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A quartet of trusts have joined forces to form one of the single largest “boards in common” in the country.

In the spirit of collaborative working and shared leadership, north west London’s acute trusts have announced they will take it a step further this autumn.

The four providers – Chelsea and Westminster Hospital Foundation Trust, Imperial College Healthcare Trust, The Hillingdon Hospitals FT and London North West University Healthcare Trust – will establish their own committees of board directors, who will meet publicly four times a year.

Each individual trust will meet in public at least once per year, while their chair Matthew Swindells will convene meetings with their respective chief executives and vice chairs as a cabinet to consider “key decisions”.

The announcement will be seen as a formal recognition of the close working relationship between the organisations, which have stressed they will remain independent and continue publishing trust-level data.

Their partnership working was turbocharged during the coronavirus pandemic and now they are exploring whether to set up a new elective orthopaedic centre in the region to help boost elective recovery.

Although there are several examples of shared leadership across the country, this may stand out as the largest one yet.

The wild West

Some of the starkest examples of the pressure on NHS emergency care have been seen in Cornwall this summer.

Last month it emerged that more than one patient per day waited longer than 48 hours in Royal Cornwall Hospital’s emergency department during spring, and now the county’s ambulance crisis has been laid bare.

Cornwall Partnership FT CEO Debbie Richards told her board on Monday that response times for category 2 patients were currently “hovering at around 200 minutes”.

Category 2 patients include people with suspected heart attacks and strokes, and the national response target is 18 minutes.

In what must be something of an understatement, Ms Richards said she was “not proud to be reporting this”.

The revelation is yet another example of the pressures in emergency care, and Cornwall’s rural geography adds an extra challenge to ambulance chiefs.

But, as we reach the day when it was predicted ambulance services would “fail”, the NHS looks further away than ever from solving its emergency care pressures.

Also on today

In this week’s Mental Health Matters, HSJ’s investigations find that fewer than half of referrals to mother and baby units resulted in admissions, while almost 200 referrals were turned down, and we ask where the women are going. And our waiting times guru Rob Findlay says that while attention turned towards the improvement in 104-week waiters during June, the underlying pressures on waiting times continued to worsen.