Staffing is the issue keeping NHS leaders awake at night  and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, ensures you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. Contact me in confidence

In an interview with the BBC this week, former NHS chief executive David Nicholson said people who are denying the impact covid is having on the NHS must be dealt with “vigorously”.

Sir David told BBC Radio 4’s Broadcasting House programme of the pressing need to “tackle” this attitude towards the pandemic and spoke about how it is badly affecting staff morale.

He told a story of someone who had taken a video of a Redditch hospital — part of Worcestershire Acute Hospitals Trust, where Sir David is chair — in the evening to support their view it was not overrun with covid patients.

This story is sadly not unique and attitudes like this will continue to prevail if nothing is said to counter them.

Politicians and NHS leaders at the very top must denounce covid deniers publicly and show their support to the workforce, many of whom are enduring the toughest time of their working lives.

Luckily those denying the existence of the pandemic are still in the minority, but visible leadership is more important now than ever, to show solidarity with those working on the frontline and denounce dangerous and covid-denying myths.

More emergency measures

Amid the flurry of news this week, the Nursing and Midwifery Council announced plans to allow overseas nurses to join the temporary nursing register without undertaking their formal clinical assessment, or objective structured clinical examination.

This echoed what happened in March, when 2,000 nurses were invited to join the temporary register to assist the covid effort.

It is unclear how many of these nurses overlap and how many have since completed their OSCE, but accelerating their path to work in the health service underlines how desperate a situation the NHS is in.

However, it is absolutely essential these nurses are properly supported and supervised and, of course, risk assessed.

As Unison national nursing officer Stuart Tuckwood pointed out: “Covid-19 has disproportionately affected black staff. It’s vital overseas nurses are given risk assessments, suitable safety kit and appropriate training to ensure their health is protected.”

Along with this, it has been reported London’s Nightingale Hospital is due to reopen, with a much smaller bed base for patients needing step-down or rehab care. It will also be one of seven vaccinations centres nationally.

The same old question follows — who will staff the Nightingale? London hospitals have few staff to spare, especially nursing staff.

Meanwhile, the prime minister has set the NHS the target of vaccinating up to 11 million people over the next six weeks. This will require a huge — and trained — workforce to make the target a reality.

With demand for staff outstripping supply long before covid hit, the NHS workforce is having to bend further and further as the pandemic progresses. How long before it breaks?