CEO Blogs
From hospital to home: what the DRD metric is really telling us about flow this winter
The signal: NHS England is now tracking Discharge Ready Delay (DRD), the days between a patient being clinically fit for discharge and the day they actually leave hospital. July 2025 data confirm DRD is stubbornly above plan, with widening system variation. Why this matters: DRD is a direct reflection of patient flow. A high…
Read MoreFinances Under Strain: Navigating the £6.6bn Gap Without Breaking Care
The NHS entered 2025/26 with a projected £6.6bn system deficit and an instruction to deliver the toughest efficiency programme in its history. Against that backdrop, government messaging has zeroed in on an agency-spend crackdown, presenting it as the main culprit and solution. This narrative is politically convenient, but financially dishonest. Even if the headline…
Read MoreBeyond averages: reducing mental health OAPs and long stays by building community capacity
The signal: June 2025 data show 439 out-of-area placements (OAPs) in adult mental health, +105 year-on-year. 24.5% of adults had inpatient stays >60 days, and 40.5% of older adults delayed >90 days. Why this matters: These aren’t just inefficiencies, they separate patients from families, erode continuity of care, and drive escalating system costs. …
Read MoreThe 2025/26 UEC Plan: What ICS and Providers Must Stand Up by November
Executive Summary Urgent and Emergency Care (UEC) is the frontline test of NHS resilience. For winter 2025/26, NHS England has set out a plan to stabilise UEC performance, reduce long waits, and improve patient flow. Yet translating this plan into operational reality within Integrated Care Systems (ICSs) and Trusts is fraught with challenges: workforce fragility,…
Read MoreThe 89% problem: designing ethical, scalable autism assessments to close the wait gap
Scale of need:In June 2025, 236,225 people had an open referral for suspected autism; 89.4% were waiting ≥13 weeks. Why this matters:Delays worsen educational disruption, family strain, and crisis presentations, while compounding health inequalities. What to do now:Commission hub-and-spoke MDT pathways with single-front door triage, scalable digital components, and embedded post-diagnostic support. Accountability:Link contracts to…
Read MoreFrom ‘War-Games’ to Ward Rounds: Making NHSE Winter Stress-Tests Count Locally
Every year, NHS England conducts pre-winter “stress-tests”, scenario planning exercises often likened to war-games, to assess how well systems are prepared for seasonal surges. Yet, too often, these exercises remain paper exercises rather than operational reality. As winter 2025 looms, with urgent care demand set to collide with elective backlogs and workforce fragility, the…
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