Read Jack Serle's latest HSJi Review, which notes how UK patients are experiencing long waits for ambulances, long waits to get out of ambulances into the ED, long waits to be seen by a clinician, and long waits – all too often in corridors – before being admitted.

On occasion this can be due to problems within the ED itself. Growing demand and aging estates with insufficient capacity rapidly results in congestion. Read the full article here.

Latest investigations

South West London ICS

South West London Integrated Care System agreed to a £120m deficit target for 2024-25 with NHS England. Key to hitting the target is the delivery of £256m in cost improvements, equivalent to 5.7 per cent of total expenditure. The system reported that it was on course to deliver its financial plan as of November 2024. Delivering the savings relies on high-risk plans, including workforce cuts of 1,285 whole-time equivalents. The system is also seeking to reduce hospital length of stay by 1.5 days and cut emergency admissions. It plans to generate income from increased elective recovery fund activity.

The Princess Alexandra Hospital Trust

Princess Alexandra Hospital Trust is one of the worst-performing trusts in emergency care in the country. Local primary care services are under pressure due to the relatively poor health of Harlow residents, and the difficulty in attracting GPs to the area. The trust’s town centre accident and emergency is very convenient for those struggling to get a GP appointment. Two-thirds of attendees at the A&E did not have an urgent care need, and the department was built to cope with far less patients than current footfall, which makes overcrowding even more likely.

Imperial College Healthcare Trust

As the acute workhorse of the inner part of the North West London system, Imperial College Healthcare Trust’s focus has been on maximising the amount of planned work it undertakes. This has the twin advantages of reducing the system’s elective waiting list and maximising revenue from the national elective recovery fund. This approach has been successful in driving activity, but less so in generating financial surpluses, as it was often realised via expensive overtime or outsourcing to the private sector.

Data

Last week, the following datapoints were updated:

• GPs per 100,000 population and GP nurses per 100,000 population of ICS for Q3 2024-25
• Patients spending under 4 hours in ED (%) and Red emergency responses arriving within 8 minutes (%) of Wales for Q3 2024-25
• Specialised Services Income of Acute,Sp,Com,MH for 2022-2023, 2023-2024, and 2024-2025