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The curse of SLHT

If you wanted, you could see the late-year travails of south east London trusts as the curse of South London Healthcare Trust.

In 2013, Jeremy Hunt completed what Andrew Lansley started and formally dissolved the organisation, giving one of its hospitals to Lewisham, one to King’s and leaving the third to be managed as a kind of Switzerland with cantons run by different providers.

In the confusion and threats to Lewisham’s A&E, managers and the local MPs got away with the third hospital’s A&E in Bexley never reopening.

But it’s fair to say the trusts that formally took on parts of SLHT regret it.

Meltdowns don’t come much bigger than at King’s, which made national headlines for a couple of days.

Departing chair Lord Kerslake made specific mention of King’s taking over the Bromley part of SLHT in his resignation letter in The Guardian.

Lewisham’s absorption of the Greenwich part also put non-payment of PFI support, bizarre wrangles with commissioners and involvement with Circle and competition law on the board’s plate.

This is all by way of saying good luck to Ben Travis, the new chief executive at Lewisham and Greenwich Trust. The job was described by one figure in the system as “a difficult ask”.

Announced in the top role on Wednesday, I wonder what would induce someone running a fairly successful foundation trust (Oxleas, also in south east London) to take over an overheated organisation of which too much has perhaps already been asked.

A report into the financial governance of the trust earlier this year found some loose practice around the hiring of consultants and the like, but fundamentally showed an organisation being asked to do improbable things by its regulator.

These included a savings plan equalling 8.6 per cent of turnover, the closure of seven wards and a reduction in the average length of stay from 8.1 to 4.7 days.

Whether Mr Travis will be charged with delivering this kind of miracle remains to be seen.

Winter so far

There are lots of different ways to consider A&E performance – trolley waits; the 95 per cent target; one day, maybe even clinical harm – but by one important measure at least, the capital is doing well.

NHS England’s daily situation reports show the number of patients waiting more than an hour to be transferred from the ambulance to an A&E.

From 20 November to 10 December, the English NHS saw 6.145 of these incidents – nearly 10 per cent of them at one trust in Lincolnshire.

Of the 20 trusts with the biggest problem, and which accounted for 3,563 of the national total, only one was in the capital.

London Ambulance Service Trust has been the subject of strenuous improvement efforts and its odd that London’s problem should be concentrated in one trust – London North West Healthcare Trust.

The questions that remain for the capital are whether north west London can rescue its disastrous type one A&E performance, which saw some of its trusts score in the fifties against the 95 per cent target.

LNWH faces particular pressure and has had meetings with the secretary of state.

Also, North Middlesex University Hospital Trust: if it can avoid a disaster like had last winter it will be doubly impressive considering that the fundamentals of its position – a lack of staff, recent changes to the provision of other trusts – remain unchanged.