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

“If at first you don’t succeed, try again” – that is the approach being taken by the government as ministers tease plans to cap redundancy payments at £100,000 and above.

This old chestnut has resurfaced after health and social care secretary Steve Barclay penned an open letter to NHS staff on Agenda for Change.

This followed the majority of trade unions voting to accept the government’s offer. It was when the “non-pay” elements of the deal were outlined that the cap proposals emerged. Unions have stressed they are only compelled to discuss it, not necessarily agree to it.

Jon Restell, chief executive of the Managers in Partnership trade union, has described a proposed cap as “unnecessary”, and told HSJ it would “disproportionately” impact staff in NHS England, integrated care boards and arm’s-length bodies.

Remember that ministers were forced to drop previous plans to cap exit payments at £95,000 for public sector workers in 2021.

The proposed legislation sparked widespread opposition from unions and led to the launch of a judicial review.

Whether the government believes it will succeed this time remains to be seen.

The consultancy party

The Conservative party pledged to build 40 new hospitals in the run-up to the last general election.

Fast forward a few years, and two consultancy firms have been the main winners of external work on the new hospital programme so far.

Mott MacDonald, an engineering consultancy, had received £29m and KPMG £25m by the end of April this year.

This was a significant chunk of around £60m paid to all consultants for work on the project, according to a breakdown of spend obtained by HSJ.

The Department of Health and Social Care says it is standard practice to employ consultants for major government projects. This one has been promised more than £20bn in total. 

But in the meantime, many schemes are still waiting to properly get going. Most have not even started construction – including those originally pitched for 2025 completion, but which have since been delayed. 

Work looks set to continue for Mott MacDonald and KPMG. The former has since been awarded a further £41m year-long contract as interim delivery partner, while the latter won a £23m contract as interim commercial partner in May.

Also on today

After Steve Barclay and Amanda Pritchard this week reported “really positive signs” in emergency care, Dave West in The Integrator asks if these are real, bankable wins, or just a seasonal blip? And Julian Patterson says that the NHS has finally produced its “first ever” workforce plan but what ought to be a cause for embarrassment is a source of immense pride.