Read Jack Serle's latest HSJi Review, which discusses people moving across multiple trusts, highlighting safety, workforce, and infrastructure challenges.

The restructure of integrated care boards has hit choppy waters. Read the full article here.

Latest investigations

York and Scarborough Teaching Hospitals Foundation Trust

The Trust is undergoing significant change as its long-serving Chief Executive prepares to step down. The incoming leader will face several challenges, including sharply declining staff morale and longstanding difficulties with emergency care. Efforts are underway to improve the efficiency of same-day emergency care services, while the Trust remains in a comparatively stronger position on elective care. A major digital transformation is in progress with the implementation of a new electronic patient record system. The organisation is also expanding the rollout of patient-initiated follow-ups across a wider range of specialties. Financial pressures are intense, with the Trust required to deliver a substantial cost improvement programme, which includes a strong focus on reducing the pay bill. To manage workforce costs, all vacancy hires are subject to a 13-week "firebreak." Additionally, there is a strategic plan to significantly increase the use of NHS Supply Chain procurement routes in order to drive further efficiencies.

West Hertfordshire Teaching Hospitals Trust

The Trust is actively pursuing greater commissioning powers for local health contracts as part of its broader ambition to become an integrated health organisation by 2028. In April 2025, WHTH took over adult community contracts, marking a key step toward this goal. To support this transition, the Trust recognises the need to expand its commissioning capacity. Efforts are also underway to strengthen the frailty workforce through enhanced financial incentives. A bid has been submitted to establish a mental health crisis centre, and plans are in place to transform virtual wards into a care coordination centre. Financially, the Trust has set a break-even plan for the year, with a particular focus on reducing reliance on temporary staffing. Meanwhile, major capital redevelopment is planned, with Watford General Hospital set to be rebuilt near its current location. However, delays to the project have necessitated additional investment in maintaining existing infrastructure.

Datapoints:

The following data points were updated this week:

• Online/video GP consultations for ICS in Q2 2025-26
• Treatment started within 28 days of assessment (%) and Patients receiving secondary mental health services for Wales in Q1 2025-26
• Outpatient waiting list and Elective waiting list for Scotland in April, May, and June

• 12-week waiting target – inpatients and 13-week waiting target – outpatients for Scotland in Q1 2025-26