Read Jack Serle's latest HSJi Review, which discusses how Cancer performance remains one of the most stubborn challenges facing NHS providers, with a significant number of trusts falling well short of the 85 per cent standard for treating patients within 62 days of an urgent referral. Read the full article here.

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Medicines optimisation priorities and problems in 2026

Spending on hospital medicines has overtaken primary care prescribing for the first time, with cancer treatments accounting for the largest share of hospital drug expenditure. Within this category, the biggest subset is medicines that must be prepared in aseptic pharmacy units, an area where the NHS continues to face significant capacity constraints. In response, NHS England has outlined a series of medicines optimisation priorities, with increasing the use of best-value biologics emerging as the most widely adopted approach. Other measures include standardising aseptic product formulations and tackling inappropriate prescribing of antidepressants. However, plans to shift responsibility for medicines optimisation from integrated care boards to trusts and neighbourhood health providers are progressing more slowly than anticipated. Meanwhile, reductions in ICB running costs are limiting their ability to deliver on optimisation priorities effectively.

County Durham and Darlington Foundation Trust

The trust is experiencing significant upheaval following a clear-out of its senior leadership team in response to a breast cancer scandal, with changes aimed at strengthening governance and driving improvements in safety and quality after patient harm. At the same time, it is facing mounting financial strain: despite agreeing to deliver a £2m surplus, it is now forecasting a deficit and is carrying a previously hidden budget gap. A recent review warned there is a “significant risk” to the delivery of its cost improvement programme, noting “little progress” so far and concluding the organisation does not have the capability to achieve even its best-case deficit scenario of £12.8m. Nevertheless, there have been positive developments, including approval of its New Hospital Programme bid, with construction due to start between 2026 and 2027, and plans to strengthen digital maturity by integrating its laboratory information management system into its electronic patient record.

Barking, Havering and Redbridge University Hospitals Trust

A large acute trust with relatively strong waiting times performance but a substantial financial deficit. It serves an urban population with high levels of deprivation. Ongoing financial pressures have led to difficulties paying suppliers on time. Maternity services have been identified as a priority for digital upgrades, and the trust is bidding for a rebuild of its accident and emergency department.

Data Points
The following data points were updated this week:

• Leadership for ICS, Wales and Scotland in January.
• Name for Wales, Scotland in January.
• Number of medical staff, Nursing, midwifery and health visiting staff, Health care assistants and other support staff, Scientific, therapeutic and technical staff, Admin and estates staff and Staff absent (%) for Wales in Q2 2025-26.
• Emergency care streaming indicator, Type 1 Departments - Major A&E %, Emergency care streaming indicator, Type 3 Departments - Other A&E/Minor Injury Unit, Four hours A&E performance (all patients), 12 hour A&E waits, 12 hour A&E waits (% of total attendances), A&E attendances, % beds occupied by delayed discharges, Discharge delays due to ‘internal’ reasons, Discharge delays due to ‘external’ reasons and Super stranded patients for Acute in January.
• Discharge delays due to ‘internal’ reasons and Discharge delays due to ‘external’ reasons for ICS in January.
• Number of cases waiting over one year and Proportion of cases waiting over one year % for Acute, community, and specialist in December.
• 62 Day Cancer Target and Elective admissions for Acute, Sp in Q3 2025-2026.
• Cancer 62-day performance for ICS in Q3 2025-2026.
• EIP waiting time performance (Early intervention Waits) for MH in Q3 2025-2026.Incidents Per Quarter, Percentage of patients taken to A &E, THE 18-MINUTE TARGET(MINS.SECS), THE APPROPRIATE CONVEYANCE TARGET(MINS.SECS) and THE SEVEN MINUTE TARGET(MINS.SECS) for Amb in Q4 2025-2026.