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A smattering of new leaders for integrated care systems were announced yesterday – with chair designates all confirmed for Greater Manchester, West Yorkshire, Norfolk and Waveney and Humber Coast and Vale.

But instead of announcing who had got the nod for Cheshire and Merseyside, the ICS was forced to admit it had again failed to appoint to the post.

HSJ understands three candidates were shortlisted in the latest effort, but has chosen not to name them.

It told staff: “Cheshire and Merseyside Health and Care Partnership did not appoint to the position of chair of the ICS during the national recruitment process which has just been completed.

“This is a key leadership appointment and we all agree it is of paramount importance that we get the right candidate for our system.”

The ICS also failed in a previous attempt to appoint a chair earlier this year.

Former chair and chief officer (Alan Yates and Jackie Bene respectively) had made some progress in their short tenures, but they also faced difficulties in managing local relationships. In May, they announced they were quitting because their jobs had become “something they didn’t sign up for”.

The ICS will have a third go at finding a permanent chair in the new year, so interim David Flory, who is also substantive chair of the Lancashire and South Cumbria ICS, will stay on until March at least.

Chilling stats

The grim reality facing many hospitals as winter draws near was laid bare in the latest data on emergency care.

Performance against the four-hour target in A&Es was the lowest on record – as has been the case for several months now.

In September, 75.2 per cent of patients were seen within four hours in all types of urgent and emergency units – down from 77 per cent in August and the lowest figure for 10 years at least.

But it was the number of ‘trolley waits’ last month that really caught the eye in the data released on Thursday.

There were more than 5,000 waits of at least 12 hours in September, which is the highest monthly total and almost double the pre-covid record.

Last month was the fifth busiest month in emergency departments on record – and the busiest September on record.

And with some tough months ahead for the NHS, we can expect some more unwanted records to be broken before the end of winter.