Read Jack Serle's latest HSJi Review, which discusses how diagnostic performance in England is struggling with demand outstripping supply, even with the NHS’s laudable increases in capacity over the past five years. Read the full article here.

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A joint committee has been established to oversee the merger, with plans to create a single executive team next year. Devon will take the lead on developing strategic commissioning plans, alongside the development of a lead provider model. Most non-specialist care will be delivered through neighbourhood teams, supported by the expansion of a shared digital care record.

The trust is planning to move to a joint board with Stockport Foundation Trust in April 2026, with executive roles formed across both trusts but no formal merger planned. Leadership is focused on procuring a new EPR for 2027, while the trust remains on track to meet its 2025/26 financial plan and cost improvement targets, driven by tighter control of agency and bank spending and reduced payments on its £100m, 34-year PFI deal. Although TGICFT is among the worst performers nationally against the four-hour A&E standard, leaders have introduced a new advanced practitioner model with North West Ambulance Service and are diverting patients away from ED. The trust is performing strongly against elective care targets, having eliminated year-long waits, and continues to prioritise substantive recruitment alongside insourcing capacity in selected specialties.

The move to an acute group has brought leadership changes, with service reconfiguration aimed at improving quality and efficiency, although new clinical collaborations have experienced early teething problems. The organisation faces a challenging path to achieving its break-even target, with elective activity being curtailed following overperformance and around 400 WTE posts at risk. A range of measures are being implemented to manage emergency demand, alongside a strong emphasis on technology to improve performance and efficiency. Maintaining a focus on quality is also delivering savings, supported by the introduction of a new commercial research role and efforts to improve access for more deprived populations.

Data points

The following data points were updated this week:

• A&E waiting target, Beds occupied by delayed discharges and Length of delayed discharges for Scotland in October.
• Total staff, Medical & dental, Administrative, Allied health professionals, Healthcare science, Nursing and midwifery, Social care, CAMHS patients seen within 18 weeks and Psychological treatment within 18 weeks for Scotland in Q2 2025-26.
• Clinical negligence premium (% of income) for  Acute,Sp,Com,MH,Amb in 2024-25.
• E-coli hospital-onset cases (12-month england average), e-coli hospital-onset cases (12-month regional average), e-coli hospital-onset cases (12-month rolling count), C-Diff hospital-onset cases (12-month rolling count) and MRSA hospital-onset cases (12-month rolling count) for Acute in September.
• Previous year system Underspend/Overspend for ICS in 2024-25.
• 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 Q1 2025-26.
• Revenue budget, Surplus/deficit and Capital spend for Scotland (for only 2 boards) in 2024-25.
• Patients spending under 4 hours in ED (%),Number of referrals, Patients waiting 36 weeks+ for elective treatment (%),Suspected cancer pathway (open pathways), Patients waiting 14 weeks+ for diagnostics and therapy (%),Treatment started within 28 days of assessment (%) and Patients receiving secondary mental health services for Wales in Q2 2025-26.