Daily Insight: Unto the breach

The number of 12-hour waits in emergency departments has been at record levels amid continuing pressures in urgent care.

And now even more 12-hour breaches are set to be reported in a move which senior emergency clinicians say will reveal the true scale of waits in accident and emergency departments.

Up until now, 12-hour waits published by NHS England were measured from the time a decision was made to admit a patient, to when they are actually admitted to a ward bed.

But this is about to change in the NHS Standard Contract for 2022-23.

In the new contract, providers will be expected to count 12-hour waits from time of patients’ arrival in the ED, to the time they are admitted to a ward.

This widening of the scope of 12-hour waits should see the number of breaches being reported rise considerably in what the Royal College of Emergency Medicine has said will provide “greater transparency”.

But while HSJ understands the new data will be published, NHS England has not commented when this will begin, and in what format.

Gas pressure rising

The pressure is mounting on NHS England to do something about the at least 16 trusts which are getting their gas from the UK subsidiary of the Russian energy firm Gazprom.

Its former chief executive Lord Stevens of Birmingham was the first big name to weigh in on the situation after HSJ first reported the provider trusts in contract with the Russian state-owned supplier.

Then Jeremy Hunt, former foreign and health secretary, joined in. His predecessor Andrew Lansley chimed in too. And now the current health and social care secretary, Sajid Javid, has told NHSE it needs to do something about the Gazprom situation.

A senior official in his department said Mr Javid had “spoken with NHSE and been clear that trusts need to stop using Gazprom as a supplier”.

His intervention came after HSJ revealed NHS leaders were in urgent talks to find a way to resolve the situation. They had asked all trust procurement teams to tell them whether they were supplied by Gazprom and what their gas costs were.

Getting out of these contracts with Gazprom is going to be a challenge. And likely an expensive one too, if trusts then have to get new energy contracts in today’s market. Mr Javid may find his instruction to sort this gas problem comes with a hefty bill.