Read Jack Serle's latest HSJi Review, which discusses workforce challenges.

The NHS’s workforce challenges are well documented, with national shortages in key roles – potentially leading to service safety concerns – and persistent cultural problems.

Read the full article here.

Latest investigations

East and North Hertfordshire Teaching Trust

East and North Hertfordshire Trust (ENHT) is set to take on a more prominent role in commissioning services, becoming the “host provider” for the East and North Hertfordshire place. The first services to be devolved under this model will be adult community contracts, with others to follow in alignment with national policy promoting neighbourhood health providers. During this transition, the trust's senior leadership has been stretched. Despite this, elective and cancer care performance remains strong. A key priority within emergency care is improving support for patients in mental health crisis, with the mental health urgent care centre based at Lister Hospital. The trust aims to enhance the presence of physical health teams within the centre. However, diagnostics, particularly audiology, remain a significant challenge. To address the MRI backlog, the trust has turned to the independent sector. Community paediatrics stands out for particularly long waiting times, while a Hertfordshire-wide initiative is underway to tackle neurodiversity assessment delays. Financially, ENHT has a breakeven plan for the year, but this is heavily reliant on a savings programme that is already facing significant pressure. As part of cost-saving measures, a mutually agreed resignation scheme is being implemented, targeting non-patient-facing roles. Additionally, the trust is transitioning to a single electronic patient record (EPR) system, Dedalus ORBIS U, with full implementation expected by next summer.

The Foundation Group

Acting chief executives have been appointed across the four trusts, as the group navigates a period of significant transformation. South Warwickshire University Foundation Trust is pursuing Integrated Health Organisation status, while three of the four trusts are in the process of rolling out new EPR systems. The use of AI tools is also being expanded across the group to enhance efficiency and care delivery. The urgent and emergency care group has identified performance in this area as its greatest concern, prompting a wide range of interventions to drive improvement. George Eliot Hospital’s cancer performance is under particular scrutiny, and the trust is implementing one-stop cancer pathways in response. SWUFT is also enhancing its elective care capacity with the opening of an elective hub and has plans to launch a surgical day unit. Financially, the group is targeting savings of more than £120m, with significant planned reductions in agency and especially bank staff usage. GEH is also establishing a wholly owned subsidiary as part of its financial strategy. Amid these changes, there is a strong focus on staff retention to maintain stability and service quality.

Dorset County Hospital Foundation Trust

Dorset County Hospital FT has set one of the most ambitious cost improvement programmes in the NHS. As part of the plan, around 200 roles are set to be removed, with a strong focus on cutting spending on bank staff and agency medics. To further support long-term efficiency, the trust is working with neighbouring providers to establish a shared services company, which is expected to deliver an estimated £58m in savings over five years. Meanwhile, work is underway on a new emergency department, and plans for a shared EPR system have received the go-ahead, marking a key step in improving digital integration and care coordination.

Data points

The following data points were updated this week:

• Locations, Board papers link, Website Link, About the board of ICS in Q1 2025-26.
• Name of Scotland, Wales in July.
• NHS members(Summary info under map) of ICS in Q4 2024-25.
• About the board, Link to Board papers, Website Address of Acute, Sp, Com, MH, Amb in Q1 2025-26.
• SURPLUS/DEFICIT FROM PREVIOUS YEAR, Income, EDUCATION INCOME, Cash Balances and SURPLUS/DEFICIT (% OF INCOME) of Acute, Sp, Com, MH, Amb in 2024-25.
• Non-NHS invoices paid on time (BY NUMBER), Non-NHS invoices paid on time (BY VALUE) of Acute, Acute- community, Ambulance in 2024-25.
• RESEARCH & DEVELOPMENT, INCOME and Total private income of Acute, specialist in 2024-25.
• SPENDING ON PRIVATE/NON-NHS ACTIVITY of Acute/Mental health/Specialist in 2024-25.
• E-COLI HOSPITAL-ONSET CASES (12-MONTH ENGLAND AVERAGE), E-COLI HOSPITAL-ONSET CASES (12-MONTH REGIONAL AVERAGE), E-COLI HOSPITAL-ONSET CASES (12-MONTH ROLLING COUNT), MRSA hospital-onset cases (12-month rolling count), C-Diff hospital-onset cases (12-month rolling count) of Acute in May.
• A&E waiting target, Beds occupied by delayed discharges, Length of delayed discharges of Scotland in June.