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

International recruitment in the NHS

The NHS has relied on international recruits since its creation in 1948, and today more than 20 per cent of staff in England are non-UK nationals. Recruitment surged in 2023 – driven by domestic shortages, active overseas campaigns and the Health and Care Worker visa – but by mid-2024, new international nurse registrations had slowed, and early departures climbed, many within the first five years of qualification.

The outlook for diagnostics in 2025-26

The total NHS diagnostic waiting list in February 2025 stood at 1,668,868. This compares to 1,611,825 in February last year and 1,082,022 in February 2020, the month before the pandemic struck. In addition to well-established trends such as the increasing number of older people in the population, demand has in part been fuelled by the expansion of screening initiatives such as the bowel cancer screening programme.

As of January this year, the faecal-immunochemical test (FIT) used in the programme is being sent to all 50-74 year-olds in England. Previously, only those aged between 54 and 74 were included. NHS England estimates that around 850,000 additional people will be eligible for the test as a result.

Blackpool Teaching Hospitals Foundation Trust

Blackpool Teaching Hospitals Foundation Trust has historically struggled with an overreliance on agency staffing and spent £28.3m on them in 2024-25. The trust has also put together a “stretch scenario” that would deliver savings of up to £40m. The trust is seeking savings through bulk purchases and contract renegotiations. It is also expanding its use of interim electronic patient record.

Blackpool has a significant problem with ambulance handover delays. To improve patient flow out of the hospital, and therefore free up beds for emergency admissions, the trust focuses on moving patients who have been ready for discharge for more than a week to other settings. Theatre productivity is hampered by slow turnarounds between operations. To mitigate this, the trust has introduced “lean lists,” where instrument trays are pre-built and packed the night before to reduce downtime between patients.

Data

Last week following datapoints were updated:

• Region (Summary info under map), Planned surplus/deficit and Planned surplus/deficit as a % of core allocation of ICS for 2025-26
• Treatment started within 28 days of assessment (%), and Patients receiving secondary mental health services of Wales for Q4 2024-25
• Online/video GP consultations of ICS for Q1 2025-26