Chief Executive's Report September 2025
Chief Executive’s report September 2025
Trust of the Year finalist
I’ve now been at our Trust for four years and it was great to mark this anniversary with the news that we’ve been shortlisted for the Health Service Journal’s (HSJ) prestigious Trust of the Year Award. We are up against eight other trusts, including Alder Hey Children’s NHS Foundation Trust, Sheffield Children’s NHS Foundation Trust and The Royal Marsden NHS Foundation Trust.
These are illustrious competitors and it’s a sign of how far we’ve travelled that we are a credible candidate to win the award, thanks to the hard work and dedication of our staff. We said thank you to them and their relatives recently when we organised a family fun weekend at King George Hospital (KGH).
The significance of this moment won’t be lost on anyone who knows our history.
In the past, we were written off as a ‘troubled’ trust and a ‘basket case’ trust; we spent more than a decade in and out of special measures where our freedom to act independently was seriously curtailed; and such was the concern in government that senior figures in Downing Street received regular updates on the organisation.
The fact we’re a finalist for Trust of the Year shows we have put the past firmly behind us and we’re now being celebrated for the striking improvements we’ve delivered in our performance and for the way we’ve made our hospitals more attractive places to work.
Our turnover has reduced from 14.7% to 9.7% (over a 14 month period) and our vacancy rate is down from 13.5% to 9.6%, as talented people want to work with us and help transform the care we offer our patients. In July, for example, we became the first trust in the UK to use the latest technology for treating brain aneurysm.
We want to be an attractive employer for the residents of Barking and Dagenham, Havering and Redbridge and part of our offer is that we have a wide range of apprenticeships to enable people to develop their careers, with one in 20 of our staff taking up this opportunity.
We have much more to do and this was acknowledged by Wes Streeting, the Health Secretary, when he expressed his delight as a local MP at what he called “such a great achievement”. On social media the Ilford North MP wrote about how the Trust doesn’t “pretend it’s all going swimmingly, but they are striving to make things better every day. They don’t shy away from challenges, they lean into them. That’s the mentality that this nomination reflects”.
And the winner is…
We’ll know the outcome in November. Win or lose, I hope our nomination helps the NHS move on from a sometimes simplistic view of trusts as either good or bad. As with much in life, the reality is more complicated. A lesson from BHRUT’s shortlisting at the HSJ awards is that every hospital has the potential to do well, whatever its history. The challenge is to unlock that potential and make the improvements stick.
I also want to highlight that we have colleagues on the shortlists for the HSJ Performance Recovery Award, the National Diversity Awards, the Nursing Times Workforce Awards, the HSJ Patient Safety Awards, the National Apprenticeship and Skills Awards and the B.A.M.E Health and Care Awards.
Let’s hope some of us come home with something for the trophy cabinet!
Electronic patient record
November is also the month when, with the help of Barts Health, we will roll out our electronic patient record (EPR) and cease to be the only acute trust in London to rely on paper records. It’s a massive undertaking which we need to get right and it’s why we’ve moved the launch date from this month. We want to ensure everyone has the right training and we’ve addressed any technical issues.
As many trusts before us have found, the transition from paper to digital can be bumpy. It’s likely to have a short term, adverse impact on our performance as our staff adjust to new ways of working. The benefits though will be considerable for them (many of whom have worked elsewhere and can’t quite believe we’re still in the digital dark ages) and for our patients.
Care Quality Commission
Another key moment on the horizon is the publication by the Care Quality Commission (CQC) of their report into our maternity services. Their inspectors were with us for a day last month and their initial feedback highlighted areas for improvement and several positive findings which reflect the hard work of the staff and senior leaders in the department.
I completely understand the concern there is nationally around the safety of maternity services and it’s one of the reasons why, with Dr Kathryn Tompsett, our Women’s and Children’s Clinical Group Director, I was keen to talk to the Barking and Dagenham Post about the challenges we face.
I hope the CQC report, when it’s published in the coming months, will reassure our residents. It’s encouraging that there’s been an increase in the number of people saying they’ve had a positive experience of our maternity services and a reduction in complaints.
Our finances
One of the main things that has the potential to harm our sustained progress is if we fail to make significant inroads into our deficit. We have delivered £30m of savings in each of the past two financial years and we have ambitious plans to go further in this one. Our year-to-date deficit in July was larger than it should’ve been, with a contributory factor being the £1m we spent on staffing cover during the strike by resident doctors. The five days of industrial action saw us re-arrange 1,112 outpatient appointments and 121 non-urgent surgeries.
We have exceeded NHS England’s (NHSE) target for cutting how much we spend on high cost agency workers, down from £47m two years ago to an expected £7m this year. However, our use of bank staff needs to reduce further, especially given that we have 1,560 more colleagues compared with five years ago. Most of these additional, substantive staff are in clinical areas.
Our outgoings are running at around £2-3m a month more than we can afford and this has an impact on our cash flow and on our ability to pay suppliers on time. With my senior colleagues, we are focusing on cutting bank usage and ensuring that each month every department keeps within their budget.
Patients with mental health needs
Our expenditure will also be cut and, much more importantly, the care that is provided will be improved if we succeed in reducing the number of patients with mental health needs who arrive in our A&Es. In July, 420 patients needing a referral to mental health services waited an average of 20 hours in our A&Es.
Around £500k a month is spent on registered mental health nurses, additional health care assistants and security guards to care for these patients in our A&Es and on the wards. We hope we’ll soon see the benefits of additional assessment capacity that has been opened at Goodmayes Hospital, a specialist mental health provider next door to KGH that is run by NELFT.
We are working with them and with PELC, who are responsible for our urgent treatment centres (UTC), to ensure that patients with mental health needs who present at the UTCs are transferred straight to Goodmayes and avoid having to wait in our A&Es.
Improving urgent and emergency care
Summer has seen no let-up in the number of people seeking urgent and emergency care. It was the busiest July we’ve experienced with 60 extra patients a day, compared with the year before. 10 of the busiest months ever for A&E attendances at BHRUT were in the last 12 months.
In two years, the number of ambulances arriving at Queen’s Hospital has risen from 2,813 a month to 3,315. One of the ways we’re trying to prevent too many frail, elderly residents ending up in our noisy A&Es is by encouraging the London Ambulance Service to use our frailty line.
It’s staffed by our geriatricians and they are providing advice on alternatives to coming to Queen’s or KGH. It’s still early days and will take time to bed in, however 60% of the initial calls did result in A&E attendances being avoided.
Despite the demand, our performance remains strong. Our overall (All Types) performance was 79.9%, against an NHS target of 78% of all patients being admitted, transferred or discharged within four hours. This placed us 3rd out of 18 acute trusts in London and 22nd out of 121 in England.
We are helped by our GP colleagues who work for PELC and see the less seriously ill (Type 3) patients. I’m delighted that the CQC has improved the ratings for the UTCs at Queen’s and at KGH from ‘requires improvement’, to ‘good’. Steve Rubery, PELC’s Chief Executive, said it was recognition of “the significant progress we’ve made in improving the services”.
Our Type 1 performance (the most seriously ill patients) was 59.4% which meant that 789 more patients were seen within four hours compared with the month before.
£35m campaign for a new A&E at Queen’s Hospital
The pressing need to transform the Queen’s A&E is reinforced by the data. We are caring for an average of 46 patients each day in the hospital’s A&E corridors. We’re grateful to Jas Athwal, the Ilford South MP, who is the latest of our local MPs to back our campaign to secure the £35m needed to rebuild the department and get rid of corridor care.
Cutting our waiting lists
We are the best acute trust in London for tackling waiting lists with 71.2% of our patients waiting no longer than 18 weeks from referral to treatment (RTT). NHSE’s target (to be achieved by next March) is 71.4%. July’s performance was a 9% improvement on the same month the year before.
The number of residents on our waiting list increased slightly to 58,597, though this total is lower than 12 months ago. Nine out of ten of them require an outpatient appointment with one of our specialists. 591 patients have waited more than 52 weeks which is in line with 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 14th consecutive month and our cancer performance in June was in line with the trajectories we submitted to NHSE.
Reducing waiting times for women
Too many women wait too long for specialist surgery. More than 10% of our waiting list is made up of those needing women’s related healthcare and we are determined to tackle this inequality.
We’ve expanded our gynaecological robotic surgery and performed more than 560 operations; our urogynaecology service has been recognised as a specialist centre for complex operations which means we can carry out more of these procedures; and our Women’s Health Hub has seen more than 1,000 patients since it opened nine months ago.
The Women’s Health Hub, inside a shopping centre in Ilford, aligns with the government’s plans to move more care out of hospitals and closer to where people live and work.
Our staff
The progress captured in this report (and underpinning our Trust of the Year nomination) is down to our staff. I’m always keen to celebrate them and their achievements which have included six young people getting work at our Trust. They are on a trailblazing scheme that helps those with learning disabilities and/or autism find employment.
We held a special graduation day in July to honour colleagues who’ve completed training or apprenticeships. One of the guest speakers, Winnie George, NHSE’s National Programme Retention Lead, said we were an organisation that “doesn’t just talk the talk, it walks the walk”.
Matthew Trainer
Chief Executive
September 2025