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Using a mixture of proprietary intelligence, HSJ Intelligence brings you the top strategic issues facing specific providers and health systems.
Latest HSJi Review discusses the broken estates of the NHS
Read Jack Serle's latest HSJi Review, which notes that the Department of Health and Social Care is at pains to tell us at every opportunity since the arrival of its new management that the NHS is broken.
Debating whether or not this new departmental leitmotif is true is the health policy wonk equivalent of arguing over how many angels can dance on the head of a pin. The health service is unquestionably beset with an array of deep-seated problems. None of them is more self-evident to the public, patients and staff alike than the state of its estates. Read the full article here.
Latest investigations
Cornwall and The Isles of Scilly ICS
The Royal Cornwall Hospitals Trust, now part of a provider collaborative with the three Devon acute trusts, is navigating the early stages of joint working. Facing severe pressures in emergency care and dentistry, the trust’s financial break-even plan is under threat, with tight cost restrictions on acute care. Challenges include critical shortages in adult social care and an over-reliance on community hospitals. In response, efforts to expand virtual wards and urgent community response services are underway, alongside innovative partnerships with the third sector to support independent living.
A new operating model will delegate more decision-making to place-based partnerships, which will oversee out-of-hospital services. Programme boards are addressing major clinical areas amid a forecasted £120m system deficit, driving workforce cuts. Consultants, brought in by NHS England, are reviewing ICS financial plans. Meanwhile, Midland Metropolitan University Hospital has opened but faces cost and bed shortfalls. New beds are being added across the system, and Walsall is receiving support to manage increased urgent and emergency care demand.
The trust's main site faces a fire risk due to cladding, which must be removed, impacting inpatient capacity as safety measures and refurbishments proceed. Plans are underway for a new ICU at Darent Valley Hospital, alongside a push to relocate more elective and diagnostic work off-site. As part of an ICS under intense financial strain, the trust aims to achieve a £21m cost improvement plan, heavily reliant on workforce and non-pay savings. Currently “digitally immature,” the trust is also seeking to procure a modern electronic patient record system to improve its digital capabilities.
Datapoints
Last week, the following datapoints were updated:
- Annual Report of Acute,Sp,Com,MH,Amb, Scotland, Wales for 2023-2024
- Link to Quality Accounts of Acute,Sp,Com,MH,Amb for 2023-2024
- Leadership of Acute,Sp,Com,MH,Amb for Q2 2024-25
- Leadership of ICS, Wales, Scotland for October
- Board papers of Wales, Scotland, England for October
- Quarterly staff absence rates of Acute,Sp,Com,MH,Amb for Q1 2024-25
- Total Workforce of Acute,Sp,Com,MH,Amb for Q2 2024-25
- Workforce- Medical staff, Nursing Staff, Other Staff of Acute,Sp,MH, Comm for Q2 2024-25
- Workforce- Amb Staff of Amb for Q2 2024-25
- Locations, NHS members(Summary info under map), GPs per 100,000 population, GP nurses per 100,000 population, Nursing workforce, Board papers link, Website Link, About the board, Local Authorities of ICS for Q2 2024-25
- Patients spending under 4 hours in ED (%), Red emergency responses arriving within 8 minutes (%) of Wales for Q2 2024-25
- Proportion of list waiting over 52 weeks, % beds used by elective care of Acute, community, MH and specialist for all data till Aug
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HSJI Experts
With unrivalled access to senior figures, NHS data sources and rigorous primary research, HSJ experts have a unique insight on the NHS, and deep understanding of the strategic issues facing NHS organisations and leadership teams. HSJi offers exclusive, predictive analysis explaining key trends and the specific NHS organisations that are likely to be affected.
Alastair McLellan
Editor
Ben Clover
Bureau chief
Annabelle Collins
Senior correspondent
Matt Discombe
Correspondent
Oliver Hudson
Analyst
Nick Kituno
Correspondent
James Illman
Bureau chief
Alison Moore
Correspondent
Jack Serle
Senior insights correspondent
Dave West
Deputy editor