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.

We discuss Wes Streeting’s tumultuous 22 months in charge – and analyse the Health Bill he has left in his wake, which was published on Thursday.The bill will give ministers sweeping new powers, as well as abolishing NHS England, and make important changes affecting foundation trusts, integrated care boards, and councils. The HSJ Health Check podcast welcomes Hugh Alderwick, Health Foundation director of policy and research, to help unpick the 200-page legislation and what it will mean for the service.

This week we talk in more detail about HSJ’s Top 50 CEOs – not only who topped our annual ranking of hospital leaders, but also interesting trends from this year and beyond, and a behind the scenes from the judging.We cover the surprising new entries, why a third of individual chief executives included in the rankings over the last 12 editions have appeared just once, and why London and ambulance trusts are finally coming out top.The full top 50 can be viewed here.

Millions of people are turning to AI chatbots to manage their mental health, driven by a combination of long waiting lists and not meeting clinical thresholds for treatment.We cover how regulation is running to keep up with this surge in demand and why suppliers are not finding compliance straightforward. Also this week, the NHS has a legal duty to reach net zero by 2040. We discuss how – and how well – is it being held to account.

On this week’s podcast we talk about relationships between CEOs and chairs - and why the CEO of East Kent Hospitals has not been at work since mid-November.And with staff pride at a record low in the Care Quality Commission, according to its latest internal survey, we cover what will be in the in-tray of its new CEO and why the regulator wants to find someone with “clear political licence”. (Update): On Thursday evening, following the recording of this podcast, East Kent Hospitals Trust issued a statement stating Ms Doherty was stepping down so that the organisation could “appoint a chair who can focus exclusively on leading East Kent through the next phase of improvement work ahead.”Ms Doherty remains chair of Maidstone and Tunbridge Wells Trust and is also the president of the Royal Society of Chemistry.

HSJ Health Check discusses the latest squeeze on GP resources, and controversy over reform of referral processes.Analysis of new figures show the share of NHS spend going to general practice fell to its lowest point in 2024-25 - a decade on from NHS England vowing to shift the balance the other way.The share of doctors in the English NHS who are GPs also fell.Meanwhile, GP groups are among those crying foul over the latest "advice and guidance" reforms.NHS England is asking systems to introduce universal A&G for 10  "high volume specialties" chosen locally, for which it has set an ambition of a "diversion rate of at least 25 per cent by March 2027".With HSJ deputy editor Dave West, bureau chief James Illman and correspondent Caitlin Tilley.