This is undoubtedly the right decision: Medway needs a CEO who can concentrate on its problems and not havew to worry about another trust. Brave to make that decision though...https://www.hsj.co.uk/leadership/trusts-pause-shared-ceo-plan/7041062.article

Didn't realise it was April already.

Do I smell toast?

Enjoyed H is for Hawk but a little surprised that Cambridge gives research fellows nice spacious houses in the middle of the city......

Is it appropriate that councils should spend council tax monies on promoting the local government reconfiguration they want to see (which usually involves more power for them)?

If Nipah spread more easily between people, we would have a major problem....if nothing else, this is a reminder of how a few mutations could lead to a pandemic.

An astonishing amount to overspend by (or be underfunded by?). Things are really beginning to come out of the woodwork as we get toards year end. A lot of cost improvment programmes are backweighted so the failure to achieve them is becoming clea. www.hsj.co.uk/finance-and-...

Could we see a major shake up in how ambulance trusts are measured? AACE wants to see outcome indicators given more of a role rather than simply response times, as ambulance crew and control room staff increasingly do more than just taking people to A&E. www.hsj.co.uk/quality-and-...

Interesting position in Oxfordshiure where local media reported on a politician's arrest after allegations of coercive behaviour. Police have dropped the case - no charge. But potentially he could have a privacy case against the media for naming him....will he pursue it?

Oxford dodged a bullet when it failed to elect Mandelson as Chancellor (he came fourth)

If this is the case, America is in a very dark place indeed.

My daughter, a resident doctor with a worsening condition which has not responded to self-care and an initial telephone consultation with a GP and prescription, has just been told she can't see a GP - it has to be a "physician associate who can do everything a doctor can."

From me this morning: independent provider of ADHD services suspended over concerns. It says they relate to an administrative issue at Companies House: the ICBs seem to think otherwise. www.hsj.co.uk/quality-and-...

Crumbs. This is a heck of a story for a student newspaper to uncover and be bold enough to publish. cherwell.org/2026/01/21/o...

Handover times for ambulances stuck outside hospitals gradually moved back to normal last week - they had been very high the week before. But some notable patches of poor performance - East of England, parts of the Midlands and RUH in Bath.

Three Kent trusts in this list of savings plans for 2025-26. A lot of people would say this level of savings is not achievable without very significant changes to services/workforce/processes - can that be achieved?.

Wasn't aware of this campaign but I am sure it will resonate with many ambulance staff. Issue is the same issues of pressure and manual work probably apply to many NHS staff.who would also like to retire early. www.unison.org.uk/our-campaign...

A major story from me this afternoon - a medical director sacked (a rate event) after "irreparable breakdown" in relationships, www.hsj.co.uk/leadership/d...

Used several sites with multi-actor authentication today - mostly with a code sent to my phone which often has to be used within a few minutes (5 in some cases). I just wonder how older, less digital literate, people, potentially with poor sight, manage this without getting timed out?

Today I am off to a study afternoon about John Locke, who developed the idea of a social contract between citizen and state. How this plays out in relation to the NHS and other services seems to me to be key: people give up something (mainly money) in return for healthcare etc. Bur are we at a 1/2

It will not surprise you to learn that Toby Youngs 'Free Speech Union' has obtained a High Court injunction banning the publication of a list of its donors open.substack.com/pub/democrac...

The number of times I have read this as Al Murray......

Once in a while you wonder what is really going on in the NHS.

This was incredibly sad....

This is a fascinating graph: ambulance trusts are managing to increase the % of hear and treat cases but this seems to be partly replacement of see and treat. However, the % taken to A&E is slowly declining - great news for pressurised A&Es!.

December was a mixede mnth for ambulance trusts - response times were generally a bit worse but against the backdrop of the highest every number of incidents per day. But good performance on hear and treat and relatively low percentage of patients taken to A&E. Handover times creeping up though....

Indications that the flu in 2025, though infections started spreading early, was substantially less deadly than the last two years. That

Wes claims his turbo teams have cut NHs waiting lists & it’s “not only a technocratic back office exercise” - 🤔 I suspect that’s exactly what it is, my own experiences of being on list was sneaky tricks to bump me off it, including letters sent over Xmas demanding instant response to stay on list.

This week’s critical incidents in SE trusts underline a long‑warning signal: the medical workforce is stretched past safe limits. ✅ Expand specialty trng places ✅ Retain & value Drs ✅ Fund a credible long‑term workforce plan Patients & staff deserve better. www.bbc.co.uk/news/article... @bma.org.uk

Time for a rethink on the rhetoric around what different countries sacrificed during WW2?

This is quite astonishing - separation of roles is fundamental yet "The accounting firm found weak separation of duties at the trust, with the same individual able to set up, approve, and process transactions, increasing the risk of error or fraud." www.hsj.co.uk/finance-and-...

This will hack off some boards who have been desperately trying to reduce costs while believing it was what they were being asked to prioritise.

Why does the NHS struggle to improve productivity? Could it possibly be because of problems like this? One of a long list of equipment issues at a capital-strapped trust.

Yesterday's workforce data paint a concerning picture on nursing employment in England > increase over Sep and Oct, when new grads typically recruited, at +3,982 (1.1%) is lowest in over a decade. > cumulative increase over calendar year (2,569 to the end of October 2025) is the lowest since 2018.

There were some awfully long waits for ambulance handover at some A&Es last week - mainly in East and England and Midlands. But the South West, for so long the worst affected area, did reasonably well. Very welcome progress, even under pressure.

Odd case which did not quite make an HSJ story: an echocardiographer who apparently changed 150 of their colleagues' reports, covering 85 patients, prompting a trust investigation (no harm found). Disciplinary matters ongoing.

An ICB CEO who "retires" with a £300K redundancy and pay in lieu of notice package. A few weeks later the ICB cut the number of funded IVF cycles from 2 to 1 to save £400K a year.... www.hsj.co.uk/leadership/r...

Flu test data now in for the start of the year. 2025-6 shaping more into a the low-and-bumpy 2023-4 dynamics than other years' spike-and-drop behaviour. All other things being equal, a preferred situation in terms of NHS pressure.

Great initiative - could other trusts follow?

This - from my story in the HSJ this morning - is horrifying beyond belief. There seems to be growing concern at national level about the disruption that an EPR installation can bring - especially at times when trusts are already under severe pressure from increased demand. .

We have the first week of "sits rep " reporting - 9580 ambulances waiting over an hour for handover last week. I think that is about a third down on the previous year's first week of reporting. Some very worrying long waits in the West Midlands and also East of England.

Advert out for the group chair of SCAS/SECAmb - the first ambulance group. Anyone fancy a punt?

So the flu peak was very temporary. Test numbers say influenza in the UK has just jumped back into huge growth this week: +76% up. Sustained, that would be very bad news. Measles cases have suddenly stepped up too. Don't like either of those. www.gov.uk/government/p...

What happened to the prospect of a multi-year pay agreement between the BMA and government? That seemed to be on the table in September but was it spiked by the Treasury? Frankly, it's one of the few ways out of an increasingly bitter dispute. www.hsj.co.uk/workforce/ex...

The tension in NHS policies laid bare: provider has capacity to treat more patients and reduce waiting lists/time but ICB does not have the money to commission more work. DHSC silent. www.hsj.co.uk/finance-and-...

This was very much the basis of a talk @torstenbell.bsky.social gave at Mansfield College, Oxford, on Friday night - he used some of the same charts and examples. It was well-communicated and he was passionate about inequalities - why can't politicians talk like that all the time?

Yes, like LOUVRE

Downturn in performance = upturn in average response time!

Downturn in amb response times last month - not unusual for October but I would be surprised if the sector met the gov's 30 min target for category calls this year. Oct's performance was 32m 37s and year to date is now 29m 11s. This is a graph of performance since April 2023