Chief Executive’s report July 2025

Our annual plan

We have published our plan for the next 12 months at the same time as the government is charting a course for the health service over the next decade. Our plan highlights some of the work we’re doing with colleagues in the other acute trusts in north east London (NEL) and in the boroughs we serve.

This aligns with one of the transformational shifts the government wants to see in the NHS. Ministers expect the provision of a wide range of care to move from inside hospitals out into the community, ideally onto the high street. 

At a meeting of senior leaders in Manchester last month, I was fortunate to be on the panel for one session where I mentioned the Barking and Dagenham health and wellbeing events we’ve been a part of and I spoke about how hospital appointments for women are now available on the high street in Ilford. We’re keen to work with partners and run women’s health hubs in our other boroughs.

The same principle applies to what we’re doing in our Ageing Well Centre in Havering and at our Community Diagnostic Centres in Barking Community Hospital and St George’s Health and Wellbeing Hub. These services are a foretaste of the fundamental shift that will occur as acute hospitals become smaller and more care is provided closer to where people live.

At the Manchester conference my colleague, Sophia Murphy, was part of a discussion about an initiative in Redbridge that is tackling cardiovascular disease which affects one in three of the borough’s population. Based in the community and working with a number of other organisations  - including primary care and the voluntary sector – we’re empowering residents, improving access to care and reducing avoidable hospital admissions.

Our finances

Another clear and consistent government message is that they want to end what they see as an NHS culture where deficits are regarded as a fact of life. At our public Board meeting in May, I outlined some of the steps we are taking to start to achieve this goal by saving £61m in this financial year. These include the temporary closure of wards during the summer months and a review of our drugs bill and procurement spending.

Our biggest expenditure is our staff costs. We are a more attractive employer than we once were and this is helping us recruit substantive colleagues, rather than relying on more expensive agency staff. 35 permanent senior doctors (consultants) have joined us since January and posts that in the past were difficult to fill are no longer vacant.

We have exceeded NHS England’s (NHSE) target for reducing agency spending. Two years ago, the bill was £47m. This year, we’re on track to only spend around £7m – a £40m reduction that is more than the total savings we have delivered in each of the past two years. Where once we relied on 466 (WTE) agency workers in any given month, now that figure is 79. In January we had 50 (WTE) agency allied health professionals (AHPs). This number was down to 11 in May.

We need to replicate our agency success in the work we’re doing to curtail our spend on bank staff. We must build on the reduction in these additional shifts we’ve already achieved in the first few months of the financial year and cut further. It’s a considerable challenge and a tough ask of our teams.

However, if we aren’t successful, our new found freedom to make decisions about the future will diminish and outside scrutiny of our actions will increase. Like the other NEL trusts, NHSE is paying close attention to whether we are delivering our financial savings plan.

Improving urgent and emergency care

It’s no longer the case that winter is when we witness our greatest demand. May saw our 2nd highest number of people seeking urgent and emergency care, with an average of 998 attendances each day across both A&Es. The highest number ever was recorded two months earlier, in March.

Despite this pressure, our overall (All Types) performance was 79.2% which represents a 20% improvement on May 2022. Our Type 1 performance (the most seriously ill patients) was 56.3%. The NHS target is for 78% of all patients being admitted, transferred or discharged within four hours. Our 79.2% May performance placed us 3rd out of 18 acute trusts in London and 19th out of 121 in England.

Patients with mental health needs

A recent report on Sky News by their health correspondent captured, with skill and compassion, the plight of patients with mental health needs in our A&Es that I have written about repeatedly in my Board reports. I would encourage you to watch Ashish Joshi’s report which the Health Secretary and Ilford North MP, Wes Streeting, said had “shone a spotlight” on the problem

In May, we referred 436 patients (up from 389 in March) to mental health services. They waited an average of 16 hours in our A&Es before being moved to somewhere that could offer them the support they needed.

This average length of stay is a reduction on previous months and shows that the opening of additional assessment capacity at Goodmayes Hospital – a specialist mental health provider next door to King George Hospital (KGH) – is starting to have a beneficial impact. We need to both speed up the assessment and transfer of these patients to Goodmayes and try and spare them coming to our A&Es in the first place.

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

I am grateful to all our MPs whose constituents use Queen’s for their support of our campaign to transform the hospital’s badly designed A&E. I went with Andrew Rosindell, MP for Romford, to meet Karin Smyth, the Health Minister, and press our case for the £35m we need to transform the department and eradicate corridor care. In the House of Commons a few days later, Ms Smyth said we’d made an excellent case and the situation in Queen’s A&E was unacceptable. 

Cutting our waiting lists

Delivering care in a timely fashion is what our patients are entitled to and we are working hard to hit an NHSE target (to be achieved by March 2026) of 71.4% of patients waiting no longer than 18 weeks from referral to treatment (RTT). In May, our RTT performance was 70.6%, a 9% improvement on the same month three years ago. Our initiatives to cut waiting lists have included carrying out 12 prostate surgeries, over eight hours, at no additional cost.

The total number of residents on our waiting list grew slightly to 57,913. (Nine out of 10 of them require an outpatient appointment with one of our specialists). Of these, 620 (1.1%) have waited more than 52 weeks. The NHSE requirement is that no more than 1% of people on the waiting list remain there for more than a year. We have made significant inroads, particularly in areas like gynaecology where the number of women waiting for treatment has reduced by more than 1,500 in the past year.

Electronic patient record

Our performance will be affected temporarily when we introduce our electronic patient record (EPR) in the coming months and our teams adjust to working digitally. Any short term pain will be far outweighed by the long term benefits of the new system for patients and staff. We’re using the same platform as Barts Health, so medical records will be accessible across the seven hospitals run by the two trusts.

Our Radiology department

We continue to perform above the England average across all the cancer waiting time standards and we met the target for diagnostic waiting times for a 13th consecutive month. This achievement is testament to the improvements that have taken place in our Radiology department since the pandemic.

87% of routine MRI scans were reported in 14 days between October and December last year. The figure for the same period in 2021 was 33%. We’ve saved £3m in each of the last two financial years by stopping the use of private providers and we’ve moved from being 80th in the country for diagnostics performance (patients having their scans within six weeks) to 15th.

“What the future of the NHS should look like”

This was Wes Streeting’s verdict after he opened a one-stop shop Urology service at our KGH Elective Surgical Hub which is in his constituency. It will allow patients with suspected bladder cancer to have a scan, cystoscopy and see a consultant to receive their results, all on the same day. Mr Streeting spoke of how our Trust was outperforming others and he said he’d seen some of the best of the NHS during his visit.

Our staff

The successes the Health Secretary spoke about are all down to our staff and I was pleased that recent events have allowed us to celebrate some of their contributions. We marked International Nurses Day, International Day of the Midwife and Learning Disability Week which gave us an opportunity to draw attention to the work our colleagues do to improve the experience of people with learning disabilities when they’re with us. Maggie Watkinson, one of our new learning disability nurses, changed profession after 14 years as a teacher.  

Our volunteers

Another group who play a key role are our 340 volunteers. They gave more than 10,000 hours of their spare time last year and we highlighted the varied work they do during Volunteers’ Week. Once a week for 20 years, Yezdi Maravala has sat with those who don’t have visitors because, he says, “it’s good that patients don’t feel like they are alone”.

Matthew Trainer

Chief Executive

July 2025