PERFORMANCE: There is an extreme risk that accident and emergency performance at Royal Berkshire Foundation Trust “not sustainable”, commissioners have said.

The Berkshire primary care trust cluster’s board assurance framework said there was a risk of breaching national performance targets.

The impact of this was rated four out of five, and the likelihood rated three, making the risk “extreme”.

Capacity in the trust’s A&E department, and patient awareness of alternatives to A&E were both identified as “gaps in control”.

Additional permanent nurse staffing in A&E had been agreed, and plans to open an extra four to six bays, and a longer term project to “model projected demand and redesign the urgent care flow” had been agreed.