Chief Executive’s Board report November 2025
Dear colleague,
Our Board meeting takes place on Thursday 6 November in the Lecture Theatre at King George Hospital. It starts at 13.15 and you are welcome to join in person or virtually .
Ahead of next week’s meeting, I thought I would share my report that covers the introduction of our electronic patient record; our position in the NHS league table; and the transformative impact of trailblazing brain surgery on a patient with Parkinson’s.
I hope you find it a useful read.
Matthew
Chief Executive’s Board report November 2025
Electronic patient record
This month we are undertaking the biggest single change programme in the history of our organisation with the introduction of an electronic patient record (EPR) . We are the last acute trust in London to rely on paper; every year we generate more than 25m sheets of A4.
Our digital transformation isn’t confined to just EPR. We’re also launching an EPMA (Electronic Prescribing and Medicines Administration) to replace paper prescriptions and we’re upgrading our radiology information system, picture archiving and communications system and laboratory information management systems.
Further down the track we will need to address the fact we rely on out-of-date equipment in our pathology service which is the last stand-alone one of its kind in England and we need an EPR for our maternity services.
Our EPR - Millennium by Oracle Health - is the same as the one being used at Barts Health which means that patient information will be available across the seven hospitals run by the two trusts. We are indebted to colleagues at Barts Health for all their support as we’ve got ready to go live.
It will benefit residents and staff by improving patient safety, reducing errors (with the introduction of electronic prescribing) and cutting form filling, allowing clinicians more time to focus on their patients.
As a digitally immature trust, we’ve relied heavily on the experience of Barts Health and on learning from other trusts who’ve introduced one. It’s clear that our transition from paper to digital will be bumpy and visitors to our sites will have to be patient as all of my colleagues get to grips with EPR.
We’re helped by the fact many staff have worked on digital systems elsewhere in the health service and had to be trained, when they joined us, in our paper ways of working!
Our digital overhaul is likely to have a short-term, adverse impact on our performance (we will be safer, but slower as we adjust to new ways of working) and we have plans in place to fully recover within a few months of launch.
Another challenge we will have to navigate, in the immediate aftermath of the system starting to be used, is the five day strike by resident doctors (the new name for junior doctors) which is scheduled to begin six days after we have gone live.
Transforming our Trust
Introducing an EPR is just the latest of the changes we’ve made at BHRUT that have led senior people in the NHS to regard us as a London success story. Professor Sir Mark Caulfield , one of our most experienced non-executive directors, spoke at a recent Board meeting about how we now projected a different kind of confidence.
We have stabilised the Trust, reduced vacancy rates and sickness absences and improved performance. We need to ensure these positive changes are embedded and become sustainable. We can see lots of new opportunities, not least around outpatients, pharmacy and prescribing and developing neighbourhood health centres in our boroughs.
We are also part of a new national programme in Barking and Dagenham that will bring services for those with long-term conditions closer to their homes. It will help them manage their health better and avoid unnecessary hospital admission.
NHS league table
Our progress has meant we have been ranked 57th out of 124 acute trusts in the new league table published by NHS England (NHSE). We would have been nearer the bottom a few years ago, not mid-table.
We were scored in segment 1 (high performing) for access to services and effectiveness; segment 2 (above average) for people and workforce; and segment 4 (low performing) for finance and productivity, and for patient safety. Our overall position is segment 3, as no trust in deficit can be above this ranking. If our money was in better shape, we would be in segment 2.
Our finances
We’re spending around £500k a week more on staffing than we have the budget for. We’ve reduced our agency spend by 50% and our bank costs by 13% compared to last year. However, we need to go further given we have more substantive staff than ever before and we are using more bank staff than we can afford.
As we take money out, we are determined to ensure we don’t undo all the work we’ve put in place to turn the organisation around or put quality and safety at risk. We are always on the lookout for opportunities to spend less.
For example, a £1m grant we’ve received to install solar panels on the roof of King George Hospital (KGH) will generate more than £3m of savings and reduce our carbon emissions by around 125 tonnes each year. We’ve also saved more than £400k a year thanks to the contracts we’ve negotiated with the companies that help us run the KGH site.
Amos Investigation
We are one of 12 trusts that are part of a national investigation into maternity services in England which is being led by Baroness Amos. She has made clear repeatedly that she’s not investigating ‘failing’ trusts and she’s not in the business of apportioning blame. Instead, her focus is on learning, with the support of families, and establishing ways that maternity services can be improved.
When the Care Quality Commission (CQC) visited our department at Queen’s Hospital in August their inspectors told us about the positive changes they’d seen in the past year. Given this feedback, I am confident that when their report is published we will see an improvement to our current maternity rating of requires improvement.
I spent an uplifting afternoon with maternity colleagues last month when I saw for myself the improvements the CQC inspectors had commented on. I am conscious, as I write this, that these beneficial changes have come too late for those who have lost a child and those who have experienced poor care.
Improving urgent and emergency care
The NHS target (to be achieved by next March) for those seeking urgent and emergency care is that 78% of them should be admitted, transferred or discharged within four hours. Our overall (All Types) performance in September (when we had an average of 976 daily attendances) was 79% which placed us 3rd out of 17 acute trusts in London and 21st out of 124 in England.
The need to transform our A&E at Queen’s (we are campaigning for the £35m needed to rebuild the department and eradicate corridor care) is reinforced by the fact we still have too many people waiting more than 12 hours in the department to be treated.
Patients with mental health needs
Our A&Es are becoming the default place of safety for those with mental health needs. In September 373 patients, waiting for a referral to mental health services, spent an average of 22 hours in the departments.
One of the potentially game changing ways we’re working to improve the experience of these patients is taking place at KGH. There, they are now assessed in our urgent treatment centre by our GP colleagues (who look after the less seriously ill, Type 3 patients), with support from NELFT , our mental health provider. They only come into A&E if they need emergency care.
We’re also setting up monthly meetings with the police, social services and the ambulance service to agree a strategy to respond appropriately to children and young people who end up in our A&Es when they are in crisis or their placement has broken down.
Cutting our waiting list
Colleagues are constantly looking for ways to reduce the time residents wait to be seen. Our TonKidz project saw 648 children who needed tonsillectomies being treated in just three months - it would usually take two years – and we carried out our largest number of gall bladder removals (18) in one day by using two theatres and our surgical robots. We’ve also reduced by a quarter the number of last minute cancellations for planned operations.
We were once again the best acute trust in London for tackling waiting lists (and 5th nationally), with 73.5% of patients waiting no longer than 18 weeks from referral to treatment. NHSE’s target, to be achieved by March 2026, is 71.4%. September’s performance represented a 9.5% improvement on the same month, the year before.
The number of residents on our waiting list has risen slightly to 60,711 which reflects a noticeable increase in demand. Nine out of ten of them require an outpatient appointment with one of our specialists. 542 patients have waited more than 52 weeks which, for the 7th consecutive month, is below NHSE’s requirement that no more than 1% of people remain on the waiting list for more than a year.
We met the target for diagnostic waiting times for a 17th consecutive month and our cancer performance in August was in line with the trajectories we submitted to NHSE.
Our staff
As we go through a period of upheaval, I am mindful of the impact it will have on our staff and of the need to ensure they are supported. It was great that some of my colleagues could take time out from their day job to mark their long service . One attendee had clocked up 47 years; the combined years of service of those we celebrated was 7,885. One person told me they’d come for the job and stayed for the people.
One of the things that encourages staff to remain is if they can develop their careers. I am excited by the work two of our consultants are doing to improve the training we offer doctors in anaesthesia and intensive care.
Ankit Kumar and Ayub Khan both trained here and, in the last year alone, they’ve succeeded in recruiting 10 new consultants who wanted to come back after studying at BHRUT . Ankit has said he’s passionate about making the Trust a great place to learn and develop.
Surfing granny
It’s one of the joys of the NHS that I can write such a headline in my CEO report. Linda Pearcy, who’s 74 and has Parkinson’s, was back on her bodyboard (there’s a video on our website to prove it!) just four months after receiving trailblazing brain surgery.
We’re one of the first to trial the use of electromyography (EMG) as part of deep brain stimulation (DBS) which is a surgical technique where electricity is delivered to select areas of the brain via electrodes. It’s used to treat movement disorders such as Parkinson’s and dystonia.
The success of this procedure is yet another reminder that our staff have chosen to spend their working lives making a difference to the lives of others. As Ian Low, our neurosurgeon who conducted Linda’s operation, put it: “I’m so pleased this has allowed her to have fun with her family again”.