Read Jack Serle's latest HSJi Review, which talks about how the finances of the NHS in England are in their worst state for nearly two decades.

Deficits are widespread, and many trusts face unpalatable cuts to spending and staff even as they try and recover their performance from the pandemic low.  Read the full article here.

Latest investigations

Essex Partnership University Foundation Trust

Concerns over patient care at Essex Partnership University Foundation Trust have increased dramatically in recent years. A Channel 4 investigation exposed significant failings in 2022. Deaths of service users over a 23-year period are being investigated. The inquiry is now statutory so it can compel staff to give evidence. The probe is placing a high demand on leadership time and resources. External support is being used to manage a reputational hit. The trust is under pressure to deliver efficiencies to help tackle system deficit. Reducing temporary staffing costs and reducing out-of-area placements is key for the trust.

Greater Manchester Mental Health Foundation Trust

The trust’s main priority is quality improvement, following the broadcast of a BBC Panorama documentary exposing patient mistreatment at the Edenfield Centre adult forensic inpatient facility. A subsequent independent review criticised the trust board heavily for being “disconnected from patient experiences” and presiding over a toxic culture. A new chair and CEO have since been installed. Improvement strategies focus on co-production, giving patients and staff a greater voice, recruitment and making the estate safer. Longstanding staff shortages are a driver of poor culture at the trust, as noted by both the independent review and the CQC report. It is struggling to boost inpatient capacity, improve flow and reduce OAPs.

Nottingham University Hospitals Trust

The trust is reliant on insourcing and outsourcing to the independent sector to maintain planned care performance. Virtual ward expansion and discharge processes are key to improve urgent and emergency care. A tough financial recovery plan has been agreed with NHS England. NUH is the subject of an independent and very high-profile review of its maternity and neonatal services. The investigation stretches as far back as 2012 and almost 2,000 families are involved. NUH has two schemes within the New Hospitals Programme. The £2bn "Tomorrow’s NUH" project has been delayed by five years.

Data

Last week, the following data points were updated:

• Leadership, Link to Board papers, Website Address, About the board of Acute,Sp,Com,MH,Amb in Q1 2024-25
• A&E waiting target, Emergency admissions of Acute in Q1 2024-25
• Out of area placements of MH in Q1 2024-25
• A&E Performance, Emergency admission per 1000 population of ICS in Q1 2024-25