Annual report summary 2025/26

The quality of care we provide remains exceptional, and we made significant progress in increasing our clinical activity and reducing the number of people on our waiting list, particularly those who have been waiting the longest for treatment.

During 2025/26, we remained in Segment 1, the highest-performing category of the NHS Oversight Framework and improved our national ranking from 15th to 12th out of 134 acute trusts.

The Trust was also awarded the second highest provider capability rating of green/amber for 2025/26 which is further recognition of our strong performance. This reflects the continued hard work and commitment of colleagues across the organisation.

Urgent and emergency care – our urgent and emergency care performance was amongst the best in the country, consistently achieving the national standard that 78% of patients are admitted or discharged within 4 hours.

However, increased demand in the final quarter meant our performance against the 4-hour standard fell to 74% in March. While we narrowly missed the national standard, this provides a strong foundation for further improvement.

Increasing activity – despite periods of industrial action, in 2025/26 we saw an additional 47,000 new outpatients and completed 42,000 surgical procedures, an increase of 9.3% and 3.3% compared to 2024/25.

This was achieved through extended working hours, our theatre refurbishment programme and national ‘sprint’ programmes to treat additional patients. We also had a Trust-wide focus on supporting patients to go home as soon as it’s safe to do so.

Reducing waiting times – we reduced our overall waiting list by 12% (almost 15,000 patients) during the year and made significant progress in tackling the longest waits for treatment.

The number of patients waiting more than 52 weeks reduced from 2,700 to 775. We worked hard to eliminate all waits over 65 weeks for routine treatment, and achieved this apart from a small number of complex cases.

Although the Trust entered NHS England’s tiering programme for planned (elective) waits, performance improved substantially over the year and reducing long waits remains a key priority.

Cancer care – our performance against the Faster Diagnosis Standard has shown sustained improvement, and in March 87% of patients received their diagnosis within 28 days (national standard 80%).

Performance against the national standard that 70% of patients should begin their cancer treatment within 62 days remains our greatest operational challenge with an overall performance of 65% in March 2026.

While we remain in NHS England’s tiering programme for cancer we have made progress, and the number of cancer patients waiting longer than 62 days for their treatment to begin reduced from 418 in March 2025, to 307 at the end of the year.

Diagnostic tests – demand for diagnostic tests has continued to grow and we saw a 5.2% increase in patients being referred onto our diagnostics waiting list.

While improvement work is ongoing, our performance did not yet met our plan, and at March 2026 34% of patients have been waiting more than 6 weeks, against a target of 12%. As a result we remained in NHS England’s regulatory tiering programme for diagnostics.

We remain committed to improving diagnostic performance and ensuring our patients are offered the most appropriate pathway to secure high standards of care and clinical decision making.

The Trust’s adjusted financial performance at the end of the financial year was a surplus of £5.2 million against a planned target of breakeven. This is the measure used by NHS England to rate the Trust’s financial performance.

The reported position after making a number of technical adjustments was a deficit of £39.3 million.

We set ourselves an ambitious cost improvement programme of £102 million, reflecting the level of savings required to deliver the financial plan, achieve national efficiency targets, and support increased patient activity.

Delivery remained challenging and required a combination of workforce controls, operational productivity improvement and tighter financial management. To support this, we implemented a Mutually Agreed Resignation Scheme (MARS), strengthened vacancy controls, and established a Productivity Programme focused on opportunities linked to administration, patient flow, surgery, ambulatory care, and private patient income.

At the end of the year, the Trust had identified £84 million of potential savings and had delivered £73 million of these – 72% of the cost improvement target we had set.

In January we published our Green Plan to 2028, which sets out how we will protect the environment while continuing to provide the best possible care for our patients.

We have committed to incorporating sustainability into everything we do and creating a healthier local environment to improve the health and wellbeing of our patients, colleagues and visitors.

While we have a long way to go to reach Net Zero we are pleased to have reduced our NHS Carbon Footprint (the emissions we directly control) by 7% over the year. Our NHS Carbon Footprint Plus (which we can only influence) has remained flat.

Reducing emissions – we invested in solar panels, electric vehicle charging infrastructure and energy-efficient lighting across our sites to reduce emissions and lower energy costs. We also continued to expand our electric vehicle fleet and secured funding to reduce anaesthetic gas emissions.

Greenspace and air quality – we continued to improve air quality and create healthier environments for patients, staff and visitors. Pollution levels at St Thomas’ main entrance continued to fall, while we are supporting patient recovery, staff wellbeing and local biodiversity through nature-based activities and improved green spaces.

Reducing waste – we are committed to conserving resources in everything we do. Since our ‘Gloves Off’ campaign was launched in September 2024, we have purchased 1.6 million fewer gloves than the previous year, saving 8 tonnes of plastic waste and £200,000. We also launched our first inhaler recycling scheme to help avoid inhalers going into landfill.

Task force on climate-related disclosures – the Trust Board has responsibility for oversight, assessment and management of climate-related issues. We track our progress through a range of environmental impact indicators and are working to ensure environmental sustainability is a central part of our ongoing planning and reporting across the Trust.

In line with the NHS 10-year plan, our ‘Better, faster, fairer healthcare for all’ strategy sets out the Trust’s commitment to tackle differences in health and healthcare access across our communities.

We are building our capability to understand where inequalities exist so we can adapt our services and deliver fairer, faster, more equitable healthcare to all those we serve. While there are examples of positive action across the Trust, we recognise the need for a more systematic approach to drive sustained improvement.

Our Population Health Hub is helping achieve this by bringing together expertise from across the Trust and our university partners to improve health outcomes for defined patient groups. The Hub has been working with South East London Integrated Care Board to improve data quality, access and analytics to support population health.

We are working to embed NHS England’s statement on information on health inequalities measurement framework, focusing on operational and Core20PLUS5 priorities, where we are investigating inequality indicators relating to deprivation, sex, age and ethnicity.

We employ around 23,900 staff, all of whom contribute to providing high quality patient care across our 5 hospitals and in the community. Their wellbeing and welfare remains our absolute priority. 

We achieved a response rate of 49% in the 2025 NHS Staff Survey, which is 2% above the national average for our category of ‘acute, and acute and community trusts’, and the second highest level of participation for the Trust ever.

We are proud that we scored above the national average in all 7 People Promise elements as well as the staff engagement and morale themes. While national scores have declined across several areas, the Trust achieved statistically significant year-on-year improvement in all 9 areas. We achieved the highest score nationally for the ‘We are always learning’ theme. ‘Diversity and equality’ and ‘negative experiences’ both scored above the national average for the first time in 5 years, reflecting progress in areas where we have historically struggled to achieve positive results.

While the results reflect positive progress and a strong sense of pride across the organisation, we know there are areas where we need to do better and remain committed to delivering further improvement.

There are ongoing concerns about fair opportunities for career progression, and despite overall improvement, some colleagues continue to experience discrimination, bullying and harassment across the organisation.