1. Introduction
Our Auditor’s Annual Report (AAR) summarises the work that we (Bishop Fleming) completed for West Midlands Ambulance University Service NHS Foundation Trust (the Trust) for the year ended 31 March 2025.
The Trust is responsible for keeping proper accounts and proper records in relation to the accounts and for maintaining an appropriate system of internal control. The Trust is responsible for the preparation of annual accounts for each financial year. Such accounts must present a true and fair view and comply with the requirements of enactments that apply to them.
The Trust is also responsible putting in place appropriate arrangements to secure the economy, efficiency and effectiveness in its use of resources and to maintain an effective system of internal control that supports the achievement of their policies, aims and objectives whilst safeguarding and securing value for money from the public funds at their disposal.
The scope of our work is set in accordance with the National Audit Office’s Code of Audit Practice (the Code) and the International Standards on Auditing (ISAs) (UK). Our work is planned to provide a focused and robust audit. We are responsible for and are required to provide an independent opinion as to whether the financial statements:
- give a true and fair view of the financial position of the Trust at the year end and of the Trust’s expenditure and income for the year then ended;
- have been properly prepared in accordance with international accounting standards as interpreted and adapted by the Department of Health and Social Care’s Group Accounting Manual; and
- have been prepared in accordance with the requirements of the National Health Service Act 2006.
We are also responsible for:
- reviewing the Annual Governance Statement to ensure it complies with the guidance issued;
- ensuring the parts of the Remuneration and Staff Report to be audited have been properly prepared; and
- reviewing the Trust’s arrangements in place to secure economy, efficiency and effectiveness in its use of resources. The Code requires us to report on the Trust’s arrangements under three specified reporting criteria:
- Financial sustainability – how the Trust plans and manages its resources to ensure it can continue to deliver its services;
- Governance – how the Trust ensures it makes informed decisions and properly manages its risks; and
- Improving economy, efficiency and effectiveness – how the Trust uses information about its costs and performance to improve the way it manages and delivers its services.
We carried out our work in accordance with our Audit Plan that we issued to the Trust on 18 March 2025.
2. Executive summary
Results from the audit of the financial statements
We completed our audit of the financial statements and issued our unmodified audit opinion on 24 June 2025. See section 3 for more details.
We also completed component auditor procedures, in line with the National Audit Office group auditor instructions. We had no matters to report from this work.
Results on our work on other matters and the Annual Governance Statement
We completed our review of other matters and the Annual Governance Statement in line with our issuing of the audit opinion on 24 June 2025. There were a small number of areas that required updating and amending in the financial statements, which have been completed by management. See section 3 for more details.
Results from our work on VFM (Value for Money) arrangements
Under the Code, we are required to consider whether the Trust has put in place proper arrangements to secure economy, efficiency and effectiveness in its use of resources for the year ended 31 March 2025.
Our conclusions are summarised below. See sections 4–8 for more details.
Financial sustainability: We did not identify any significant weaknesses in the Trust’s financial sustainability arrangements. We have not made any recommendations.
No significant weaknesses in arrangements identified and no recommendations made.
Governance: We did not identify any significant weaknesses in the Trust’s governance arrangements. We have not made any recommendations.
No significant weaknesses in arrangements identified and no recommendations made.
Improving economy, efficiency and effectiveness: We did not identify any significant weaknesses in the Trust’s arrangements for improving economy, efficiency and effectiveness. We have not made any recommendations.
No significant weaknesses in arrangements identified and no recommendations made.
3. Audit of the financial statements
Audit opinion on the financial statements
The scope of our work is set in accordance with the Code and the International Standards on Auditing (ISAs) (UK). We are required to provide an independent opinion as to whether the financial statements:
- give a true and fair view of the financial position of the Trust at the year end and of the Trust’s expenditure and income for the year then ended;
- have been properly prepared in accordance with international accounting standards as interpreted and adapted by the Department of Health and Social Care’s Group Accounting Manual; and
- have been prepared in accordance with the requirements of the National Health Service Act 2006.
We gave an unqualified opinion on the Trust’s financial statements on 24 June 2025.
Other matters
We are required to give an opinion on whether the other information published in the Annual Report is materially inconsistent with the financial statements or the knowledge obtained by us in the course of our audit. The following issues were identified and amended by management:
- Some minor inconsistencies were noted between the figures in the draft Annual Report and the financial statements.
We are required to consider whether the Annual Governance Statement does not comply with the guidance issued by NHS England or is misleading or inconsistent with the information of which we are aware from our audit.
We have nothing to report in this regard.
We are required to give our opinion on whether the parts of the Remuneration Report and the Staff Report to be audited have been properly prepared in accordance with international accounting standards and in conformity with the requirements of the Accounts Directions issued under Schedule 7 of the National Health Service Act 2006. We issued an unmodified opinion in this regard on 24 June 2025; however, amendments were required to the Remuneration Report to comply with the requirements of the Group Accounting Manual. The following issues were identified:
- A non-executive director was omitted from the report; and
- The brought forward figures in the report included a real increase of 6.7% and therefore did not agree to the prior year report.
These were amended by the Trust prior to us giving our opinion.
Audit certificate
At the end of the audit, we are required to certify the completion of the audit. The effect of this certificate is to close the audit and marks the point when the auditor’s responsibilities in respect of the audit of the period covered by the certificate have been discharged.
The National Audit Office has highlighted to auditors that as a result of revisions to ISA 600 (Audits of Group Financial Statements) further work may be needed over and above that set out in their Group Instructions issued to auditors in late March 2025. As a result, we cannot formally conclude the audit and issue an audit certificate for the Trust for the year ended 31 March 2025 until we have confirmation from the National Audit Office that no additional work will be required in respect of the Consolidated NHS Provider Accounts exercise that auditors must undertake.
More detailed findings can be found in our Audit Completion Report which was reported to the Audit Committee on 23 June 2025.
4. Value for Money
Under the Code, we are required to consider whether the Trust has put in place proper arrangements to secure economy, efficiency and effectiveness in its use of resources for the year ended 31st March 2025.
The Code requires us to report our commentary on the Trust’s arrangements under three specified reporting criteria:
- Financial sustainability – how the Trust plans and manage is its resources to ensure it can continue to deliver its services;
- Governance – how the Trust ensures it makes informed decisions and properly manage its risks; and
- Improving economy, efficiency and effectiveness – how the Trust uses information about its costs and performance to improve the way it manages and delivers its services.
The National Audit Office has issued guidance for auditors to report against each of the three specified reporting criteria the guidance also includes a number of further areas for review within each criterion for the auditor to assess those arrangements.
Our risk assessment undertaken at the planning stage did not identify any potential risks of significant weakness.
We asked management to complete an evidenced self-assessment of the Trust’s arrangements we then reviewed the evidence provided and carried out follow up work as appropriate to consider whether there were any significant current weaknesses in the Trust’s arrangements for securing economy efficiency and effectiveness in its use of resources.
Our commentary on the Trust’s arrangements in each of these three areas is set out in sections 5, 6 and 7 of the report. We have not raised any recommendations in respect of 2024/25.
5. Financial sustainability
We considered how the Trust plans and manages its resources to ensure it can continue to deliver its services, including how the Trust:
- ensures that it identifies all the significant financial pressures that are relevant to its short and medium-term plans and builds these into them;
- plans to bridge its funding gaps and identifies achievable savings;
- plans finances to support the sustainable delivery of services in accordance with strategic and statutory priorities;
- ensures that its financial plan is consistent with other plans such as workforce, capital, investment, and other operational planning which may include working with other local public bodies as part of a wider system; and
- identifies and manages risks to financial resilience, e.g. unplanned changes in demand, including challenge of the assumptions underlying its plans.
Overview and 2024/25 outturn
The Trust’s draft financial statements for 2024/25 show a surplus of £10k against a planned deficit of £1.36m, compared with a surplus of £2,068k in the 2023/24 year. The deterioration in financial performance year on year is mainly attributed to an increase in salary costs, resulting from a pay rise during the year. Additionally, a decrease in interest income from bank accounts contributed to the reduction in outcome.
The Trust’s total income for patient care activities in 2024/25 amounts to £442.8m. Over 84% of this income is secured for the provision of Emergency and Urgent services, commissioned by six Integrated Care Systems (ICSs), that is, from Birmingham, Black Country, Staffordshire, Coventry & Warwickshire, Shropshire and Hereford & Worcester.
Financial planning and monitoring
The Trust has appropriate financial planning and monitoring arrangements in place. Finance reports are regularly presented to the Trust Board throughout the year. In addition, the Trust also submits monthly monitoring reports to NHS England (NHSE) in accordance with established guidelines and requirements. The forecast is regularly updated to reflect any evolving circumstances.
At the start of the 2024/25 financial year, both a budgeting report and workforce planning reports were presented to the Trust’s Executive Management Board (EMB) as integral components of the planning and budget-setting process. Finance and workforce work together to produce these documents to ensure consistency across the Trust. In 2024/25, there have been monthly informal discussions to assess the current Emergency & Urgent workforce status and anticipate future recruitment trends, ensuring their accurate integration into the financial projection. Additionally, joint meetings have been established between finance, workforce and the lead commissioning Integrated Care Board (ICB) and NHSE each month to monitor the Trust’s performance.
The Board Assurance Framework (BAF) (which we discuss further in the Governance section of this report) includes appropriate financial risks and metrics. Financial planning and monthly reporting documents highlight risks. The Trust’s risk register and BAF offer a formalised process for risk reporting and management, encompassing the identification of principal financial risks and their mitigation measures.
We reviewed the assumptions underpinning the 2024/25 financial plan, the reports prepared for the Board, and the minutes of relevant meetings where the financial plan was considered. In our view the assumptions made by management appeared reasonable, the reports were clear and concise, and the Board’s scrutiny was evident and appropriate. The risks associated with the plan, including those related to the Cost Improvement Programme (CIP – that is the Trust’s savings plan), were clearly articulated. As mentioned above, the Trust performed better than its financial target for the 2024/25 financial year over-achieving its approved deficit financial plan. This is further evidence of the Trust’s effective management arrangements of its finances.
Achieving efficiency savings
Initially the Trust set a savings target of £19.3m for 2024/25. The plan consisted of £12.2m in relation to ten non-recurrent areas with the majority allocated to reductions in the Emergency & Urgent Pay CIP of £9.9m. The remaining £7.5m was in relation to 53 other identified recurrent areas.
During 2024/25, the Trust’s internal auditors undertook a review of financial sustainability, with the findings reported to the Audit Committee in October 2024. The review concluded with a rating of “Partial assurance with improvements required,” primarily due to significant delays in identifying sufficient CIP schemes to meet the Trust’s efficiency target agreed with NHSE for the year. This was highlighted as a high-priority area for action.
Despite these challenges, the Trust delivered total financial efficiencies of £21.3m, exceeding its target. Of this, £13.8m related to non-recurrent savings and £7.5m to recurrent savings. The positive variance was largely driven by the strong performance of the fuel and taxi schemes, as well as an additional insurance rebate received in month 12. While this demonstrates effective in-year financial management, the reliance on non-recurrent savings underscores the importance of embedding longer-term, sustainable efficiency measures.
2025/26 financial planning
Looking forward, the Trust’s financial planning arrangements for 2025/26 are consistent with those of 2024/25. The Trust was required to provide a financial plan to the Black Country ICS (its lead commissioner) aimed at contributing to the ICS’s breakeven position for the year. Our assessment of documents submitted for the 2025/26 process illustrates the Trust’s involvement in the planning process at both the system and local levels.
The Trust has set a breakeven budget for 2025/26, underpinned by assumptions around additional income and efficiency savings. Key income assumptions include £22.9m from ICBs to reflect the impact of hospital handover delays and £12.9m in new ambulance growth funding expected from NHSE. On the cost side, the budget incorporates the effect of the expanded Emergency and Urgent workforce and includes a significant CIP target of £19.8m, representing 4.3% of turnover.
There are material risks to delivering the planned breakeven position. These include the need to secure the nationally held £12.9m ambulance growth funding, the full achievement of £19.8m in CIPs – particularly within operationally constrained areas such as Emergency and Urgent – and the recovery of the £22.9m income linked to lost ambulance hours. While partial non-recurrent support was secured from ICBs in 2024/25, confirmation of recurrent funding at the same level remains uncertain and poses a notable financial risk.
As of the latest CIP update, £6.9m of schemes are fully developed or at an advanced stage, while £13.0m remain at the opportunity or concept phase. These include broad categories such as operational productivity and procurement savings that require rapid progression into actionable plans. Timely development and implementation will be essential to avoid in-year slippage and ensure the Trust remains on course to achieve its financial objectives.
Based on the work carried out, we were satisfied that there are no significant weaknesses in the Trust’s financial sustainability arrangements.
6. Governance
We considered how the trust ensures that it makes informed decisions and properly manages its risks, including how the Trust:
- monitors and assesses risk and how the body gains assurance over the effective operation of internal controls, including arrangements to prevent and detect fraud;
- approaches and carries out its annual budget setting process;
- ensures effective processes and systems are in place to ensure budgetary control; to communicate relevant, accurate and timely management information (including non-financial information where appropriate); supports its statutory financial reporting requirements; and ensures corrective action is taken where needed, including in relation to significant partnerships;
- ensures it makes properly informed decisions, supported by appropriate evidence and allowing for challenge and transparency. This includes arrangements for effective challenge from those charged with governance/audit committee and
- monitors and ensures appropriate standards, such as meeting legislative/regulatory requirements and standards in terms of officer or member behaviour (such as gifts and hospitality or declarations/conflicts of interest), and for example very procures or commissions services.
Risk management
Risk management arrangements are in place at the Trust. As stated earlier, there is a Board Assurance Framework (BAF) in place that covers relevant strategic risks which are linked to strategic objectives. The BAF summarises strategic objectives, the risks to achieving those objectives, controls in place to minimise the likelihood and magnitude of the crystallisation of those risks and details assurances that the controls are operating effectively.
Each risk identified is also linked to a corporate objective and assigned to a senior officer at the Trust. The BAF details each risk’s RAG rating the progression of the risk score, current challenges, gaps in control/assurance, future opportunities and details of how the challenges are being managed.
The Audit Committee receives the BAF at every meeting. The BAF is reported to the Trust Board bi-monthly as part of the Chief Executive’s report. All risks including strategic risks scoring 12 and above are also reported to Sub Committees.
Risk review is a standing agenda item for the Trust Board, Finance and Performance Committee, Quality Governance Committee and the Audit Committee. The Trust’s Governance Structure is made up of the Trust Board and six sub-committees which are each chaired by a Non-Executive Director (NED) alongside various sub-groups which are in turn chaired by one of the Executive Directors. This allows for reliable and direct channels of communication between the sub-committees and the Board in order to report any risks.
The Trust maintains a NED skills matrix which is updated annually in order to ensure that the make-up of the Board is complete and appropriate in terms of undertaking the stewardship of the Trust.
The detailed risk register sits below the BAF and details how risks outside of the Trust’s risk appetite will be escalated, ensuring that the Board is able to focus on the key risks.
Internal Audit’s “BAF and Risk Management” report issued in June 2025 rated the Trust’s arrangements in this area as having “Significant assurance with minor improvement opportunities”.
Internal control
Key to the Trust’s internal control arrangements is Internal Audit. In 2023/24, the Trust’s Internal Audit function was outsourced to KPMG for part of the financial year, who provided a “step in” arrangement before conducting a full programme for the current year. Internal Audit has a representative at each of the Audit Committee meetings to present any findings from their work. The Audit Committee approves the Annual Internal Audit Plan and is provided with a progress report against the plan at each meeting.
The Audit Committee has a key role to play in ensuring the overall effectiveness of internal controls. The Committee discharges this function appropriately by adhering to its terms of reference and challenging officers in relation to internal and external audit findings.
The 2024/25 Head of Internal Audit opinion issued in June 2025 stated that ‘Significant assurance with minor improvement opportunities’ can be given on the overall adequacy and effectiveness of the organisation’s framework of governance, risk management and control.’
Through our review of the Internal Audit reports, along with review of the Audit Committee minutes and supporting documents, we have not identified any significant gaps in the assurance the Trust receives over matters in the work programme.
The Audit Committee has a key role to play in ensuring the overall effectiveness of internal controls. The Committee discharges this function appropriately by adhering to its terms of reference and challenging officers in relation to internal and external audit findings.
The Local Counter Fraud Service (LCFS) is provided internally. An annual plan for LCFS work is produced and approved by the Audit Committee – for example the 2025/26 Plan was approved at the June 2025 Audit Committee. There is a named Counter Fraud lead for the Trust who reports progress against the plan to the Audit Committee and who attends all Audit Committee meetings. LCFS newsletters are published to the wider Trust which ensures that counter-fraud is something practised by the whole organisation.
Budget setting and budgetary control
Financial budgets within the Trust are developed at the cost centre level and undergo a thorough review by both budget and finance managers before receiving Board approval. Central NHS assumptions, including those related to staff costs, are integrated during the budget development process. Upon completion, budget holders sign off on their respective budgets at the cost centre level.
Heads of Directorate/Division (HODs) assume ownership of their area budgets for ongoing reporting and monitoring purposes. Budget holders have online access to financial reporting data, ensuring they remain engaged and can inform, discuss, and challenge throughout the process. HODs are also required to sign off on their budgets. Draft budgets are initially presented to the EMB. Following this review, the final budget is submitted to the Trust Board for approval.
A review of meeting minutes has provided sufficient evidence that budget setting and monitoring processes are reported frequently throughout the year. Our examination of the integrated reporting pack to the Trust Board confirms the inclusion of relevant non-financial information, which supports the explanation of significant variances reported.
Decision making
We are satisfied that appropriate arrangements are in place to ensure that all relevant information is provided to decision makers before major decisions are made, and that there are arrangements for challenge of such decisions before they are made. Attendance at Audit Committee has confirmed that it holds officers to account and provides effective challenge.
All Board and Committee reports have a mandatory cover schedule setting out the purpose of the paper, recommendations and actions required. They also include a summary of the key elements including the relevant strategic objectives. This is in line with best practice.
Ensuring appropriate standards
The Trust has other appropriate policies and procedures in place to ensure appropriate standards are maintained. These include the Counter fraud, corruption and bribery policy and Gifts and Hospitality policy.
We have been informed that there have been no instances of any non-compliance in relation to Trust’s standards and policies in place during the year. Throughout our work, we have not identified anything that has contradicted this. The Trust’s Quality Governance Committee monitor issues that may have an impact on non-compliance throughout the Trust.
The most recent CQC inspection (August – October 2023), was published in February 2024 and rated the Trust overall as “Good”. All categories (Safe, Effective, Caring, Responsive, and Well-led were rated at least Good, with the Caring category being rated as Outstanding. However, there was a ‘must do’ recommendation raised in the findings as detailed in next section of this report.
Declarations of interests are completed on an annual basis by the Board, with the Register of Interests being on the Trust’s website. Arrangements for making a declaration of interest are in place at the beginning of all Board and Committee meetings.
We are satisfied that the Trust has appropriate arrangements in place to monitor compliance with legislation and regulatory requirements.
Based on the work carried out, we are satisfied that there are no significant weaknesses in the Trust’s governance arrangements.
7. Improving economy, efficiency and effectiveness
We considered how the Trust uses information about its costs and performance to improve the way it manages and delivers its services, including:
- how financial and performance information has been used to assess performance to identify areas for improvement;
- how the Trust evaluates the services it provides to assess performance and identify areas for improvement;
- how the Trust ensures it delivers its role within significant partnerships and engages with stakeholders it has identified, in order to assess whether it is meeting its objectives; and
- where the Trust commissions or procures services, how it assesses whether it is realising the expected benefits.
Assessing performance and evaluating service delivery
The Trust reports its performance against its objectives to the EMB and the Board through a monthly report. The report provides a detailed assessment of performance against key indicators linked to the Trust’s objectives and includes financial and performance information. The report monitors the reasons for movements to identify areas for improvement. The reporting covers the ICS areas that the Trust works across.
The Trust’s clinical performance report gives comparisons to national standards, which gives the Trust opportunities to see areas of improvement. From this, the Trust identifies key areas of focus within each of their local health and care systems and how these can be implemented in order to improve the services that are offered. The Trust’s Operational Plan demonstrates in further detail how the Trust plans to achieve these priorities and objectives. There is clear collaboration across all six health economies and how they support each other in order to improve overall performance.
The Trust’s Well led Improvement Plan sets out actions arising from review against the Key Lines of Enquiry from the Well Led Framework. This provides details for areas of improvement and guidance on the approach to be taken. Our review noted a number of actions that have been completed since the Plan was developed. This demonstrates that the Trust is identifying services to improve, actions to improve them and evidencing that these are being implemented.
When identifying efficiencies, the Trust has a CIP policy that details how reviews are conducted and the processes that follow a decision being made. Larger value or transformational savings/efficiencies have a Quality Impact Assessment to consider the overall impact of proceeding.
Care Quality Commission inspection
Last year we reported that the Care Quality Commission (CQC) had conducted a series of inspections of the Trust in August 2023 and October 2023, with the findings published on 23 February 2024. These inspections were part of the CQC’s ongoing commitment to ensuring that healthcare providers deliver safe and effective care to patients. The inspections focused on various aspects of the Trust’s operations, with particular attention given to emergency response times and the quality of care provided.
At the time, the CQC’s report highlighted several areas of concern, leading to the imposition of a Regulation 12(1)(2): Safe care and treatment. This regulation mandates that the Trust must ensure national response time targets are met, with a specific emphasis on addressing the risks associated with Category 2 calls. These calls typically involve serious medical emergencies, and the requirement aims to mitigate the risks posed by potential delays in response times. The findings and subsequent regulation underscore the importance of adhering to established response benchmarks to enhance patient safety and care quality.
To address this, we noted that the Trust had established the Operational Oversight Delivery Programme Board. The purpose of this programme board was to provide focused oversight on the operational performance of the Trust, specifically aiming to improve response times for Category 2 calls, thereby enhancing the safety and quality of service provided to patients and the public.
As part of our follow up work, we have obtained an update on the Trust’s progress in this area. The Trust provided to us the final version of the Operational Oversight Delivery Programme Board – Action Log, dated December 2024. At this meeting, the Operational Oversight Board was formally stood down, having completed its remit. The action log provided detailed information for each action, including the nature of the task, the responsible officer, and the completion date. All actions were recorded as completed, indicating that the Trust had made substantial progress in addressing the concerns raised by the CQC and fulfilling the requirements set out under the oversight framework.
Partnership working
Partnership working arrangements are appropriate. Due to the nature of the services it provides, six ICSs are covered by the Trust. There is a lead commissioner for six of these who co-ordinates service commissioning. As noted earlier, the Trust’s lead commissioner is Black Country ICB.
The Trust has established collaborative arrangements monitored through the Board and has established governance structures, with, for example, the Black Country ICB. There is evidence of clear communication between the Board and its partners. The Trust has Board level representation on Black Country ICB.
Activities within the local ICS areas are reported and monitored by the Board via the Integrated Governance Report. There is good evidence which supports that the Trust works closely with its key stakeholders across the ICS areas in which it operates.
Recent developments published by NHSE in its update on the draft model ICB blueprint indicate a move towards increased collaboration and potential mergers between ICBs. These structural changes are part of a wider ambition to streamline system leadership and improve the efficiency and consistency of NHS service delivery across regions. For West Midlands Ambulance Service NHS Foundation Trust, which operates across multiple ICB footprints, such changes could introduce a number of emerging risks.
These include challenges around maintaining clear lines of accountability, managing operational complexity across evolving system boundaries, and aligning resources and priorities across ICBs that may be at different stages of transformation. While these developments are not expected to have a direct impact on our 2024/25 Value for Money work, we note that they represent an important area of strategic and operational focus. As such, we will look to engage with the Trust in future year’s audits to understand how it is planning for, and responding to, these system-level changes, and how it is ensuring appropriate oversight and adaptability as these developments progress.
Commissioning and procuring services
The Trust has a procurement strategy that was last updated in January 2022. The procurement strategy has now been integrated with the finance strategy of the Trust.
The Trust’s Standing Financial Instructions include operating guidelines regarding quotations, tendering and requisitions. They also include limits at which tenders or quotes are required and delegated levels of authorisation as well as details regarding selection of suppliers, providers and approved contractors. There is no evidence that suggests the Trust is failing to operate a fair procurement exercise for significant contracts.
The Trust monitors the performance of service providers and takes action to resolve issues when they arise.
The financial dashboards in the reports from the Director of Finance are reported to each Clinical Operational Board. In addition, the Trust Board reviews financial performance, quality of services offered, any issues that are faced and how any negative issues can be managed with actions to be implemented. The Trust is thereby able to review the financial effectiveness of ongoing services.
Based on the work carried out, we are satisfied that there are no significant weaknesses in the Trust’s arrangements to secure economy, efficiency and effectiveness.
8. Recommendations
Prior year recommendation – Resolved
Unidentified savings – The Trust is facing significant challenges in relation to meeting its financial targets for 2024/25 in part due to the imposition of Regulation 12(1)(2): Safe Care and Treatment by the CQC.
In addition, in order to meet its approved financial position for the 2024/25 financial year, the Trust must implement a CIP savings plan totalling £19.7m. As of April 2024, £13.1m of this efficiency target remains unidentified.
Recommendation
Working with the wider NHS healthcare system, the Trust should conduct a thorough financial impact assessment to identify opportunities for cost optimisation and ways of making further savings.
Management comment
Achieving the required CIP is intrinsically linked to additional costs of lost hours incurred due to the hospital handover delays. There is work taking place across the 6 West Midlands ICBs and with NHS England to recognise and work on solutions regarding meeting these additional costs and reducing the lost hours. There is work ongoing in the Trust, across all areas, to reduce costs, realise efficiencies and review ways of working to meet the CIP target.
Update 2024/25
The Trust has been able to deliver the planned savings during the year. Hence the recommendation is considered to be resolved.