Read Jack Serle's latest HSJi Review, which reports on how the emergency care performance in England had been on the decline for several years before covid hit.

It is now approaching the point where observers of the NHS are almost becoming blind to the thundering inadequacy in this area of care, creating the danger of normalising what is a very grim situation. Read the full article here.

Latest investigations

Maidstone and Tunbridge Wells Trust

The main maternity unit of Trust was rated "inadequate" by the Care Quality Commission, prompting a response involving recruitment, training, and service redesign. Recruitment and retention challenges persist, especially with lower-paid staff. Addressing turnover involves emphasising apprenticeships and rapid career progression. The trust aims to centralise cardiology services at Maidstone Hospital through a partnership with its managed equipment services provider. Several building projects are underway, with a focus on expanding services at Maidstone Hospital. Cost-saving measures include reducing agency spending, optimising patient flow, and leveraging digital technology. The trust's financial stability allows for strategic investments to improve efficiency and quality of care while meeting savings targets.

Great Ormond Street Hospital for Children Foundation Trust
Great Ormond Street Hospital is focusing on retaining nurses amidst challenges like the cost-of-living crisis and competition from Dublin's new children's hospital. The trust has introduced retention measures per department and joined retention improvement programs. To aid staff welfare, GOSH provides various support services funded by its charitable arm. Efforts include increasing bank rate pay for senior nurses, offering flexible working options, and exploring accommodation support. GOSH is also intensifying international recruitment efforts, partnering with agencies and consortia to attract nurses globally. Additionally, GOSH is embarking on two major projects: a £300m Children's Cancer Centre and a model change to enhance critical care capacity. The trust is addressing bed availability and patient flow issues by seeking mutual aid agreements with other trusts and exploring options like increasing day cases and improving efficiency in spinal surgery.

The Dudley Group NHS Foundation Trust
Dudley Group Foundation Trust's accident and emergency performance improved, with 73 per cent seen within 4 hours. Yet, serious cases faced delays, worsened by ambulance and A&E wait times. A £17m upgrade aims to boost capacity. Discharge schemes tackle patient flow issues. Financially, the trust aims to cut costs by 4 per cent. Collaborating closely with other trusts, it will now oversee primary and community care services, absorbing Dudley Integrated Health and Care Trust's functions. Becoming the lead provider for the Dudley area, it will manage primary care services, urgent treatment centres, and corporate functions.

Data

• Last week the following data points were updated:
• Leadership of ICS for March 2023
• A&E waiting target, Emergency admissions of Acute for Q4 2023-24
• A&E Performance, Emergency admission per 1000 population of ICS for Q4 2023-24
• Name of Wales and Scotland for March 2023
• Patients spending under 4 hours in ED (%), Red emergency responses arriving within 8 minutes (%) of Wales for Q4 2023-24
• C-diff rate, MRSA rate of Scotland for Q3 2023-24