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

Overall, volumes of cancer surgery are up, for the year to date, compared to the same period last year.

This is what you would expect as the pandemic’s disruption to pathways abates. But the performance against the measure for patients receiving surgery within 31 days hit a record low in the September data (the latest available).

So although more people are being treated that treatment is less timely.

Several major tertiary centres in the Midlands saw their performance go backwards compared to the same period in 2020, even as volumes for the most part increased.

Surgeons report treating patients whose cancers are more advanced than they would usually be when they reach them.

Outcomes are set to get significantly worse.

Referrals are increasing and the data (which is updated to the end of October tomorrow) will not yet take account of the usual expected disruption to lists from winter pressures.

Getting the P2 patients treated in time is going to be a big challenge over the next three months.

Stevens sets sights on bill

During his maiden speech in the House of Lords this week Lord Stevens called for numerous changes to be made to the Health and Care Bill.

Speaking publicly for the first time since he stepped down as NHS chief executive, he called for greater transparency on letting contracts to the private healthcare sector and more detailed workforce planning.

He backed an amendment proposed by House of Commons health and social care committee chair Jeremy Hunt that would force the government to publish independent workforce projections biennially.

He said one of the key challenges facing health and social care at the moment is the “strength and resilience of the “workforce”, adding that it is therefore ironic that detailed workforce plans stretching up to 15 years have been “muzzled” by the Treasury previously.

The amendment was recently defeated in the House of Commons, but Lord Stevens supports the Lords adding a similar measure into the bill.

He went on to reject the idea that the bill encourages privatisation of the NHS – but said the legislation should be strengthened to ensure the process of awarding contracts to the private sector is “transparent and fair”.

He also addressed clauses added to the bill by former secretary Matt Hancock, which would give the health secretary more direct power over service reconfigurations. The clause has attracted a significant amount of criticism, and Lord Stevens said the bill should not “centralise” decisions “best made locally”.