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NHSE warns new policy creates risk for service ‘already under enormous pressure’

NHS England has warned the decision by police forces to respond to far fewer incidents involving people in mental distress could pose ‘risks’ to both patients and a service “already under enormous pressure”. 

National mental health director Claire Murdoch has written to integrated care board leaders and mental health trust CEOs about the possible impact of the “right care, right person” policing model which is being rolled out across England.

In July, policing minister Chris Philp gave all forces the green light to implement the RCRP model. The approach was first trialled in Humberside and involves officers only attending mental health calls where there is a risk to life or serious harm.

Now, in a letter seen by HSJ, Ms Murdoch has admitted the new model is a “major change for services already under enormous pressure” and warns that implementing all of the actions set out in the national partnership agreement may take time between the police and the NHS. This took three years in Humberside, she notes.

Ms Murdoch wrote: “I know you will all be doing your best to make this work, but I am so mindful of the risks to services and people with mental health problems, as I am sure you are too.”

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Source: HSJ, 15 September 2023

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NHSE warned of ‘inaccurate’ and ‘unethical’ investigation into man’s death

An independent investigation into the death of a man with autism and learning difficulties in NHS care may never be published in full as his sister has rejected several drafts as inaccurate, telling NHS England they were ‘totally unethical’.

Anthony Dawson died from a burst gastric ulcer in Ashmount, a residential care home run by Surrey and Borders Partnership Foundation Trust, in May 2015. The jury at an inquest into his death found there were gross failings in his care and his death was contributed to by neglect.

NHS England commissioned an independent investigation into the incident from Sancus Solutions in June 2017. But seven years after Mr Dawson’s death the investigation’s report has yet to be published, despite several reports being submitted.

His sister, Julia Dawson, has written to NHS chief executive Amanda Pritchard in recent weeks saying: “The investigation has not had my brother at its heart which we were assured would be the case” and that its reports had been “totally unethical”.

Ms Dawson has asked that only the executive summary of the latest draft of the investigation be published, alongside a statement saying that she feels it has inaccuracies and misses out important points.

She says that successive drafts have misrepresented her brother’s situation and failed to address what she believes was the real cause of his death – the frequent use of NSAIDs (ibuprofen) without any measures taken to protect his stomach. This ultimately led to the undiagnosed gastric ulcer bursting. An expert witness told the inquest into his death that treatment with proton pump inhibitors and stopping NSAIDs would have eradicated the ulcer.

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Source: HSJ, 4 April 2022

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NHSE wants ‘witch hunt’ lessons shared widely, says trust’s CEO

NHS England wants lessons learned by a trust overhauling its culture after a high-profile bullying scandal to be shared systemwide because similar problems have been evident at other trusts, the hospital’s boss has said.

West Suffolk Foundation Trust interim chief executive Craig Black said the trust was getting national level “support” to help with a cultural overhaul after a scathing independent review published in December concluded the trust’s hunt for a whistleblower had been “intimidating… flawed, and not fit for purpose”.

Mr Black said he thought NHSE would be “looking to learn from what we are doing” because senior managers viewed concerns raised in the West Suffolk review as having ”resonance with a number of organisations in the NHS at the moment”.

As well as the specific “witch hunt” case, the review raises wider issues about how trusts respond to whistleblowing and other concerns about care and patient safety.

West Suffolk’s executive director of workforce and communications Jeremy Over told the meeting the cultural change required was “organisational development which will take time, significant time”.

The report, West Suffolk Review – organisational development plan, sets out nine broad themes of work, linked to the trust’s core functions, “that capture the priority areas for organisational and cultural development at WSFT in light of the learnings from the report”. 

The document sets out how the trust’s governance, freedom to speak up, HR, staff voice, patient safety and other parts of its corporate infrastructure failed and contributed to a scandal.

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Source: HSJ, 1 March 2022

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NHSE wants ‘urgent’ meetings over ambulance handovers risk

NHS England and the Care Quality Commission have asked systems with large numbers of ambulance handover delays to urgently hold a meeting to try to fix the problem by “balancing the risks” of long 999 waiting times.

The request was made in an email to chief executives, which warned the service was “in a difficult position with all parts of the urgent and emergency care pathway under considerable strain… most acutely in ambulance response times which in turn is linked to challenges in handing patients over to emergency departments”.

The NHSE headed letter was signed by its chief operating officer, nursing director and medical director, but also by the CQC’s chief inspector of hospitals Ted Baker.

It said there was a “strong correlation” between handover delays at hospitals — which take place where A&Es are unable to receive patients from ambulances — and long delays for category two ambulances. This is because ambulances have to wait for long periods outside the hospitals.

The letter said: ”It is vital that we have a whole-system approach to considering risks across the urgent and emergency care pathway to provide the best outcomes for our patients. This may mean consideration of actions to be taken downstream to help improve flow and reduce pressures on emergency departments.”

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Source: HSJ, 17 February 2022

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NHSE vows to end ‘bombardment’ of trusts

NHS England has vowed to “reduce duplication and prevent providers from being bombarded with conflicting instructions”, including by removing integrated care boards’ performance management role.

A new draft NHS Performance Assessment Framework, published today, promises to “streamline oversight” by “providing consistent and co-ordinated oversight to reduce duplication and prevent providers from being bombarded with conflicting instructions”.

The document attempts to set out how integrated care boards and trusts will be regulated by NHS England, starting from July. 

It confirms that NHSE, not ICBs, will be responsible for provider performance management – a move announced late last year but met with anger from many ICBs.

The new paper says: “Discussions about performance will be led by colleagues at NHS England, who are experienced in addressing delivery challenges.”

The proposal that NHSE performance management will be carried out “with and through” ICBs — included in earlier versions of the framework — has gone.

In addition, trusts’ performance “segments” will no longer take into account wider system performance, nor a proposed judgement of their “capability”, as they will “solely [be] linked to delivery metrics”.

ICBs will still have to “hold their partners to account using the system levers that bind them together, such as their joint system plans, partnership agreements, joint committees and collaboratives”, however.

The framework is subject to consultation, and new NHSE CEO Sir Jim Mackey told its board today it was likely to be changed. There will “absolutely be some things we need to change and adjust”, he said. “This isn’t something that can be perfect at the first go.”

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Source: HSJ, 27 March 2025

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NHSE trying to ‘undermine’ doctors strike, claims BMA

NHS England has been accused of bowing to political pressure and trying to “undermine” the junior doctors strike.

British Medical Association council chair Philip Banfield tonight wrote to NHSE chief executive Amanda Pritchard accusing her organisation of the “weaponisation” of the process used to agree minimum services level during the strike.

Junior doctors walked out yesterday to begin a six day strike, the latest in their 10 month campaign and the longest in NHS history.

Professor Banfield’s letter claims that NHSE is not respecting the terms of the voluntary agreement to provide “derogations”. These, says the letter, “allow for junior doctors to return to work in the event of safety concerns arising from ‘unexpected and extreme circumstances’ unrelated to industrial action”.

The BMA accuses trusts of not providing the information the union needs to determine if the requests for derogations are justified. It said that the lack of information provided by trusts had led to it turning down 20 requests for derogations.

The letter states: “We are increasingly drawing the conclusion that NHS England’s change in attitude towards the process is not due to concerns around patient safety but due to political pressure to maintain a higher level of service, undermine our strike action and push the BMA into refusing an increasing number of requests; requests, we believe, would not have been put to us during previous rounds of strike action.

“The change in approach also appears to be politicisation and weaponisation of a safety critical process to justify the Minimum Service Level regulations.”

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Source: HSJ, 3 January 2024

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NHSE tries to put £2.3bn cap on agency staff spend

NHS England is introducing a new ceiling on the amount spent within each integrated care system on agency staff — cutting it by at least 10% in each area in one year — as part of a drive to find further savings across the health service.

Integrated Care Services (ICSs) have been told to cut spending on temporary staff by providers in their area by at least 10%, or £257m, on 2021-22 levels, taking expenditure down to a total of £2.3bn nationally. A letter to finance directors sent today, seen by HSJ says: “This will mean that some systems will need to go beyond their current financial plans to reduce agency expenditure.”

The move is part of a wider efficiency crackdown from NHS England, with further national control measures to be introduced over the next 18 months. HSJ understands that the renewed drive will focus on five other areas in addition to agency spend: medicines, pathway redesign, corporate services, procurement and specialised commissioning.

The extra savings ask comes on top of ICSs already committing to £5.5bn in efficiencies over 2022-23, which Nuffield Trust CEO Nigel Edwards said was “not a credible savings target”.

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Source: HSJ, 20 July 2022

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NHSE to slash targets in latest performance regime overhaul

NHS England is revising its new performance framework yet again, with a focus on slashing 77 indicators down to core priorities.

Its board signed off a version of the NHS Performance Assessment Framework just six weeks ago for consultation.

But HSJ understands engagement on that iteration was delayed as officials wanted to overhaul it again.

The March version moved integrated care boards’ regulatory performance management role to regional teams, and promised to “prevent providers being bombarded with conflicting instructions”. But it still listed 77 “delivery metrics”, covering operating objectives; finance and productivity; public health and patient outcomes; quality and inequalities.

New proposals expected this week will include significantly stripping the measures down, to primarily focus on headline performance and delivery asks in the 2025-26 planning guidance. That document axed numerous targets and asked,  which health and social care secretary Wes Streeting said would allow more local autonomy.

The new version will also seek to further clarify the changing roles of ICBs, providers, regions and the centre. 

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Source: HSJ, 12 May 2025

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NHSE to revive 2000s-style improvement collaboratives

NHS England plans to revive compulsory “structured improvement collaboratives” for outpatients, urgent and emergency care, and frailty services – in an echo of the Modernisation Agency approach of the 2000s.

The three collaboratives will be on a compulsory basis “to improve care at scale across the NHS”.

The approach is explicitly modelled on the “emergency services collaborative”  run by the NHS Modernisation Agency between 2002 and 2005. It played a big part in driving services towards meeting the new four-hour accident and emergency target, according to a 2004 evaluation.

A paper presented to NHSE’s board this week set out a wider reset of NHSE’s improvement framework, making clear responsibility is firmly with providers, while the centre focuses on “creating the conditions”, regional teams “support”, including with strengthened “local improvement networks”. Integrated care boards will focus on commissioning.

But the proposals – developed by Sarah-Jane Marsh, national director of urgent and emergency care and operations, and Glen Burley, financial reset and accountability director – said a “small number of national priorities will require a systematic ‘all-in’ effort to improve care at scale across the NHS”.

These will be targeted at specific changes in the three priority areas, with improvement experts and clinicians facilitating sessions where teams share best practice and improvements.

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Source: HSJ, 7 February 2026

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NHSE to catalogue ‘harm and near misses’ where BMA rejects derogations

The NHS will start recording harm caused to patients during strike action where exemptions have been rejected by the British Medical Association (BMA).

BMA council chair Phillip Banfield yesterday accused NHS England of the “weaponisation” of the strike “derogation” process, saying trusts had this week submitted more of the requests, which would permit some striking doctors to return to work, and were not providing information needed to determine if they were justified.

NHS England wrote back to Professor Banfield, insisting it was only trying to prioritise safety, but also saying it would revise its own approach to derogation requests.

This will include: asking trusts whose requests were rejected by the BMA “to compile a picture” of the impact on services; reinforcing requirements to report patient safety incidents during strikes and after mitigation requests, so “we can evidence harm and near misses which might have been avoided”.

The letter says: “We have consistently asked local medical and other clinical leaders to consider applying to the BMA for patient safety mitigations where they have significant concerns for patient safety that cannot be mitigated through other options available to them, and where they can make a strong evidential case that the return of a limited number of junior doctors would address these risks.

“We have done this, in part, because we have received a number of reports over previous periods of action that some teams have been put off seeking patient safety mitigations because of their prior experience of having applications rejected, or not receiving a response in time. We are sure you would agree that this is an unsatisfactory position, and that where patient safety concerns exist, these should always be escalated appropriately.”

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Source: HSJ, 4 January 2024

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NHSE to act over fears covid-19 focus could ‘do more harm than virus’

National NHS leaders are to take action over growing fears that the “unintended consequences” of focusing so heavily on tackling covid-19 could do more harm than the virus, HSJ has learned. 

NHS England analysts have been tasked with the challenging task of identifying patients who may not have the virus but may be at risk of significant harm or death because they are missing vital appointments or not attending emergency departments, with both the service and public so focused on covid-19. 

A senior NHS source familiar with the programme told HSJ: “There could be some very serious unintended consequences [to all the resource going into fighting coronavirus]. While there will be a lot of covid-19 fatalities, we could end up losing more ‘years of life’ because of fatalities relating to non-covid-19 health complications.

“What we don’t want to do is take our eye off the ball in terms of all the core business and all the other healthcare issues the NHS normally attends to."

“People will be developing symptoms of serious but treatable diseases, babies will be born which need immunising, and people will be developing breast lumps and need mammograms.”

HSJ understands system leaders are hopeful that in the coming days they will be able to assess the scale of the problem, and the key patient groups, and then begin planning the right interventions and communications programme to tackle it.

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Source: HSJ, 5 April 2020

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NHSE tells trusts: ‘be robust’ with GP referrals

An NHS England director says trusts should use ‘as robust triage as you can possibly do’ when deciding whether to accept referrals from GPs.

Ian Eardley, NHSE’s joint national clinical director for elective recovery, was asked during an internal NHSE webinar how trusts can encourage GPs to work more closely with secondary care to make sure they only send appropriate referrals.

He said: “There’s got to be as robust triage as you can possibly do, so if you’ve got referrals coming in which haven’t got the relevant or wrong information, then I think you need senior clinicians in a position to go back to the GP and say we need this bit of information or the other… Ultimately, it’s about robust front-end management.”

However, he admitted it was a “difficult [issue and] really difficult to do anything centrally”.

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Source: HSJ, 23 November 2022

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NHSE tells trusts to deliver 95% of planned activity during doctors’ strike

Trusts should deliver at least 95 per cent of planned elective activity during the forthcoming five-day resident doctor’s strike, according to NHS England chief executive Sir Jim Mackey.

In a letter to trust and integrated care board CEOs, he also says a “predicted spike” of flu expected immediately after the strike action makes it essential the service recovers as quickly as possible.

The letter, seen by HSJ, begins by stating: “Frustratingly, the British Medical Association has confirmed their planned strikes for next week will go ahead from 7am on Friday 14 November to 7am on Wednesday 19 November.”

The NHSE chief executive writes: “Reducing volumes of bookings, rescheduling appointments and other activity should only happen in exceptional circumstances to safeguard patient safety. This should be undertaken in consultation with your NHS England regional chief operating officer.”

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Source: HSJ, 10 November 2025

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NHSE tells trusts to ‘immediately stop all ambulance handover delays’

  • ·        Trusts told to identify actions to “immediately stop all delays”
  • ·        Letter calls for issue to be discussed at every board meeting
  • ·        It follows concern over harm to patients from delays

Trusts and integrated care systems are being told by NHS England and Improvement to take urgent action to ”immediately stop all delays” to ambulance handovers, which will require “difficult choices”.

A letter yesterday from NHS England’s medical director, director for emergency and elective care, and its regional directors was sent to all local chief executives and chairs yesterday.

It also says they should discuss the issue of ambulance handovers at every board meeting they hold, warns that “corridor care” is “unacceptable as a solution”, and says ambulances should not be used as “additional ED cubicles”.

The move comes amid signs of large numbers of very long handover delays, and concern about the risk to patients from this and the knock-on damage to ambulance response times.

Read the full article here (paywalled)
Original source: Health Service Journal

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NHSE tells trusts not to dismiss unvaccinated staff, after government U-turn

Trust were tonight told to cease plans for dismissing unvaccinated staff, as the government announced it would consult on dropping its mandatory covid vaccine policy.

An email to local NHS leaders said: “Today the Secretary of State has announced that [the vaccination as a condition of deployment policy] is being reconsidered. The government’s decision is subject to Parliamentary process and will require further consultation and a vote to be passed into legislation.

“We are aware that, based on the guidance already issued to the service, you will have begun to prepare for formal meetings with staff on their deployment if they remain unvaccinated. This change in government policy means we request that employers do not serve notice of termination to employees affected by the [vaccination as a condition of deployment] regulations.”

Previous guidance had required that, after 3 February – the deadline to have a first vaccination in order to have two vaccines by the 1 April legal cut-off – trusts begin formal meetings and issue dismissal warnings to unvaccinated patient-facing staff. 

Huge efforts have been put into encouraging staff to be vaccinated and to preparing for the next steps in recent weeks. However, tens of thousands across England are still believed to have had no vaccine, or to have an “unknown” vaccine status.

The brief NHSE letter gave no further guidance on whether trusts should continue to press staff to be vaccinated by that date, or continue to have discussions about redeployment.

Sajid Javid, who introduced the legal requirements last year, told the Commons: “I am announcing that we will launch a consultation on ending [VCOD] in health and all social care settings.

“Subject to the responses – and the will of this House – the Government will revoke the regulations. I have always been clear that our rules must remain proportionate and balanced – and of course, should we see another dramatic change in the virus, it would be responsible to review this policy again.”

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Source: HSJ, 1 February 2022

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NHSE tells staff: Consider legal action against patients who refuse to leave beds

NHS England has encouraged trusts to consider taking legal action against patients who refuse to leave hospital beds when step-down care is made available.

NHSE guidance sent to trusts late last year, seen by HSJ, advised clinicians that where people “with mental capacity” refuse to vacate a bed because they do not accept NHS-funded short-term care offers, the “local discharge choice policy” should be followed, which could involve legal action.

The guidance said the process “may include seeking an order for possession of the hospital bed” under civil law, and that “appropriate formal notification of the process must be given to the person and their representatives/carers”.

These legal powers were open to trusts prior to covid, but the memo from NHSE comes amid increasing pressure on trusts to improve discharge rates, as waits for emergency and elective care continue to soar.

Helen Hughes, chief executive of Patient Safety Learning, said: “Given the current pressures posed by covid, it is understandable that the NHS is seeking to ensure that the hospital discharge process is as swift and effective as possible.

“However, hospital discharges are complex processes and can potentially result in avoidable harm if patients are discharged before they are clinically ready. It only takes one element of this complex process failing to put a patient’s safety at risk.

“We would be particularly concerned if patients and their carers were put under pressure to accept potentially unsafe discharge options due to the threat of possible legal action by an NHS trust.”

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Source: HSJ, 14 January 2022

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NHSE tells ICBs to slow elective referrals

NHS England has told integrated care boards they need to slow down elective referrals dramatically – nearly eliminating year-on-year growth – with high-profile waiting list targets under threat.

Glen Burley, the NHS transformation executive team’s financial reset and accountability director, said the year-on-year increase in demand in 2025-26 needed to be just 0.2%, compared to a forecasted 1.8%. 

His letter to Integrated Care Board (ICB) chief executives, sent on Friday and seen by HSJ, set out “expectations” for ICBs on elective care demand management. It came as new data revealed the waiting list had grown for the first time in seven months.

Mr Burley said: “The elective care referral to treatment and cancer expectations for 2025-2026 require a significant step up in performance from the last few years, and, given the financial constraints in the system this year, the improvement can’t simply be delivered through additional capacity.”

The message reminds leaders that the single elective care target for ICBs proposed under the new national performance and assessment framework is the annual change in waiting list size. 

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Source: HSJ, 22 May 2025

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NHSE tells GPs they’re ‘breaching contract’ by denying record access

NHS England has taken the unusual move of warning multiple GP practices they are breaching their contract by refusing to give people automatic access to future entries in their record.

Under the current national GP contract, practices were ordered to give people on their list automatic access to prospective (future) medical records, via the NHS App, by 31 October. 

However, the British Medical Association GP committee has urged GPs to instead adopt an “opt in” model, saying it is concerned that giving automatic access could endanger some people.

The BMA gave practices a template letter to use to tell their integrated care boards they cannot move ahead with automatic access “due to several risks that cannot be sufficiently mitigated”.

NHS England’s own template letter for ICBs to use in response, seen by HSJ, states: “Based on your letter we interpret that the required changes were not implemented by 31 October 2023, thereby putting you in breach of your contractual obligations. We would therefore like to discuss with you your plan, including the timeline to become compliant.”

It is an unusual warning from NHSE which could potentially apply to hundreds or thousands of practices.

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Source: HSJ, 16 November 2023

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NHSE targeting 50% cut to waiting list

NHS England is floating proposals to cut the elective waiting list by nearly 50 per cent to under 4 million over the next five years.

HSJ understands this scenario is being discussed among system leaders as they brace themselves for the next government, whoever wins the general election, demanding a radical reduction in the waiting list. The list stood at 7.5 million as of the last official figures.

The figure of just under 4 million is in part being targeted because this is the level NHS bosses estimate the list would need to be reduced to if the service is to return to meeting the standard that 92 per cent of patients referred are treated within 18 weeks, which has not been met since February 2016.

Waiting list expert Rob Findlay estimated the required level would need to be closer to 3.5 million if the 92 per cent target is to be met. He told HSJ the list “would need to shrink to around 3.6 million before the statutory 18-week target became achievable again”.

HSJ understands NHSE’s leadership believes a target of under 4 million could be credible—albeit likely dependent on targeted extra capacity, technology, resolution of strikes and on which other targets are set, especially around emergency waiting times.

Progress could be accelerated by, for example, major outpatient reform to remove many appointments deemed unnecessary and use of technology to overhaul some pathways, officials believe. These could have a similar impact to the likes of faecal immunochemical testing, known as FIT, which is said to be playing a big role in reducing the cancer backlog.

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Source: HSJ, 26 April 2024

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NHSE steps up intervention over cancer delays

Two additional trusts have been placed in NHS England’s highest level of oversight for their performance on cancer and diagnostics.

West Suffolk Foundation Trust and University Hospitals Leicester (UHL) Foundation Trust have been moved into tier one of NHSE’s tiering frameworks on cancer and diagnostics.

The national body’s quarter four update, seen by HSJ, also shows:

  • A total of 17 trusts, some of the country’s biggest providers among them, are now in tier one for their performance on either cancer, diagnostics or electives.
  • Five trusts are in tier one for all three: Mid and South Essex; Norwich and Norfolk; Shrewsbury and Telford; Sheffield Teaching Hospitals; and University Hospitals Sussex.
  • Leeds Teaching Hospitals Foundation Trust, a major cancer centre, has been moved to tier two for its cancer performance. It was previously in tier one for cancer and electives.

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Source: HSJ, 20 February 2025

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NHSE steps up action on blood test tube shortage

According to NHSE guidance today, non-essential blood tests should be stopped and GPs should prioritise genomic tests over others. Vitamin D testing should also be stopped in all, but "exceptional circumstances" amid shortages in the blood collection tube stocks. 

The guidance, issued by the NHSE has advised genomics for testing of unwell neonates, prenatal screening and cancer diagnoses are “a high priority". NHSE have also said changes to testing “should be made in consultation with individual patients” and that “it is important to make clear that routine tests will be deferred only where it is clinically safe to do so”.

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Source: HSJ, 10 August 2021

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NHSE should intervene in trust safety investigation, says inquiry chair

The chair of the major inquiry into rogue surgeon Ian Paterson has raised concerns over a separate patient recall process conducted by Salford Royal Hospital, and suggested NHS England should intervene.

Leaders in Salford have been resisting pressure to expand a review of patients treated by the former head of its spinal division, John Williamson, over his 23-year career at the hospital.

A review of his last five years established clear problems with his surgical techniques and found multiple cases of avoidable harm.

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Source: HSJ, 7 May 2024

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NHSE sets trusts ‘100-day challenge’ to reduce delayed discharges

NHS England has set trusts and systems a ‘100-day challenge’ to discharge more patients from hospital and free up beds before winter.

David Sloman, chief operating officer of NHSE, has asked leaders of integrated care boards, acute and community trusts in a letter sent last week to adopt 10 “best practice initiatives” which he said “can make a significant difference in facilitating discharge and improving care for patients”.

Trusts and systems have been given until 30 September to have a “full understanding” of the initiatives (listed below) and “infrastructure in place” to implement them.

The initiatives include setting expected dates of discharge for patients within 48 hours of admission, “apply seven-day working” to discharge more patients at weekends, treat delayed discharge as “a potential harm event” and to manage workforces in community and social care services “to better match predicted patterns in demand”.

Sir David has told regional and local leaders that a dedicated national NHSE team will set up “launch meetings” in each system, which will ensure there is “a focus on improving processes and performance around discharge”.

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Source: HSJ, 5 July 2022

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NHSE sets requirements for neighbourhood health centres

A building can be designated a “neighbourhood health centre” (NHC) without offering mental health services, urgent or minor-injuries care, diagnostics or an on-site pharmacy, as determined by NHS England criteria published this week.

Guidance issued by NHSE set the minimum threshold for a building to qualify as an NHC at two functions: an on-site general practice and a community health or integrated neighbourhood team presence. Centres must be open at least 12 hours a day, six days a week.

All other services commonly associated with a “one-stop shop” health centre appear only in the larger tiers of the accompanying design specification, or are not required at any tier.

The specification sets out three tiers of NHCs. It notes, however, that: “The precise mix of complementary services, including diagnostics and other hospital-to-community functions, will vary by place according to local need and the wider service model.”

In relation to NHC’s mental health services, the guidance says it “focuses on primary care‑led and early intervention support, closely integrated with GP services”, meaning “community-based mental health centres complement, rather than replace, NHCs”.

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Source: HSJ, 15 April 2026

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NHSE sets new target for longest waiters

NHS England has tasked systems and providers with ending or significantly reducing 104-week waits for community mental health services by March 2025, following worsening performance.

It was announced in a webinar held by NHSE last week, in which mental health programme directors explained how the new metric would be implemented this autumn.

They confirmed that when an integrated care board or provider has a “small number” of 104-week waits, they should work to end them by March, and provide “trajectories” for 78-week and 52-week waits.

For those with a “larger number” of long waits, NHSE said ICBs should work with providers to agree an improvement plan throughout the rest of 2024-25. It said they would need to “detail ICB and provider-level trajectories” and submit these soon.

It said: “At a minimum, ICBs should ensure that less than 10 per cent of community mental health waits are over 104 weeks.”

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Source: HSJ, 18 July 2024

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