Chief Executive's Report March 2025
Dear colleague,
Our next Board meeting will take place on Thursday 6 March at 12.30 in Lecture Theatre 1 at Queen’s Hospital. You are welcome to attend in person or virtually .
Ahead of next week’s meeting, I’m sharing my report which covers a groundbreaking clinical trial, our successful apprenticeship programme and our challenging financial position.
I hope you find it a useful read.
Best wishes.
Matthew Trainer
Chief Executive’s report March 2025
World-leading research at BHRUT
We are part of a £6.5m groundbreaking NHS trial that could deliver transformative therapy for people with depression and anxiety. It’s a further sign of the way our Trust is raising its game to the benefit of our patients and staff.
Aimun Jamjoom, one of our consultant neurosurgeons, will work with partners at Forest Neurotech and the University of Plymouth, on an ambitious study using ultrasound waves to stimulate the brain to improve mood and reduce depression. Aimun told the Guardian the technology could be a “life-changing solution”.
Research and innovation like this are vital. They improve patient care, open up new treatments and help us attract and retain high calibre staff. It’s why we’re really pleased to be part of a new clinical research centre at The Royal London Hospital that has received £4.75m of funding.
The Commercial Research Delivery Centre (CRDC) will be a site for research for all residents of north east London (NEL) who will benefit from faster access to advanced treatments and clinical trials. We will be active partners in the CRDC and we want to increase the number of commercial clinical trials we run by 25% in the first year and double patient recruitment over the next three years.
Celebrating our apprentices
Another example of our desire to continually improve is our expanding apprenticeship programme. It was started by Kathryn Halford, our Chief Nurse, in 2018 when she built on a successful training pilot that had taken place the year before and offered apprenticeships to those who wanted to be a nursing associate , a career path that can be a stepping stone to becoming a registered nurse. Seven years later, we have 400 apprentices across 39 different programmes and we are offering training to other organisations.
With one in 20 of our staff undertaking apprenticeships, we are a proud member of The 5% Club and we have been awarded gold status for investing in these colleagues and for providing paid training to those in entry level roles who don’t have the relevant experience or qualifications. We were inspected recently by Ofsted and are hopeful of a good outcome when they publish their report.
During National Apprenticeship Week we recognised this year’s graduates with an awards ceremony and afternoon tea at the Houses of Parliament which was hosted by Nesil Caliskan, the MP for Barking. One of those being celebrated told me that the Trust was “a great place to be right now”. Another graduate, Kelly Rose, is one of our first midwives to have received their training via an apprenticeship . Kelly, a mature student, is keen to stress that the scheme is for people of all ages.
At the ceremony, Wes Streeting, the Health Secretary and MP for Ilford North , spoke of how we care about our staff and invest in them. He said it was “really inspiring” to see our organisation “going from strength to strength.”
Our finances
Mr Streeting has also told all NHS providers they have to “live within their means” and that “the culture of routine overspending without consequences is over.” For us, one of the ways we will save money is by ensuring we continue to fill vacancies with permanent staff, rather than using more expensive agency workers. In our new recruitment video colleagues speak about what it’s like to work at the Trust and at our recruitment day last month we offered jobs to 103 nurses .
Among them are five nurses specialising in patients with learning disabilities (LD). As I wrote in my report in November last year , this was one of our commitments after the death of Chloe Every at Queen’s Hospital. Chloe had learning disabilities and at her inquest the Coroner raised concerns about the absence of LD nurses to help her communicate.
Despite such recruitment – and a £9m reduction in the money spent on agency staff when compared with last year – our financial position remains very difficult. Our deficit in January was £5m worse than we had forecast, due to a reduction in the income we received, a rise in our wage bill and an increase in the money we spent on clinical supplies and drugs.
As well as getting a better understanding of why our financial performance deteriorated in a way that we hadn’t anticipated, we also need to deliver at least £50m of savings in the next financial year.
Doing even more with less is not a viable option. So, like many other trusts, we will have to reduce what we do to ensure we live within our means. The challenge will be to achieve this in a way that minimises, as best we can, any adverse impact on our residents.
We will deliver our savings against the backdrop of the NHS’s national priorities for 2025/26 that will usher in a welcome reduction in the oversight we are subjected to and an increase in our ability to make decisions in the interests of the communities we serve.
£35m campaign for a new A&E at Queen’s Hospital
We are spending around £100k every month on additional staff to care for patients on beds in the corridors of the A&E at Queen’s. As well as the cost, it is the single biggest risk to quality, safety and the experience of our patients and staff. When the hospital was opened in 2006, it was built to accommodate a maximum of 325 people a day seeking urgent and emergency care. Now, it regularly sees at least double that number.
We’ve launched a campaign to secure £35m to transform the department and get rid of corridor care. The need for this vital improvement work has been covered by the BBC , Channel 4 News and the Times .
We’re encouraging residents to get in touch with their MP to ask for support. By the end of February, more than 550 people had clicked on the contact links that are accessible via a QR code displayed on posters across Queen’s and 3,600 people had visited the dedicated web page .
Several of our MPs have given us their backing and Andrew Rosindell, MP for Romford, has asked the Health Minister, Karin Smyth, to meet him and his parliamentary colleagues from neighbouring constituencies to discuss the campaign.
Improving urgent and emergency care
This year, we successfully navigated the pressures we experience every winter in the health service. It was our busiest January on record and our fourth busiest month ever. We saw more than 50 additional patients each day and more than 110 ambulances each week, when compared with the same month the year before.
Despite this, our overall (All Types) performance was 77.7%, just shy of the NHS target of 78% of patients being admitted, transferred or discharged within four hours. It placed us 3rd out of 18 acute trusts in London and 15th out of 121 in England.
Our Type 1 performance (the most seriously ill patients) was 54.5%. We are focusing on ways of providing frail, elderly patients with viable alternatives to going to hospital. These include our virtual ward where a multidisciplinary team offer care in the community; our Ageing Well Centre in Hornchurch; and our Same Day Emergency Care (SDEC) departments at Queen’s and King George Hospital (KGH).
We opened the new Queen’s SDEC in the space that used to be occupied by the renal service which is now at the St George’s Health and Wellbeing Hub . It enables frail, elderly patients to be moved out of A&E to be assessed and have their treatment (including diagnostics) start on that same day.
We are seeing early signs of it having a positive impact on reducing corridor care. A relative of a patient who was treated there emailed to praise the service and the staff and to thank us for respecting their father’s dignity.
Patient with mental health needs
For the past three years I have highlighted my concerns about the experience of patients with mental health needs when they visit our A&Es. In January, we referred 370 patients to mental health services. They waited an average of 20 hours before being moved to a more suitable place that could offer them the support they needed.
KGH receives a significant number of Section 136 patients , even though it is not a specialist provider. In January it was 23, more than double the number that were taken to Goodmayes Hospital which is next door to KGH and run by NELFT , a mental health and community provider.
NELFT are planning to increase their assessment capacity at Goodmayes which should reduce the amount of time patients with mental health needs spend in our A&Es and the number who come to us in the first place.
Cutting our waiting lists
Our strong performance in urgent and emergency care is replicated when it comes to our provision of elective (planned) care. NHS England has set an initial target of 65% of patients waiting no longer than 18 weeks from referral to treatment (RTT). This has to be achieved by March next year. We were at 68.44% in January which is a 7.6% improvement in a year and means we were the best acute trust in London for RTT performance.
The total number of residents on our waiting list was 56,370 which represents a 10% reduction in twelve months. 9 out of 10 of them need an outpatient appointment with one of our specialists. 859 residents have waited more than a year. This is the lowest number of 52 week waiters we have had since June 2020. Colleagues continue their drive to cut waiting times and last month our surgeons took 27 gall bladder patients off the list in one day.
Our cancer performance
We met all three of the cancer targets in December last year that cover diagnosing as quickly as possible and starting treatment within an agreed timeframe. We also met the target for diagnostic waiting times for a 9th consecutive month, which is an impressive achievement. With the opening of our second Community Diagnostic Centre, at the St George’s Hub in Hornchurch , we will perform an extra 35,000 scans and tests a year.
I am mindful, when I write about our strong performances across the board, that they will be adversely affected during the introduction of our electronic patient record later this year. A temporary dip in performance has been the experience of other trusts where staff have had to adjust to working digitally, after getting used to relying on paper records.
The coming months
I am looking forward to working with Sarah Betteley , our new Chair, as we strive to embed the improvements I’ve highlighted in this report. Sarah, together with the newly appointed Chairs of Barts Health and Homerton Healthcare , will also be ensuring that the acute provider collaborative (that the three trusts belong to) delivers for NEL residents.
There are already examples of where clinical teams from the eight hospitals work well together, including in the provision of cardiology services and critical care. The three trusts are also used to offering mutual aid, as was the case when we stepped up to provide a 24/7 lifesaving stroke service while a specialist machine was replaced at The Royal London.
Later this month we will publish our staff survey results. We saw our biggest ever response rate, up by more than 14%. With my senior leaders, we will reflect on the findings and work hard to address the areas that colleagues highlight as needing to be improved.
In response to last year’s survey, we ran a pilot to give colleagues more flexibility to pick their shifts. The feedback was that it improved work-life balance and helped staff with their childcare.