Dear colleague, 

Our Board meeting takes place on Thursday 15 January in the Lecture Theatre at King George Hospital. It starts at 13.15 and you are welcome to attend in person or join virtually. 

Ahead of next week’s meeting, I thought I would share my report that covers our improving maternity department; the growing demand we’re experiencing for urgent and emergency care; and the launch of our electronic patient record. 

I hope you find it a useful read. 

Matthew

Chief Executive’s Board report January 2026

Improving maternity care

We enter the new year having turned the corner on a once troubled past in our maternity service. We have the third largest single site unit in England (the largest in north east London) and, in 2025, 7,002 babies were born at Queen’s Hospital – 14 of them on Christmas Day.

The good news for expectant parents is that the Care Quality Commission (CQC) have rated the unit as good overall thanks to extra midwives and doctors, better  governance and a changing culture. We have invested significantly to improve safety and the care we provide. 

The improvements the CQC inspectors saw during their visit last August included more midwives and medical staff in our triage area (we’re one of only a few units with a dedicated senior doctor in obstetric triage); 24-hour flow coordinators to reduce delays; and innovative use of theatres to address the rising demand for caesarean sections. They wrote in their report that the senior leaders in the department had the “skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.”

Wes Streeting, the Health Secretary and MP for Ilford North, visited this month to thank the team for what he called “a huge achievement” that would benefit his constituents. He said the service had improved “in leaps and bounds”. Colleagues spoke to him about a range of issues, including the pressure on theatre availability (caesarean sections have increased by more than 40% since 2020) and the lack of a Level 3 Neonatal Intensive Care Unit (NICU) at Queen’s. 

The CQC report is an important moment for the Trust given our recent history and it is also a validation of all the hard work of the teams involved. I hope it offers residents greater confidence and will be reflected in the responses from our mothers in the maternity survey the CQC will publish later this year. The most recent one was carried out before many of the improvements had taken place. We still have more to do though to ensure every mother and baby get the care they deserve. 

It was good to demonstrate the positive changes during visits to the department by Margaret Mullane, MP for Dagenham and Rainham, and Baroness Amos. We are one of 12 trusts that are part of her national investigation into maternity services. The two day visit by Baroness Amos and her team was thorough, with a focus on learning and improvement. They spent much of their time talking to clinicians to get a ‘shop floor’ view of what it was like to work in the unit. 

Improving endometriosis diagnosis and treatment

I’d like to highlight what we’re doing to support national research into improving endometriosis diagnosis and treatment. We’re one of just a handful of trusts who are offering advanced ultrasound technology to detect the condition. The study is looking into whether this approach can spot signs of the disease earlier and more accurately. 

Urgent and emergency care

We continue to see growing use of these services, with the total number of attendances last year reaching 360,966 - 14,286 more than 2024. Last month, we saw an average of 995 people each day; it was our busiest December ever and our third busiest month on record. This demand (and the introduction of our new electronic patient record) meant that 70.7% of the patients were admitted, transferred or discharged within four hours. The NHS target, to be achieved by the end of March, is 78% and we have plans in place to recover our position. 

These record numbers resulted in too many people being cared for in A&E corridors, particularly at Queen’s, and their experience was highlighted by ITV News. As I said to the broadcaster, corridor care isn’t right or fair and it’s not something I would want for one of my relatives. It’s happening because we’re seeing more and more patients and it is safer to bring people into the hospital rather than keeping them waiting outside on ambulances for hours, as happened in the past. 

I first invited the media to capture the reality of corridor care at Queen’s, and its adverse impact on patients and staff, in January 2023. In the three years since, the number of people seeking urgent and emergency care at our Trust has increased by an extra 153 a day. 

£35m campaign for a new A&E at Queen’s Hospital 

I am confident – in this the year Queen’s turns 20 – that we will receive the £35m needed to rebuild the A&E. Our plans will come before the Board in March. The transformation of an overcrowded department that was designed for 325 patients a day will make it fit for purpose and eradicate corridor care. 

In the meantime, we are working with colleagues at NHS England on ways to improve the situation (including ensuring there is a regular flow of inpatients being discharged each morning) and we are piloting a Frailty SDEC (same day emergency care) for frail, elderly patients who arrive in our A&E.  

We showed Wes Streeting, during his visit to Queen’s, how a multi-disciplinary clinical team is focused on offering rapid assessment and intensive support so that  these patients leave the hospital as quickly and safely as they can. 

We are also working closely with colleagues at London Ambulance Service to increase the use of our frailty advice line to ensure the elderly are only brought into A&E when necessary. 

Patients with mental health needs

We’re continuing to see high numbers of people waiting in our A&Es for a referral to mental health services, despite the fact we do not provide mental health care or run mental health inpatient beds. We hope the Mental Health Crisis Assessment Hub which has opened at Goodmayes Hospital - next door to King George Hospital (KGH) - will mean that suitable patients go to the Hub and avoid having to come to A&E in the first place. 

At the invitation of all the chief nurses in north east London (NEL), the Health Services Safety Investigations Body (HSSIB) has visited hospitals in NEL, including Queen’s and KGH. It’s part of their national review of safety issues affecting those experiencing a mental health crisis who come into contact with urgent and emergency care services. The HSSIB team want to understand what is working well and what are the current challenges and barriers. 

Our finances

Not surprisingly, the extra expenditure I’ve outlined in this report – on vital maternity improvements, corridor care and looking after patients with mental health needs in our A&Es – has put a strain on our finances and left us with a deficit higher than was planned. In addition, the two recent strikes by resident doctors  have cost us around £1m each time. Unlike other trusts, we don’t have the benefit of reserves in the bank to draw on as we come to the end of the financial year.

Despite the ongoing pressures and the challenge of taking out resources while not compromising care, we will redouble our efforts to save money. We delivered around £100m of savings over the past three years. We will be expected to deliver much more in the years ahead. 

One way of achieving this will be through the new NEL procurement partnership. It has been set up to get better value for money for the NHS by reducing duplication and exploiting the collective buying power of all those involved. 

Our digital transformation

Another significant - and invaluable - expenditure (£50m) has been on our electronic patient record (EPR) and Electronic Prescribing and Medicines Administration (EPMA) which we introduced two months ago. We also upgraded our radiology information system, picture archiving and communications system and laboratory information management systems.  

Many people across the Trust worked extremely hard to ensure the launch went as well as it did. We’re using the same system as the one at Barts Health and colleagues there have been supporting us. Their involvement has been a model for how providers can share knowledge and expertise to help improve patient care, safety and staff experience. 

The benefits of our new EPR have been more easily delivered on the wards, where time has been freed up for clinical staff to spend with patients, and harder to realise in theatres and outpatient clinics. I’m sorry some patients have experienced delays as a result. 

Such short-term teething problems are inevitable in a change programme of this size. As noted already, the EPR roll out affected our performance (which we anticipated and have factored into our recovery plans) and we’ve also experienced issues in radiology as our different systems connected with each other.

Despite the predictable bumps along the way, it’s exciting to have entered a new digital era at BHRUT which will improve safety, reduce errors and transform the experience of working here. 

You win some…

We didn’t win Trust of the Year at the Health Service Journal Awards, but our shortlisting was an acknowledgement of how far we’ve come in recent years which we’ve tried to capture in this video. It’s well worth a watch. 

However, we were successful elsewhere. Our finance and cancer teams were recognised for their work improving care for cancer patients; Kristina Talusan has been awarded a Rising Star Award by the Royal College of Nursing; Sharon Piper received an Unsung Hero award for her work with HIV patients; and I was pleased to acknowledge the work of our sexual health and HIV teams at Barking Community Hospital. 

I am also pleased that West Ham are maintaining their relationship with us. They visited the wards just before Christmas and, according to nine year old Lyanna, meeting the players was the best moment of her life!