The trust faces a major challenge in delivering a £92m savings plan in 2025-26 while managing the fallout from a significant care quality investigation and the departure of its CEO. It targets a reduction of around 500 posts, has been placed in the most challenged category for elective performance by NHSE, and has acknowledged that deterioration followed a leadership focus on financial recovery. Alongside plans to increase both insourcing and outsourcing, the trust is dealing with major capital pressures, including significant delays to its £2.3bn hospital rebuild and a £235m maintenance backlog on the existing estate, while continuing to hold a prestigious role in the national £5bn genomics programme.

Derbyshire, Lincolnshire and Nottinghamshire ICS

Most of the cluster’s executive board is now in place, with the three ICBs expected to merge in due course, as part of a significant cost-cutting programme that includes voluntary redundancies. The cluster is consulting on structures below the executive level and is developing a strategic commissioning plan due by April 2026, signalling a shift towards population health management supported by a respected Nottingham-based analytics unit working across the footprint. Plans also include reducing spend on private acute providers and building on well-established neighbourhood working in Nottinghamshire and Derbyshire, with Nottingham City participating in a national pilot, while Lincolnshire is progressing more slowly due to longstanding challenges in its relationship with primary care.