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

The implosion of urgent care services in recent years means patients can face long delays for an ambulance, and when they get to hospital, another long wait in accident and emergency.

Part of the problem could be ambulances bringing patients to hospital unnecessarily, according to an internal audit that found half of the conveyances at one hospital were “inappropriate”.

The review, which was carried out by a senior doctor at Scarborough hospital, highlighted three groups: Patients who needed community support; those who could have made their own way to the hospital; and another chunk where an ambulance was called from primary care.

The report, which looked at a sample of patients who attended the seaside town’s emergency department, warned the inappropriate conveyances were hitting triage times for patients in A&E and resulting in “fewer ambulances on the road”.

Data suggests that Yorkshire Ambulance Service is one of the trusts most likely to take patients to hospital following a 999 call, but YAS told HSJ almost 40 per cent of cases were resolved without accessing the ED. But the findings will undoubtedly play into the ongoing blame game between hospitals and ambulance trusts over who exactly is to blame for collapsing A&E performance.

From Leeds to leads

The new chief executive of NHS Providers brings a track record of improvement to the job.

Sir Julian Hartley is currently CEO of one of the largest hospital trusts, Leeds Teaching Hospitals, which he joined from improvement agency NHS Improving Quality, before that, leading hospital trusts in Blackpool and Manchester, and Tameside and Glossop Primary Care Trust. He has regularly been named among HSJ’s top provider chief executives.

During his time at Leeds it saw sustained improvements in staff satisfaction and engagement, and put a focus on care quality improvement, as well as developing joint working with neighbours in Leeds and West Yorkshire.

He will take up the role at NHS Providers in February, taking over from Saffron Cordery. Ms Cordery has been interim chief since June, when Chris Hopson left to join NHS England.

Also on today

In news, we report that the chief executive of one of the largest hospital trusts has been appointed to lead NHS Providers, and in Recovery Watch, James Illman asks whether, given the surprise disclosure last week by Sir Jim Mackey that NHSE estimates there are 5.5 million people on elective referral to treatment waiting lists, rather than the 7 million widely reported, should the NHS communicate the figures in a different way?