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Portsmouth’s challenge

Struggling trusts’ CQC reports are never good to read if you want to feel happy about the NHS, and some of the findings at the Queen Alexandra Hospital in Portsmouth included particularly unpleasant details.

The latest inspection, carried out in May, set out a string of failings within the trust’s emergency department and rated the hospital’s medical care inadequate.

The report’s themes will not have come as a shock to new chief executive Mark Cubbon, who only joined in July, but they were sufficiently troubling to lead his old employers at NHS Improvement to describe the report as “sobering”.

Mr Cubbon, who is in his first chief executive job, told HSJ the trust would not shy away from the challenge ahead and hopes a new acute medical model will be a step in the right direction.

He will be aided by new improvement director Alison Tong, but needs to find a permanent crew to fill a new look executive board – with the CQC inspectors warning: “The board appeared to have no real understanding of what was happening on the wards.”

The trust also faces questions over the management of its elective care waiting lists after external advisers claimed up to 12,000 outpatients may have been put at risk of clinical harm after missed appointments.

At a time when the city recently welcomed a new £3bn aircraft carrier into its docks, Mr Cubbon will need to assemble his new team quickly to steer the trust out of choppy waters.

Running out of time

Another day, another set of statistics, another sharp intake of breath.

Official data published on Thursday suggests the NHS is unlikely to meet a government target to cut delayed transfers of care to 3.5 per cent of its overall 131,000 bed base by September.

Quarterly data covering April to June showed the DTOCs rate fell to 5.2 per cent, compared with 5.6 per cent in the previous quarter, suggesting it is unlikely to reach the 3.5 per cent target next month.

The target has always been considered heroic by most in the sector. But the statistics were viewed as further evidence that without (or even with) a fresh funding injection, the sector faces being overwhelmed this winter.

As HSJ’s Dave West pointed out this week, this all comes on top of system leaders getting increasingly nervous about the extremely precarious financial state the NHS finds itself in.

NHS Improvement set out some very sensible guidance on patient flow earlier this year, but the underlying problems are deep rooted, systemic and likely to require time as well as money. It feels like the NHS is running out of both.