Read Jack Serle's latest HSJi Review, which discusses how NHS maternity services are in a poor state. The problems are known, but the solutions are still to be found. Read the full article here.

Latest Investigations

Norfolk & Norwich University Hospital Foundation Trust, James Paget University Hospitals FT, and Queen Elizabeth Hospital King's Lynn FT

The collaboration between Norfolk & Norwich University Hospital Foundation Trust, James Paget University Hospitals FT, and Queen Elizabeth Hospital King’s Lynn FT formalises a long-running partnership between poorly performing trusts. However, significant geographical distances between the centres make effective joint working challenging. In addition, weak financial positions create risks around the timely payment of suppliers. Delays to the implementation of a new EPR system are also expected to slow progress, meaning recovery across the trusts will now likely take around two years.

The trust has reported a higher-than-planned deficit for 2025/26 and expects deeper financial challenges in 2026/27. Performance against the RTT target is well below plan, indicating that targets for 2026/27 will be particularly stretching. The trust requires central funding for IT improvements, including a new PAS. It has formed a group with Medway NHS FT, although earlier plans for a joint CEO and chair have been dropped; the trust still aims to maximise the benefits of group working, including procurement. Rising demand, driven by population growth and changing demographics – particularly in paediatrics and maternity – is also putting pressure on services. In response, the trust is exploring placing some facilities in new communities while making better use of existing estate such as Queen Mary’s Hospital. Over the longer term, it may deepen collaboration with Medway FT, which faces similar capacity issues. A £25m ICU expansion is expected to be completed in 2027–28. Fire safety is currently one of the trust’s highest-rated risks due to cladding on Darent Valley Hospital, an early PFI site, with remedial work potentially taking up to five years. To maintain capacity while this work is undertaken, the trust plans to install a modular ward.

Oxford University Hospitals Foundation Trust will become part of the new Thames Valley Integrated Care Board from April. A shift toward out-of-hospital commissioning could pose risks to the trust’s income, so it hopes to work with other trusts to move resources into community settings without losing funding. Maintaining research income remains a priority, with a focus on quickly recruiting patients to studies. The trust has also faced national media attention over families reporting traumatic birth experiences and is prioritising improvements to patient experience and safe staffing in maternity services, including listening events and enhanced support for families; it is also considering lifting the trust-wide recruitment freeze for maternity roles. Performance on cancer targets is among the worst in the country, particularly for 62‑day cancer waiting time standard and gynaecology pathways, and the trust is considering using private providers to help reduce demand. Meanwhile, it has launched an AI pilot using ambient voice technology to support clinical documentation. Financially, the trust faces a steep £99m savings target – around 6 per cent of income – leading to recruitment freezes, tighter controls on bank and agency staffing, and deferred supplier payments to preserve cash. Despite these measures, it is proving difficult to identify further savings within clinical divisions.

Data Points

The following data points were updated this week:

• About the board, Link to Board papers and Website Address for Acute,Sp,Com,MH,Amb in Q3 2025-26
• Locations and NHS members(Summary info under map) for ICS in Q3 2025-26
• 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 Q3 2025-26
• Online/video GP consultations and Providers with 'outstanding' leadership for ICS in Q4 2025-26
• A&E waiting target, Beds occupied by delayed discharges and Length of delayed discharges for Scotland in January
• CQC Rating for Acute, SP, MH, Com, Amb in Q4 2025-26
• Number of referrals for Wales in Q3 2025-26