The political press may be fixated on Jeremy Corbyn’s election as Labour leader, but the real business of determining the future of the country – or at least the public sector - is being conducted backstage; by the Treasury mandarins and departmental ministers, advisors and civil servants who are cutting deals in this year’s spending review.

This week, the country’s three leading health think-tanks made their submissions to the review. And grim reading they are too. The King’s Fund, Nuffield Trust and Health Foundation all think the NHS is going to need the £8 billion the Conservatives promised during the election campaign sooner rather than later, and that the Treasury and Department of Health are misguided if they think it will do more than keep the wheels on.

They want a transformation fund to back the reforms set out in last year’s ‘Five Year Forward View’ and, eventually, an all-party review to increase health and social care funding. Neither of these look likely to happen; and even the £8 billion could be pushed back to the second half of this Parliament.

In the meantime, NHS England is looking to clinical commissioning groups to sort out healthcare economy finances, introduce new ways of working and, as of this month’s NHS Expo, sort out the interoperable IT that will be needed as well.

All of which looks like a tall order; not least because the pressure on the acute sector is becoming increasingly visible. There has been a wave of chief executive and finance director departures from NHS trusts this year; with Keith McNeil and Paul James from Cambridge University Hospitals NHS Foundation Trust joining the exodus this week, citing “very serious challenges.”

The trust is in debt and now reporting issues with its eHospital implementation of the Epic electronic patient record. The contribution of the EPR to the hospital’s financial woes may become clearer next week, when the CQC is due to issue a report. But the detail shouldn’t distract from the bigger picture. NHS finances are worsening, and everybody involved with the NHS is going to be living in “interesting times.”

Kelsey to leave NHS England

Tim Kelsey will step down as NHS England's national director for patients and information in December to take on a new job in Australia.

CCGs ‘must consult’ on digital roadmaps

Clinical commissioning groups must work closely with all local health providers to develop and deliver local digital roadmaps, NHS Providers and trust IT experts have argued.

Spending review 'must find NHS cash'

The NHS needs a cash injection now, a transformation fund to support change, and a long-term review of its funding needs, think-tanks have told the Treasury in formal submissions to this year's critical spending review.

Cambridge chief exec resigns

Cambridge University Hospitals NHS Foundation Trust’s chief executive has resigned amidst a growing financial deficit and "significant performance and quality concerns" relating to the trust's e-hospital programme.

Mental health trust to roll-out Medchart

Leeds and York Partnership NHS Foundation Trust expects to begin implementing CSC’s Medchart electronic prescribing system early next year.

Leeds leads the way on shared records

The Leeds Care Record is live in all but one of the region’s GP practices, as well as in acute, mental health and community providers.

CCIOs issue Newcastle Declaration

Clinical information leaders from across the NHS have issued a joint declaration calling for interoperability to be recognised as vital to safe, connected patient care.

The diary award for ‘most totally baffling presentation of a healthcare IT story of the week’ goes to the Metro freebie for a story that starts: “A terrifying new hospital supercomputer tells patients if they are going to die – and if it says ‘yes’ there is a 95% chance that you will.”

Obvious questions that arise include: what is so terrifying about the computer (does it fry people with lasers? morph into a deaths head and cackle as it does so)? Isn’t it the case that 100% of people die (sometime, eventually)? And why, when the computer tells a patient they are going to die, does someone else (you) stand a 95% chance of falling down dead?

Sadly, the story doesn’t answer any of these questions. Less baffling coverage suggests that Beth Israel Deaconess Medical Centre in Boston is running a big data initiative to identify ‘risky’ situations for intensive care patients. Less baffling, but, it has to be said, less exciting.

“Reduced to essentials, it seems the method for introducing an EPR into a hospital is as follows:
1. Decide that you can’t go on as you are.
2. Go through the ritual of producing a business case and declare the project “affordable.”
3. Implement a system of choice (insofar as there is choice).
4. Discover the system is “unaffordable”.
5. Ritually sacrifice the chieftains of sufficient standing to satisfy the gods.
6. Get on with it until next time.
As a methodology, it seems to have quite a lot in common with the way things were done in pre-Roman Britain, but if that’s what it takes… ”

“It is that moment before the train crashes where everything is oddly calm.”

Anita Charlesworth, the chief economist of the Health Foundation, tells the Commons’ health select committee that there is a “gulf” between Whitehall and the day to day reality of the NHS, in the week that her think-tank, the King’s Fund and the Nuffield Trust all presented bleak assessments of NHS finances to the Treasury spending review.