay finds a pause in the growth of referral to treatment waiting lists in his analysis of NHS performance.