The must-read stories and debate in health policy and leadership.

In December 2022, NHS England announced ambitions for 100 specialist mental health ambulances to be out on the roads (and most of them by the next winter), but research done by HSJ has revealed only four regions have bid successfully for the new vehicles.

Trust responses revealed there are around 16 on the roads at the moment, with around 46 expected to arrive over the next few months.

The mental health response vehicles were meant to add to capacity to respond, as well as being better suited to patients, as they have fewer fluorescent markings and a less clinical interior to help put patients at ease.

News of their delay comes amid a growing struggle to manage emergency care demand from people in mental health crisis or those with mental illness, and coincides with fears of an even greater problem as the police withdraw from responding to many cases.

The research also revealed a degree of uncertainty around how the new vehicles would be funded, with only two regions confirming they had agreed plans with commissioners.

Epic process

The chief executive of an acute trust in one of the country’s most troubled healthcare economies has admitted his organisation is struggling to fully utilise its top-tier electronic patient record system three years after its rollout.

Royal Devon University Healthcare Foundation Trust implemented the Epic EPR in October 2020, but it continues to face problems with reporting performance. Chief executive Sam Higginson described Epic as a “Rolls-Royce of an EPR” but said they are “still driving it like a Ford Focus”.

“We assumed installing an EPR would let us switch off almost everything else. But it doesn’t quite have the functionality we thought, or we don’t quite know how to use it.”

Despite successes, such as over 100,000 patients using a portal, the EPR’s implementation negatively impacted cancer performance. By March 2024, the percentage of patients treated within 62 days dropped from 71.9 to 65.8 per cent.

Mr Higginson said the trust’s EPR use is improving and a new cancer reporting module is being tested. He also highlighted the need for a national discussion about integrating primary care within Epic’s EPR.

Also on hsj.co.uk

In Comment, Tim Horton and Alison Moulds explore the potential of health technology to alleviate NHS workforce pressures, emphasising the importance of effective implementation and utilisation for productivity gains. And in Following the Money, Henry Anderson looks at new analysis by NHSE  understand the NHS’s productivity challenges.