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

The high rates of positive coronavirus tests in the North West dominated headlines for much of the summer, without leading to significant rise in demand for hospital care.

This has now changed, with the number of patients in hospital climbing from fewer than 80 at the end of August, to around 660 on Wednesday evening. Patients on mechanical ventilation rose from around 12 to 91 over the same period.

We already know what comes next, and a sustained increase in deaths is already starting to emerge in the data.

The rise has been largely driven by a handful of providers, of which Tameside and Glossop Integrated Care Foundation Trust has already been identified as a recent high reporter.

Liverpool University Hospitals Foundation Trust is the other trust now accounting for a high proportion of deaths, and health and social care secretary Matt Hancock has now announced new restrictions on social mixing in the city. Hopefully this will start to have an impact.

Good people, bad managers

Trust chairs are good people but not so good at making sure their directors are doing their job well, according to a major study about non-execs.

Nearly half of trust chairs fail to “effectively deal with non-performing board members”, says the research by The Henley Business School.

The research included a survey of NHS NEDs, which reveals that they have a broadly positive view about their contribution but that only 55 per cent agreed with the statement that NHS trust chairs “effectively deal with/remove non-performing and/or disruptive board members”. Just 47 per cent said chairs had “positive relations with the media”.

But it seems their intentions are good, as almost every respondent said trust chairs had “high moral values” which were “aligned with those of the organisation”.

The survey was undertaken before the onset of the pandemic, but nearly a third of the respondents disagreed with the statement that NHS chairs were “effective in a crisis”. Hopefully the study’s authors will one day reveal how well chairs were deemed by the same respondents to have coped during the covid crisis…