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

It was a hugely revealing day for the NHS yesterday when the service revealed the results of a check-up – on itself.

HSJ analysis showed which acute trusts came out strongest and weakest in the annual staff survey — and which have seen the greatest change.

Each table in our story shows the share of staff who agreed with the statement “I would recommend my organisation as a place to work”.  A similar analysis of mental health trusts can be found here.

A key finding of the survey, which was filled in by around half of all NHS staff in England and took place in October and November, was that half of staff who cared for covid patients suffered stress-related illness. 

Read all our coverage of the survey, including its findings on the experience of minority ethnic staff and ambulance and community staff. 

Exceeding his boundaries?

Matt Hancock’s intervention in the Essex Integrated Care System boundaries debate has been met with little support from NHS leaders who are worried that reconfiguring three Essex-based ICSs will distract them from the big task of tackling the huge elective backlogs currently seen across England.

There is also a concern that Essex’s health system is too complex and struggling for a single ICS to be able to make real improvements in patient outcomes.

Despite that, one source said a Greater Essex ICS is likely to be created to reflect the Essex County Council boundaries, as it would “take a change in the secretary of state” to stop this from happening. Concern about boundary changes was highlighted by Sir Simon Stevens at the health select committee he spoke at this week.

While saying he was “generally” supportive of ICSs being coterminous with local authority boundaries he said this didn’t need to be legislated for – perhaps in the hope that he can restrict ICS footprint changes to the minimum.

The voice(s) of HSJ

On the podcast this week the team dissects the biggest workforce survey in the world and wonders why half of covid-working staff are suffering from work related illness, yet the number of people recommending their organisation to work in has improved. The impact covid has had on the survey results is by no means clear cut, but it gives a unique insight into how many staff were redeployed, and other disruptive effects of the pandemic.

The responses of ethnic minority staff were particularly troubling, as were those from staff members with a long-term condition and we touch on what NHS England’s new workforce equality team is planning to make things better.

And alongside this, performance. Are waiting lists as bad as we thought? Our performance expert James Illman has crunched the data and argues more granular measurements are needed to get the full picture.