Read Jack Serle's latest HSJi Review, which discusses the autumn of 2025 finds England's NHS trusts navigating perhaps their most challenging financial environment in decades. Read the full article here.

Latest Investigations

Shrewsbury and Telford Hospital Trust

Exiting “segment 4” of the national oversight framework is dependent on the Trust meeting its financial plans, which include a proposed reduction of 150 whole-time equivalent posts. In line with efforts to improve efficiency, Shrewsbury and Telford Hospital has ceased the use of agency staff in most inpatient areas, and the introduction of high-intensity theatre lists has enhanced productivity. As part of service transformation, the Rehabilitation and Recovery Units are set to close, supported by a programme to expand community rehabilitation services. A joint Chief Executive Officer has been appointed, and plans are being explored for the two trusts to form a formal group by 2026. Looking ahead, a four-storey expansion at the Royal Shrewsbury Hospital is scheduled to open in 2028, alongside a £16.2 million decarbonisation project aimed at improving sustainability.

Mid and South Essex Foundation Trust

Mid and South Essex NHS Foundation Trust continues to face significant challenges, with poor performance in cancer, elective care, and diagnostics. In response, the Trust is planning to improve community pathways to help reduce pressure on acute services and is rolling out AI technology aimed at reducing missed appointments. However, MSEFT must deliver substantial savings amid collapsing staff morale, with hundreds more job cuts expected this year and a clampdown on agency staff usage. Despite these pressures, a surgical hub is currently under construction, and a first-of-its-kind electronic patient record system is being implemented in collaboration with a mental health trust.

Lincolnshire Community and Hospitals Group

United Lincolnshire Teaching Hospitals NHS Trust and Lincolnshire Community Health Services NHS Trust

The group has undertaken a major divisional restructure and recruited a new leadership team to support its transformation agenda. Central to this is the Alliance Division, which is leading the development of out-of-hospital services and driving the “left shift” by identifying services that can be delivered in the community and reviewing surplus estate to move care away from acute sites. Efforts are also underway to strengthen relationships with primary care. On the digital front, the acute trust is preparing to implement its first electronic patient record system, supported by advisory and implementation partners. The group has made significant progress in reducing nursing agency spend, although reducing reliance on medical locums remains challenging due to fragile services. A headcount reduction is planned, primarily through vacancy control and voluntary redundancy. Despite these efforts, the group is expected to struggle to meet the government’s referral-to-treatment target, with some services nearing collapse due to ongoing staffing pressures. EY has been commissioned to support improvements in planned care productivity. While headline accident and emergency department performance has improved, delays to discharge continue to contribute to long waits. A major expansion of the emergency department in Boston is scheduled to open next year.

Data points

The following data points were updated this week:

• 62-day cancer target, 31-day cancer target and Drug and alcohol treatment target for Scotland in Q1 2025-26.
• Emergency admissions, Elective overnight admissions and Day case admissions for Scotland in 2024-2025.
• Main Location for Acute,Sp,Com,MH,Amb in Q1 2025-26.
• Location for PP, Wales in Q2 2025-26.