Read Jack Serle's latest HSJi Review, which reports on how hospitals, grappling with congested emergency departments, are adopting innovative care models to enhance patient flow.

The North Bristol model, initiated by CEO Maria Kane, strategically shifts patients from ED to appropriate wards each hour, mitigating pressure. The approach, now widespread, showcases positive outcomes, reducing ambulance waits and inspiring tailored adaptations across UK trusts. Read full article here.

Latest investigations

Royal Free London Foundation Trust

Cancer and elective waiting lists are being heavily validated at the trust. The trust is also launching a short teledermatology pilot scheme this autumn. It has also funded cancer care projects through its own charity. For example, the trust has opened London’s first one-stop NHS lung cancer diagnostic service. "Super weekends" seek to increase elective activity. £4.1m, purpose-built day surgery unit is opening this autumn. Low complexity eye surgery procedures are being concentrated at the new surgical hub. Royal Free plans to invest £4m in research activities. The trust is leading new national network for liver research.

Black Country ICS

The integrated care board is operating through four “place based partnerships”. Partnerships have been increasingly influential, but discussions in Dudley are progressing more slowly. Strong acute collaboration is promoting joint working. The ICB is mulling devolving powers to partnerships and collaboratives. The integrated care system's financial performance has significantly worsened since the start of the year. NHS England has imposed spending controls as a response. External review of the trust and ICB finances is planned. The ICB is also about to start procurement for a system improvement partner to develop a financial recovery plan. It is working with SWBH to scale up virtual wards and roll out a new clinical model. Financial situation may impact funding of a new urgent treatment centre.

The NHS in Wales: autumn 2023 briefing

NHS healthcare in Wales is delivered by seven health boards and two trusts. The health boards are responsible for both the planning and delivery of NHS-funded acute, primary, community and mental health care services across seven geographical areas in Wales. Ambulance services across the country are delivered by the Welsh Ambulance Services Trust, while Velindre University Trust provides specialist cancer across south east Wales. Social care services are overseen by local government. Unlike in England, there is no purchaser-provider split or commissioning bodies in the Welsh NHS. There is also no equivalent “arm’s length body” like NHSE, so the Welsh government is more directly involved in policy decisions and regulation of health boards.

Data

Last week the following data points were updated:

• Percentage of patients taken to A&E, THE 18-MINUTE TARGET(MINS.SECS), THE APPROPRIATE CONVEYANCE TARGET(MINS.SECS), THE SEVEN MINUTE TARGET(MINS.SECS), Incidents Per Quarter of Amb in Q3 2023-24
• Number of medical staff, Nursing, midwifery and health visiting staff, Health care assistants and other support staff, Scientific, therapeutic and technical staff, Admin and estates staff, Staff absent (%) of Wales in Q1 2023-24
• Name of Wales & Scotland in November
• Beds occupied by delayed discharges, Length of delayed discharges of Scotland in Sept
• Revenue budget, Surplus/deficit, Capital spend of Scotland in 2022-23
• Elective admissions of Acute, Sp in Q2 2023-24