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

Queen Elizabeth Hospital King's Lynn Foundation Trust

The Queen Elizabeth Hospital King's Lynn Foundation Trust, under relatively new leadership, is part of both the system-wide acute collaboration and the West Norfolk “place partnership” with local health and care organisations. It is managing one of England's largest cost improvement programs and aims to save £6m through ward reconfiguration, with plans to reduce staffing costs by £10m. The trust is also seeking external help to tackle a backlog in dermatology and skin cancer cases. With its ageing infrastructure in urgent need of replacement, the trust is included in the New Hospital Programme, although the project is expected to be scaled down and delayed.

East and North Hertfordshire Trust

East and North Hertfordshire Trust is struggling with one of the worst records for “type 1” accident and emergency wait times, despite introducing alternative pathways to alleviate pressure. Due to MRI capacity shortages, the trust is increasingly turning to the private sector. To meet its cost improvement targets, it requires higher levels of elective care activity, and a cap has been placed on agency spending. Patients are facing significant delays in community paediatric services, with a new single service for Hertfordshire in development. The paediatric audiology service was paused last year due to concerns, while a new vascular hub is being set up to perform minimally invasive procedures using advanced technology, accepting referrals from across Hertfordshire and West Essex. An upgrade to the electronic patient record system is planned for next year, and the trust has applied for teaching hospital status.

North East London ICS

North East London Integrated Care System benefits from strong, established leadership and a long history of cross-sector collaboration, though its place-based partnerships are still struggling to gain traction. The acute collaborative has identified three strategic priorities, while the mental health collaborative is advancing its goals through clinician-led networks. Community and primary care collaboratives are in the early stages of development. The ICS is already significantly behind on its financial plan, prompting NHS England to bring in consultants to improve the situation. Waiting lists continue to grow, with trusts focusing on mutual aid to reduce delays. The system has also secured funding for community diagnostic centres.

Data

Last week the following data points were updated:

• Outpatient waiting list and Elective waiting list Scotland in Apr, May, Jun
• 18 week waiting target, 12 week waiting target – inpatients, and 13 week waiting target – outpatients of Scotland in Q1 2024-25
• E-COLI HOSPITAL-ONSET CASES (12-MONTH ENGLAND AVERAGE), E-COLI HOSPITAL-ONSET CASES (12-MONTH REGIONAL AVERAGE) and E-COLI HOSPITAL-ONSET CASES (12-MONTH ROLLING COUNT) of Acute in June
• A&E waiting target, Beds occupied by delayed discharges and Length of delayed discharges of Scotland in July
• Expenditure on Primary Healthcare Services, Expenditure on healthcare from other providers, Expenditure on Hospital and Community Health Services, Net operating costs for the financial year, Gross capital expenditure, and Tax payers equity of Wales in 2023-24
• 62 Day Cancer Target of Acute, Sp in Q1 2024-25
• NHS Improvement oversight ratings of Acute, Sp, Com, MH, Amb in Q2 2024-25
• Cancer 62-day performance and System oversight framework rating of ICS in Q2 2024-25
• CAMHS patients seen within 18 weeks and Psychological treatment within 18 weeks of Scotland in Q1 2024-25