Chief Executive (Interim) Board report - September 2026
Our finances
We are receiving valuable support and oversight from NHS England (NHSE) as we work hard to achieve our financial plan; one of those helping us has described it as a Herculean effort. I know how frustrating and challenging this is for everyone, especially for those in clinical roles, but we have to cut costs and achieve financial sustainability.
Our original plan was to return a deficit of £41.3m by the end of the 2026/27 financial year. NHSE have now offered us £39.2m of one-off funding and North East London ICB (NEL ICB) have agreed to make up the £2.1m difference. To return to break even by the beginning of April 2027, we must play our part and deliver £51.9m of savings.
We have worked hard to create initiatives across the organisation, under the banner of Better Patient Care, Better value for money, and they have produced nearly £9m of savings so far. We’re launching an online portal later this month to make it as easy as possible for colleagues on the shop floor to share ideas for reducing costs.
Our current problem is that we are spending around £200k a day more than we receive from the taxpayer. If we continue at this rate, we will end up with a deficit of more than £80m.
To get back on track, and given that the majority of our £1bn annual expenditure is on pay, we are cutting our temporary staff bookings. We are reducing bank and agency use where it is safe to do so and where it isn’t compromising the care we provide our patients. We are also ensuring that safer staffing requirements are met.
We’ve also introduced recruitment by exception for all substantive and temporary roles, where only posts on a pre-approved list (which have been assessed for their impact on quality) will be recruited to. We have 1,600 more staff than we did five years ago, the vast majority of whom are clinical.
The inevitable scrutiny we are facing also means that all new requests for investment have to be approved by our regulator. It’s a further reminder of why we must urgently reduce costs, so that we regain our autonomy, have control of our finances and can develop and invest in services in the way we know is best for residents.
Amos report
We were one of 12 trusts that were part of a national investigation into maternity services. As well as her main report, Baroness Amos also published a report on our unit after she had spoken to families and staff.
Reading our report, it is painfully clear that the improvements we’ve made - which led the Care Quality Commission to rate our services as good overall – came too late for the families who have experienced harm or bereavement. I would like to apologise for the fact their experiences have had a lasting, harmful impact on them and their loved ones.
NHSE have drawn up a 10-point plan of urgent actions for the health service (following both the Amos investigation and the Ockenden Maternity Review) which we are working through to check we comply. We will also encourage maternity colleagues to take part in a national survey this month which is designed to help shape the future.
We know we must do more. We will continue to improve how we communicate with parents and respond to complaints. A pressing requirement, that was highlighted in our Amos report, is for an electronic patient record (EPR) in our maternity services.
This investment would be on top of the £5.5m we’ve already spent in the department in the last two years. The additional money funded improvements including more midwives; doctors and support staff in our maternity triage area (we’re one of only a few units with a dedicated doctor in obstetric triage); 24-hour flow coordinators to reduce delays; and significantly enhanced pre-conception support for women with diabetes.
The urgent need for a maternity EPR was just one of the topics raised during staff meetings we’ve held since the Amos investigation concluded in June. Other issues included better access to translation services and the pressure on theatres, given the rise in Caesarean sections. Inevitably, the negative publicity surrounding aspects of maternity care nationally has had an impact on some colleagues.
I am committed to supporting staff to continue with the improvements they’ve been making, and which were captured in The Guardian newspaper. I want learning and improvement to be a positive experience for staff and for families.
I was grateful to hear, at a listening event, one community midwife talk about how it was her job to make expectant parents feel safe when they come to us. I had a further conversation with her recently and also had a meeting with a senior obstetrician and a senior midwife. Our goal has to be to reflect, to continue improving and to maintain confidence in our maternity services.
Improving services
I spent a very productive morning recently with the mothers of children and young people with special educational needs and disabilities (SEND). They are frequent users of our services (their children can have dozens of admissions) and it’s clear from our conversation that we have work to do. I am grateful to Margaret Mullane, the MP for Dagenham and Rainham, for initiating what will be the first of many such meetings; I, and others from the Trust, will visit their school this term.
We will work together to ensure the experience of these children and young adults is the best it can be.
Urgent and emergency care
In July, more than four out of five patients – 81.3% - who were seeking urgent and emergency care were admitted, discharged or transferred within four hours. This All-Types performance meant we were the best performing trust in London and it was achieved in a summer month when we were seeing an average of 1,042 attendances each day. Just four years ago, the average daily attendance was 851.
We are confident we will hit the NHSE target of 82% by March next year.
Another improving statistic is our Type 1 performance (the most seriously ill patients) which increased to 60.9%. We also continue to be helped by our partner PELC who run our urgent treatment centres, where the less seriously ill patients are seen. They now divert 7 in 10 walk-in patients away from our A&Es to services better placed to meet their needs.
Despite these achievements, we still have more to do to increase the number of patients seen within four hours; cut the number of those spending more than 12 hours in A&E; and get rid of corridor care for good. Key to this plan will be reducing the length of time patients spend in our hospitals and expediting discharges when people are well enough to leave.
£42m campaign for a new A&E at Queen’s Hospital
The transformation of the A&E at Queen’s Hospital will help with corridor care and the work is continuing to secure the funding. We’ve received the support of NEL ICB to carry out the rebuild and it would be great if we could start in December when Queen’s turns 20. As well as making it fit for purpose, I’m excited by the prospect of collaborating with UCL Partners. I’ve been discussing with Dr Chris Laing, their CEO, how we could use his organisation’s expertise and research to design digitally enabled clinical pathways for the new department.
Cutting our waiting list
We continue to recover from the adverse impact on performance of the introduction, last year, of our EPR across most of the Trust. The total number of residents on the waiting list in July was the lowest it’s been since the EPR launch, down more than 2,000 to 67,500. The majority require an outpatient appointment with one of our specialist teams.
NHSE have set us the challenging target (to be achieved by the end of the financial year) of 77% of patients waiting no longer than 18 weeks from referral to treatment (RTT). In July, we achieved 67.7%; initial data suggests the final figure will be around 69% once it has been fully validated.
The improvements we’re seeing extend to diagnostic waiting times (down by 8.2% between June and July) and our cancer performance. This month we’ll be participating in a peer review of our breast cancer services to confirm we’re doing everything we can for our patients and to underline our commitment to ongoing learning and service improvement.
We are benefitting from additional funding from NEL ICB to reduce waiting times and from the North East London Cancer Alliance to improve cancer pathways and make sure patients are receiving diagnosis and treatment quickly.
Initiatives have included 20 operations in three theatres on one day and 17 joint replacements carried out over five days. We’ve also increased the number of robots we have, from two to four, so that more patients will have access to cutting-edge, minimally invasive surgery.
Doing the best for our patients
We continue to explore and introduce new ways of caring for our patients. Our £6.5m ambitious brain study research has nearly recruited all of its participants; we’ve introduced a lifechanging procedure for people suffering from seizures; and we’ve opened a purpose built red blood cell unit for those with sickle cell disease and other rare blood disorders.
The coming months
Our understandable focus on day-to-day finances has to be balanced with ensuring we’re prepared for the future. We’ve had strong interest in the Chief Digital Information Officer role that we are recruiting. The successful candidate, who will be a member of our Board, will be responsible for getting the very best out of our EPR, driving future digital improvements and aligning us with the move from analogue to digital in the 10-Year Health Plan.
In another change to my senior leadership team, Max Tolhurst has become our Interim Chief Operating Officer (COO), having been Deputy COO. Max knows our Trust, our staff and the communities we serve and will oversee the day to day running of our hospitals and services.
Fiona Wheeler
Chief Executive (Interim)
September 2026