The must-read stories and debate in health policy and leadership.

New data has revealed for the first time the trusts with the most patients waiting a week or longer to be discharged after they were deemed ready to leave hospital.

The new NHS England figures show 3.7 per cent of patients in England in September waited a week or longer in hospital following their “discharge ready date”.

But it also reveals significant variation, with some trusts more than double the national average for long waits for discharge.

NHSE has said it may use the data to implement a new target, based on how long patients wait for discharge after being deemed “ready”.

However, for now, NHSE is aiming to improve the recording of the new measure – as in September only around half of trusts supplied reliable data.

Driving ambition

Boosting ambulance numbers always sounds easy – all you need is the crew and the vehicle in place. However, as London Ambulance Service Trust has found out, getting an increase in frontline staff to coincide with an increase in ambulance numbers is not always possible,

It has recruited 900 additional crew members over the last year but the planned vehicles – ambulances, cars and motorbikes – have not all arrived on time. That’s left some staff twiddling their thumbs back at base, waiting for a spare ambulance to become available. Up to 50 crews have been left without one for some of their shift on some days, according to sources.

The reason is delays in the supply chain. As HSJ reported earlier this week, one ambulance converter has gone into administration, causing some disruption. More generally, ambulance orders are taking longer than expected to fulfil – possibly because many trusts are seeking to replace old vehicles or expand their fleet at the same time and there is limited capacity in the industry.

The good news is that LAS expects to get another 40 vehicles by Christmas – effectively solving the problem. Othe trusts hope they too will wake up to an ambulance in their stocking.

Also on today

In The Integrator, Dave West asks why integrated care systems have shied away from large-scale change, and in Comment, Martin Tett says that amid the growing winter healthcare challenges it is imperative to adopt a holistic approach and strategic solutions to enhance elderly care, optimise patient flow and build a resilient healthcare system.