EXCLUSIVE: Cabinet Office conducts A&E 'deep dive' for PM

The exercise took place late last year, and was one of six undertaken around England. The Cabinet Office confirmed that it took place, but refused to give any details of what prompted the investigation, or what the outcome of it was.

The Cabinet Office would also not say either to HSJ or to NHS leaders in Portsmouth which other areas it was reviewing.

Officials visited Portsmouth Hospitals Trust, but leaders of local clinical commissioning groups, and community and mental health providers Southern Health Foundation Trust and Solent Trust, were also present.

The visit has come to light after it emerged the leaders of three clinical commissioning groups had written to the trust’s chief executive Ursula Ward expressing concern about its leadership.

Local NHS leaders were informed the Cabinet Office would be producing a report based on this and the other “deep dives” for the prime minister, but that it would not be made public.

HSJ understands that the focus of the investigation was on how the whole system worked together, including the NHS 111 telephone service, in the context of accident and emergency performance. However, the trust’s private finance initiative commitments were not discussed.

In winter 2012-13, Portsmouth Trust struggled against the target of admitting or discharging 95 per cent of A&E patients within four hours, diving to 87 per cent in quarter 3 of 2012-13 and remaining below 90 per cent in quarter 4.

In September 2013, Portsmouth commissoiners were allocated £1.4m to spend on improving emergency performance, after the trust being identified as being at risk of missing the A&E waiting times target this winter.

Although the study was billed as a “deep dive”, the Cabinet Office’s team was only in Portsmouth a day, HSJ understands.

Board papers from Southern Health said: “The review, which is one of six being undertaken by the Cabinet Office across the country, sought to understand the system’s preparedness for winter and the level of partnership working being undertaken.

“Collectively, the organisational representatives encouraged the reviewers to share any interventions from other systems, which might be beneficial to the systems we operate in.”