Solving the £20bn productivity puzzle

This week we discuss why a £300,000 exit payment to a former ICB CEO has proved so controversial, and how NHS England has tried to justify the move.We also look at what the row reveals about the wider pressure ICBs are under, as they face deep cuts and continued uncertainty over their future role.This includes the questionable use of public money in wider ICB restructures, which are in many cases forced to pay for redundancies they may one day regret.And with devolution to mayoral strategic authorities, how do ICBs and ‘places’ fit into the new world?

Now the dust has settled on two major maternity reviews, HSJ Health Check is joined by Dr Bill Kirkup to discuss what happens next.Dr Kirkup has been investigating maternity scandals for over a decade, including Morecambe Bay and East Kent. We discuss how the sector has responded to the tranche of recommendations, whether a public inquiry is needed, and how leaders should respond when things go wrong in their organisations. He also touched on more contentious issues, warning that the current clinical negligence system is set up to be “adversarial”, and how the NHS needs to avoid “othering” maternity services.

Many breathed a sigh of relief when the resident doctors accepted the latest government pay offer, putting an end to years of strikes. However, just a week later, consultants voted for industrial action.We discuss the demands of the British Medical Association’s consultants committee and how the government could avert another set of damaging strike action.We also talk more about the first complaints made about clinicians’ use of AI, as revealed in HSJ this week, and how the national AI regulation review could change how it is used in the NHS.

This week Dave West and Henry Anderson are joined by health economist Anita Charlesworth, who is co-chairing a commission into NHS productivity for the Health Foundation.We discuss the workforce “boom and bust”, why the covid-19 pandemic cost the NHS £20bn in lost care and how the health service can recover at a time when public spending is under pressure.

NHS maternity services are again in the spotlight after an independent review revealed serious, systemic failings at Nottingham University Hospitals.The report by Donna Ockenden criticised NHS executives for refusing to speak to the review - leading the government to threaten prison time for staff who do not cooperate. Will this make a difference for future investigations? And, amid growing calls for a public inquiry into the state of maternity care across the country, we ask what this would mean for the NHS. With Henry Anderson and Emily Townsend.Send thoughts and ideas to [email protected]

Sparks are flying over how the centre of the NHS will be run once NHS England is wound up next year. HSJ Health Check discusses the options, why they matter, as well as our exclusive interview with the minister leading the changes through Parliament.Karin Smyth argued government had sought to “minimise” the powers it is taking as a result of abolishing NHS England. She also spoke about the other big aim of the bill - paving the way for a single patient record.With Annabelle Collins, Alastair McLellan and Dave West.Linked articles: ⁠We have ‘minimised’ Health Bill power grab, says minister⁠ Trusts ‘should recruit more managers locally’

We talk staff, racism, the funding squeeze, and trust groups, on the HSJ Health Check live from the NHS Confederation conference in Manchester.NHS Alliance CEO Ciarán Devane, who took up post two months ago, and University Hospital Tees CEO Stacey Hunter, join HSJ deputy editor Dave West.Guests discuss the challenges of growing racism against staff, including how it can mean some minority ethnic staff don't want to work in particular parts of the country.We also cover wider pressure on staff, as funding is squeezed and services restructure to cut costs.And we talk about the dilemmas of the wave of trusts sharing leaders, one of whom is Stacey as CEO of two Tees foundation trusts.

Hundreds of non-British NHS England staff face losing their jobs because their nationality prevents them working in the civil service.We discuss why this threat  – that seems to fly in the face of NHS values – has come about, and what it says about the wider restructure process. Also this week - the first ‘advanced foundation trusts’ have been confirmed so we cover who made the cut and the benefits this could bring for the chosen few. And on the subject of reorganisation, we discuss whether government will take the leap and overhaul primary care networks for the neighbourhood health era.

On this week's podcast, with increasing examples of staff accessing patient records inappropriately, we ask how widespread this practice really is - and whether regulators need to do more. And we dig into the NHS's elective recovery figures, which show a dramatic improvement in the final month of the year helped the service meet its headline government target by the narrowest of margins.

This week we talk more about the government’s plans for a new “single patient record” - the legislation for which was in last week’s Health Bill - and why primary care could be a stumbling block.It was hoped the Bill would provide clarity on how the new data sharing requirements would be achieved but there remain many unanswered questions. On the subject of primary care, we cover why the latest collective action being taken by the the GPs’ union may in fact help pave the way for sorting out data sharing.