This week we discuss why private providers are threatening to refuse to treat NHS patients, and why hospital bosses are equally vexed.

We also cover how the outdated NHS IT estate has become a national security issue and what needs to be done to stop future data breaches and cyber attacks.

Amanda Pritchard is stepping down as NHS England’s CEO at the end of next month, while Wes Streeting embarks on a massive reorganisation of the centre.

This week we cover the reaction to this news, what’s lies in store for NHSE and who will be steering it through this significant change.

Also - an update on some top appointments at the Care Quality Commission.

This week the HSJ team look at money and what is coming for what is expected to be toughest financial year for the NHS in a generation. HSJ editor Alastair McLellan talks about the “pig of a year” senior leaders have warned of. While finance reporter Henry Anderson takes us through what the mood music is on bringing back PFI, an expensive way of getting new capital into the system – but is it the only way?

This week we take a closer look at Wes Streeting’s tough talk on NHS deficits – the health and social care secretary has told the NHS there can be no overspending without consequences.

But what will this actually mean in practice, how has NHS England responded, and what will trusts have to cut to balance the books?

Also this week, we discuss anHSJ story that revealed Ambulance services would still struggle to respond to a mass-casualty event like the Manchester Arena bombing despite recommendations made by a public inquiry.

NHS England published the 2025-26 planning guidance last week, so we break down what it means for the service.

We discuss new targets, including a challenging elective care ambition, the high-profile commitments dropped, and news that trusts are to take on more responsibilities from ICBs next year.

A busy few days also saw the NHS’s mandate for 2025-26 from ministers published last week, so we also discuss Wes Streeting’s tough instructions to the NHS and his interview with HSJ.

Also, we cover news of further job cuts at NHS England and how its leadership of the service has been changing.

HSJ Health Check is joined by two of the most influential and experienced NHS leaders to talk about lessons for the government's 10-year plan from their systems, and from the past.

Former NHS England chief Sir David speaks about how the Black Country, where he is now a trust chair, has used community services to reduce emergency admissions among older people. He says government should ensure the plan brings about stability of financial rules, and get successful local leaders involved in writing the plan.

Dr Dash, integrated care board chair in North West London and chair of an ongoing government reviews on safety and quality, discusses how her system is approaching change. She says the plan will need to “be very clear on how [it] will be implemented” rather than setting out only a “vision”.

This week the government finally revealed its new - and mostly delayed - target dates for the building of the promised “new hospitals”.

It left many trusts and communities severely disappointed and worried about how they will deliver care from ageing, and sometimes dangerous, estates.

We discuss the revised timelines for the NHP, the reaction from trusts and the impact the decisions have had on NHP teams.

Also - we pick out a group of hospitals mostly ignored in the national coverage, who all have RAAC concrete risks.

On this episode we unpick the ongoing tensions among leaders and senior doctors at one of the biggest trusts in England.

University Hospitals Birmingham - previously a flagship teaching trust with an influential leadership - has been through the mire over the past few years, with a string of concerns over culture and care quality.

A new top team says it is tackling deep-seated problems, but over recent months rows have flared publicly over consultants’ overtime pay, confidence in its leadership, and questionable international training schemes.

Also this week, a new senior appointment at NHS England, and what it could mean for the government’s 10-year health plan.

This week the team looks at the new elective recovery plan launched this month. The government has tightened to focus on what improvement looks like and introduced some new incentives, but will it be enough? We also take a look at the ever-contentious New Hospitals Programme. Bureau chief Ben Clover is joined by Henry Anderson and Zoe Tidman.

The HSJ Health Check team reveals our predictions for the big issues — and unexpected developments — in 2025, on this week’s Christmas podcast.

What to expect in reform, finance, integration, primary care, workforce and more in the coming 12 months.

With HSJ deputy editor Dave West, senior correspondent Henry Anderson, and correspondent Mimi Launder.

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