Leadership Insights

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…

  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…

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.  …

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,…

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…