Read Jack Serle's latest HSJi Review, which discusses how temporary staffing costs are a long-standing target for trusts when they want to make savings. With deficits looming, this year is no exception. NHS England has issued edicts that all providers must reduce temporary staffing spend. Read the full article here.

Latest Investigations

University Hospital Southampton Foundation Trust

The organisation is facing a highly ambitious £110m savings target, with nearly 800 posts at risk as part of an in-year recovery plan triggered by finances going off track. Regulatory scrutiny is intensifying due to pressures on both emergency and elective performance, while a key focus remains on unblocking patient flow to improve system resilience. However, the scale of the savings programme is beginning to affect elective capacity. Alongside these operational challenges, the organisation is also pursuing growth opportunities, including the launch of a new commercial research delivery centre and plans for a £100m medical innovation institute.

Birmingham and Solihull Mental Health Foundation Trust

The Trust is struggling in almost every area, with high bed occupancy driven by limited capacity and ongoing pressure across services. While it is focused on ending the last few “out-of-area” placements and rolling out a ward empowerment programme across the organisation, it must also deliver an ambitious cost improvement programme to stabilise its position. As part of this, the Trust plans to significantly reduce reliance on bank staff, while simultaneously commissioning a new contract to secure additional beds.

The NHS market for hospital electronic patient records in 2026

The end of the Frontline Digitisation Programme means trusts must now pay for tech investments themselves, and most trusts do not realise the full benefits of their electronic patient records. With almost all acute trusts now possessing a modern EPR, their focus is on maximising utilisation, and ensuring interoperability of EPRs with the NHS App, and the single patient record is the priority for the government. This may stimulate the market for middleware, which can link EPRs with these national services, and several integrated care systems and one whole region are on course to use the same EPR.

Data points

The following data points were updated this week:

• 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), Discharge delays due to ‘internal’ reasons, Discharge delays due to ‘external’ reasons A&E attendances, % beds occupied by delayed discharges and Super stranded patients for Acute in October.
• Discharge delays due to ‘internal’ reasons and Discharge delays due to ‘external’ reasons for ICS in October.
• Number of cases waiting over one year and Proportion of cases waiting over one year % for Acute, community, and specialist in September.
• Number of beds for Wales in 2023-24.
• A&E waiting target, Beds occupied by delayed discharges and Length of delayed discharges for Scotland in September.