Read Jack Serle's latest HSJi Review, which notes how cybersecurity has once again become a high-profile issue for NHS leaders. The 3 June attack on Synnovis, a pathology service provider to two major trusts in south east London and primary care across the system, caused major disruption.

The attack on the pathology service came two years after the attack on IT provider Advanced, which supplies the Carenotes electronic patient record, and was the victim of an attack that compromised the medical records of mental health patients across the country.  Read the full article here.

Latest investigations

How the NHS is meeting the “unprecedented” efficiency challenge

NHS organisations face an unprecedented efficiency challenge in the service’s 76-year history. The briefing analyses the strategies trusts and integrated care boards adopt to keep their ballooning deficits under control. NHS funding in 2024-25 is effectively flat in real terms, with much of the additional funding provided by Rachel Reeves set to be eaten up by higher pay awards, inflation, and additional elective activity. Trusts and integrated care boards are struggling to stick to a combined planned deficit of £2.2bn, which is well above that recorded in recent years.

University Hospital Southampton Foundation Trust

University Hospital Southampton Foundation Trust has been placed in NHS England’s financial recovery support programme along with all other NHS providers in the Hampshire and Isle of Wight Integrated Care System. The system’s ICB is also included in the programme. All are now subject to close oversight and scrutiny from NHSE. UHS agreed to a £14.5m deficit for the 2024-25 financial year, but this has been revised down to £3.3m following the receipt of £11.2m in cash support from NHSE. This was part of a £70m package for the HIOW system, given in return for a pledge to deliver the revised financial plan.

Surrey Heartlands ICS

Surrey Integrated Care Board finally agreed to a £40m deficit system control target for 2024-25 with NHS England after much debate. Much of the deficit sits with Surrey and Sussex Healthcare Trust, which is projected to be more than £37m in the red at the year-end. However, both Ashford and St Peter’s Hospitals FT and Surrey and Borders Partnership FT are also struggling to mitigate their own deficits and the system deficit was adverse to plan by around £7m at the end of July. The system’s cost improvement target for the year is £201.8m. As of September, delivery was slightly behind target at £73.4m out of a planned £81.4m.

Datapoints

Last week, the following datapoints were updated:

• 12 hour A&E waits, 12 hour A&E waits (% of total attendances) and A&E attendances of Acute for Sept
• % beds occupied by delayed of Acute for Aug, Sept
• Discharge delays due to ‘internal’ reasons, Four hours A&E performance (all patients) and Discharge delays due to ‘external’ reasons of Acute for Sept, Oct
• Super stranded patients of Acute for Aug, Sept, Oct
• MRSA hospital-onset cases (12-month rolling count), C-Diff hospital-onset cases (12-month rolling count), 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) of Acute for August, Sept
• Percentage 75 and over and Percentage 4 and under of Wales for 2023-24
• 62 Day Cancer Target of Acute, Sp for Q2 2024-25
• NHS Improvement oversight ratings of Acute, Sp, Com, MH, Amb for Q3 2024-25
• Departments - Major A&E % and Emergency care streaming indicator, Type 3 Departments - Other A&E/Minor Injury Unit of Acute for Sept, Oct
• Number of cases waiting over one year and Proportion of cases waiting over one year of Acute, community, MH and specialist for Sept
• CAMHS patients seen within 18 weeks and Psychological treatment within 18 weeks of Scotland for Q2 2024-25
• A&E waiting target, Beds occupied by delayed discharges, Length of delayed discharges of Scotland for Oct
• System oversight framework rating of ICS for Q3 2024-25
• Telephone Number of Acute,Sp,Com,MH,Amb for Q2 2023-24
• Location, Telephone numbers, Website Address of PP for Q3 2023-24
• Location, Phone number, About the board link and Board paper link of Wales, Scotland for Q3 2024-25
• Main Location and Number Details of Acute,Sp,Com,MH,Amb for Q2 2023-24
• Name of Wales and Scotland for Dec