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If Channel 4’s long-running 24 hours in A&E was to follow the full journey of some of the patients arriving at Cambridge University Hospitals Foundation Trust’s emergency department in a single episode, they’d need to tweak the title.

Last week, emergency patients were left waiting more than 60 hours to be admitted to a bed, as we reported on Tuesday, and senior staff have questioned why a major hospital did not seek support from neighbours.

Patients were bedded down in corridors and facing very long waits. While the provider declared an internal incident, sources felt it should have escalated its alert level to Opel 4, which prompts calls for external support when trusts are under the most severe levels of operational pressure. This can include diverting ambulances to other hospitals.

The trust apologised to patients who had been kept “waiting for a long time” but that the required threshold for Opel 4 had not been reached.

The reality is, of course, that little mutual aid is available right now, because every hospital is running far too hot. But acknowledging the situation’s severity is always an important part of addressing a serious problem – which this clearly is, regardless of the support on offer from others.

ICB steps in

The integrated care board for Lancashire and South Cumbria has continued to flex its muscles, following the row which led to the departure of mental health chief Caroline Donovan.

Ms Donovan resigned from Lancashire and South Cumbria FT in the summer after tensions with the ICB which centred around the scale of efficiency savings being demanded of the trust, and the estimated £15m costs of out-of-area placements.

Now it’s emerged the ICB has arranged the appointment of a financial turnaround director, Mark Friedman, to LSCFT, with the agreement of the trust board.

Mr Friedman will work alongside interim finance director Richard Alexander, who joined in August.

The pair have their work cut out, as the trust was already reporting a deficit of £8m for the first five months of the year, £5m worse than planned. It still plans to end the year with a breakeven position, but this is taking an extremely optimistic view of the income it will receive and the money it will spend.

Mr Friedman is on a rolling contract, which is subject to “sustained progress and delivery in taking forward the trust’s ambitious quality assured efficiency programme and demonstrable return-on-investment”.

Also on hsj.co.uk today

Former Care Quality Commission chief inspector of hospitals Ted Baker has told the HSJ Patient Safety Congress trust CEOs risk becoming “prisoners” of organisations with poor cultures if they do not “step back and see the bigger picture”. Keith Rowley, chief officer of the Healthcare Supply Association, has warned NHS procurement is “arguably in a worse state” than during the covid pandemic. Meanwhile, the winners of the HSJ Patient Safety Awards 2022 have been announced.