Dear colleague,  

I have written to you throughout the financial year about the growing pressures our two hospitals have been facing. Last month was our busiest December (and third busiest month on record) when it came to people seeking urgent and emergency care, with an average of 995 attendances a day.  

This month, we invited BBC London to capture the reality of corridor care at Queen’s Hospital. In the three years since they first filmed its adverse impact on patients and staff, the number of patients arriving at our two A&Es has increased by an extra 153 a day.  

This demand, and the costs incurred having extra staff providing care in our A&E corridors, is just one of the reasons why our finances are not where they should be. There’s also been additional expenditure on our new electronic patient record, on vital maternity improvements (the CQC recently rated our service good overall) and on looking after patients with mental health needs in our A&Es. When you add in rising prices for supplies and drugs, you can see why this has been a challenging year financially.  

We have delivered around £100m of savings over the past three years, but we won’t succeed in reaching break even at the end of this financial year. Our budget for 2025/26 is £1bn and we expect to have a deficit of £48m by March (once we receive funding to cover the strikes by resident doctors) which will increase to around £65m if, as expected, we lose access to deficit support funding.  

This is disappointing, given the hard work of colleagues over several years that saw us move out of financial special measures. We expect to deliver the national requirement for a 15% reduction in bank staff and a 40% cut in high-cost agency workers. This expenditure is likely to be less than £7m, a significant reduction compared with previous years.  

We won’t be submitting a break-even plan for 2026/27 as we are working on a savings programme that is consistent with what we have achieved in recent years. To deliver it, we will have to take some tough decisions around head count as we need to take out the equivalent of 400 (whole time equivalent) posts.  

We will continue to focus on reducing corporate costs where we can do so without causing damage to the delivery of clinical services. I’m very aware that we are putting extra pressure on clinical teams as a result of some of our existing corporate cuts, so we need to be careful where we go next. 

When it comes to clinical staffing, we are looking at using fewer bank shifts and at using our benchmarking data to see where we can run services more efficiently. Our new digital infrastructure should also reduce running costs.  

One of my priorities for the coming months is to ensure our Trust moves to a financially sustainable position.  

NHS England CEO shown how we're cutting waits

And finally, NHS England CEO Sir Jim Mackey visited our Elective Surgical Hub at King George Hospital this week to see how we're tackling waiting times. Sir Jim praised our staff for their dedication and spoke of the “real sense of pride” they showed.

He also acknowledged how far we’ve come as a Trust, saying we’re starting to see “new things happening” with improvements in patient care and our teams working together to speed up processes. It was a great recognition of the effort everyone’s been putting in to make things better for patients.

The hub performed over 10,000 operations last year, including more than 4,000 eye surgeries. Sir Jim even had the chance to try a cataract operation on a dummy eye, giving him a firsthand look at the work we do.

Our thanks to Sir Jim for taking the time to visit and for recognising the progress our teams are making to improve patient care.

Best wishes

Matthew Trainer