Read Jack Serle's latest HSJi Review, which says it would be imprudent to take one’s eye off the state of acute providers.

If you take emergency care as a yardstick for how trusts are faring, the picture is a bleak one.

Attendances at “type 1” accident and emergency departments that are meant to treat the most seriously unwell patients are rising steadily. Read the full article here.

Latest investigations

Greater Manchester ICS

There is a strong commitment to joint working by influential local politicians, with services often planned and delivered at the locality level. The flagship LiveWell neighbourhood model needs to become financially sustainable, while local transformation projects are being targeted for cost savings. This has included significant staff cuts across a wide range of roles. A new, standardised approach to continuing healthcare has been introduced, and the system is expanding alternatives to emergency department attendance and hospitalisation. However, there are still long elective waits in specialties such as gynaecology and ophthalmology, alongside significant use of the independent sector for elective work.

Sheffield Teaching Hospitals Foundation Trust

Maternity services remain under scrutiny, and the trust is commissioning an external review of leadership. A new electronic patient record is about to be rolled out, while cuts to admin and bank staff are under consideration. Expanded use of e-rostering is planned to help hold down costs. Several “fragile” services are under review, and there is a focus on increasing high-volume and daycase surgery. Outsourcing of elective work to private hospitals is set to continue. STH is under oversight due to issues with cancer and diagnostic performance, and the trust is also struggling with 12-hour A&E waits.

Buckinghamshire Healthcare Trust

The trust is struggling to meet national cancer standards, and AI alongside insourcing is being used to address pressure on dermatology services caused by surging referrals. Theatre capacity is insufficient and further constrained by the poor quality of the estate. There are plans to procure a new EPR, along with major investment in virtual ward services and an expansion into end-of-life care. The trust is facing a challenging savings plan, with a focus on reducing the pay bill and making significant cuts to corporate services.

Data

Last week the following data points were updated:

• Leadership of Acute,Sp,Com,MH,Amb in Q4 2024-25
• Leadership of ICS, Wales, Scotland in March
• E-COLI HOSPITAL-ONSET CASES (12-MONTH ENGLAND AVERAGE, REGIONAL AVERAGE, ROLLING COUNT) of Acute in Feb
• MRSA hospital-onset cases (12-month rolling count) of Acute in Feb
• C-Diff hospital-onset cases (12-month rolling count) of Acute in Feb
• A&E waiting target, Beds occupied by delayed discharges, Length of delayed discharges of Scotland in March