Read Matt Discombe's latest HSJi Review, which says how it will come as a shock to pretty much no one reading this post that the NHS is in a dire financial situation.

This has been the case getting on for a decade, with each year more dire than the last, leaving aside the brief period through covid-19 when the magic money tree bloomed. Read the full article here.

Latest investigations

Facilities management in the NHS: 2025-26 and beyond

NHS spending on hard and soft facilities management (FM) is on the rise as trusts face growing challenges in maintaining their ageing estates and equipment. While many trusts continue to manage FM services in-house, most subcontract the delivery of specialist functions to external contractors. Financial pressures and the growth of hospital trust groups are driving a trend toward aggregating FM services. New rules have made it easier for foundation trusts to establish wholly owned subsidiaries to manage and deliver FM work. Digital technologies are creating opportunities to automate processes and improve the efficiency of equipment and estate monitoring. However, hiring freezes are making it increasingly difficult for trusts to replace their rapidly ageing FM workforce.

Ashford And St Peter's Hospitals Foundation Trust

Ashford And St Peter's Hospitals Foundation Trust, which now shares a CEO with Royal Surrey, is focusing on improving service resilience. Although a new surgical centre has recently opened, it is currently struggling to attract patients. The trust has set a £30m cost improvement target, with plans to reduce its paybill by cutting the use of temporary staff. Efforts are also under way to enhance theatre efficiency and accelerate patient discharge. Additionally, the trust aims to outsource less work to the private sector.

North London Foundation Trust

North London Foundation Trust is working to establish a single corporate culture as it prepares for the planned acquisition of the Tavistock and Portman FT. The trust continues to face challenges following the recent merger, particularly in developing common data systems. A drop in land values has complicated its land sale programme, while a review is under way to improve the safety of its estate. NLFT is taking steps to address underperformance in its adult memory services, alongside efforts to tackle continued reliance on the private sector, which has been linked to poor patient flow. In an effort to boost recruitment, the trust is changing clinical practice for psychiatrists.

Data

Last week following datapoints were updated:

• 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), MRSA hospital-onset cases (12-month rolling count) and C-Diff hospital-onset cases (12-month rolling count) of Acute for March.
• Outpatient waiting list and Elective waiting list of Scotland for Jan, Feb, Mar.
• Total staff, Medical & dental, Administrative, Allied health professionals, Healthcare science, Nursing and midwifery, Social care, 12 week waiting target – inpatients,13 week waiting target – outpatients, CAMHS patients seen within 18 weeks and Psychological treatment within 18 weeks of Scotland for Q4 2024-25.
• A&E waiting target, Beds occupied by delayed discharges and Length of delayed discharges of Scotland for April