Read Jack Serle's latest HSJi Review, which discusses how trusts across England are grappling with severe emergency care pressures, with performance against national targets falling short and patients experiencing dangerous waits. Read the full article here.

Latest Investigations

The trust faces a challenging year as it seeks record savings while cutting 400 posts amid persistently high sickness absence. Ongoing discharge difficulties are driving extremely long lengths of stay, even as the trust aims to reduce costly out-of-area placements sharply. At the same time, plans by the Reform-led council may increase reliance on private-sector step-down beds. To support efficiency and service improvement, the trust is also introducing ambient voice recording and AI technology.

The new cluster with East Berkshire brings Frimley’s stability to BOB’s historically challenging geography, with CEO Nick Broughton and chair Priya Singh remaining in post. While Integrated Care Board staff expect cuts, the restructure is delayed as the cluster reviews contracts for value for money—starting with neuro-rehab and community women’s services—while partnering with the University of Oxford on streamlined commissioning and launching an innovation fund. Shared care record data is being used to understand better and monitor cardiovascular demand, shift primary care resources toward deprived areas, and support pilot sites in the national neighbourhood programme as the cluster defines a core Thames Valley neighbourhood model. Facing a £67.7m savings requirement, the ICB is reviewing continuing healthcare cases, checking fair funding splits with local authorities for aftercare, and targeting further efficiencies, including increased use of biosimilars.

The NHS in Wales: Autumn 2025 update

NHS Wales is undergoing significant change, with a new chief executive overseeing the wide-ranging Sloman review, the appointment of a national clinical director, and new public accountability meetings between the health minister and UHBs. System reforms include nationwide maternity service reviews, a revamped complaints system, and winter plans focused on improving discharge, reducing admissions, and boosting vaccination, supported by respiratory response plans, a call-before-convey pilot, and centrally procured vaccines. New ambulance response categories are being introduced, while a £120m elective recovery plan – prioritising cataract surgery, reducing unnecessary follow-ups, and expanding private-sector use – aims to tackle long waits. Digital upgrades include new NHS App functionality, electronic prescribing, and a national lung cancer screening programme. Despite significant funding uplifts, health boards are struggling to break even and have been instructed to deliver at least 2 per cent efficiency savings, targeting agency spend, high-cost care packages, and prescribing, though none plan compulsory redundancies amid rising emergency care and litigation pressures.

Data points

The following data points were updated this week:

• Online/video GP consultations for ICS in Q3 2025-26
• Revenue budget, Surplus/deficit, Capital spend, Number of beds and Length of stay in Scotland for 2024-25
• Outpatient waiting list and Elective waiting list for Scotland in July, Aug, Sep
• 12 week waiting target – inpatients and 13 week waiting target – outpatients for Scotland in Q2 2025-26