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NHS England’s new emergency care director has told HSJ that trust leaders will welcome “extra rigour” and “a lot more focus” on the four hours accident and emergency target.

Sarah-Jane Marsh’s comments, in an exclusive interview with HSJ, come as trusts are being asked to see 76 per cent of A&E patients within four hours by the end of 2023-24.

She said the four hours target would be “an important measure, so we will be a lot more focused on it over the coming year, for sure,” and that “quite a few people have actually said: ‘We’d quite like to get into some of the rigour around [UEC performance metrics]’.” 

Elsewhere in the interview, Ms Marsh said a new discharge metric, measuring time between a patient becoming ready to leave hospital and them actually doing so, will also become an important measure come next winter.

She also described the “massive opportunity” to expand intermediate care, and the future plans for community care and the 111 service.


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NHS England’s makeover at the hands of branding agency Thompson could see it emerge as an “empowering, coach-like leader” that seeks to “rebuild lost trust” with the service.

The company has been engaged by NHSE to help “position” the “future role” of the organisation after its merger with NHS Digital and Health Education England.

An “interim update” presented by Thompson and senior NHSE comms managers last month sought to put forward a “central narrative” and “messaging framework”, for the “new NHS England”.

It concluded that “many stakeholders” felt it was “important to rebuild what they see as lost trust [in NHSE]”.

The leaders surveyed wanted “the new NHS England” to be “positioned primarily as a facilitator of improvement”, and for the organisation to be seen as “part of the solution, rather than part of the problem”. 

Among Thompson’s recommendations were that NHSE:

  • “Reframe” its “core function” away from “regulation, policy and budget control” to focus on “collaboration and system working”.
  • “Cultivate the right personality” of an “empowering coach-like leader”.
  • “Adopt a ‘down to earth’ type of voice… to avoid the perception that NHS England is an ‘ivory tower’.” The new NHSE should be “able to communicate on the same level as its audience”.
  • “Actively combat the media-driven narrative of NHS England being made up solely of bureaucrats”.

Read our full story here.

Also on today

Last month’s announcement of a national review into inpatient services was welcomed by campaigners last month, but it seems to have come at the cost of the 10-year plan for mental health, says Emily Townsend in this week’s Mental Health Matters. And in news, we report that thousands of patients are being recalled for urgent eye checks after regulators raised safety concerns related to a product used in cataract surgery.