NHS Intelligence Briefing - 2026-09

NHS Intelligence Briefing PRIVATE — INTERNAL ONLY

2026-09 · Generated 2026-09-15 17:17 · 7 Trust(s) analysed

1. Cross-Trust Insights

The peninsula health system is operating under extreme structural financial distress, with total underlying system deficits across Devon acute and mental health providers exceeding £500m. While NHS Cornwall achieved a technical breakeven outturn in 2025/26 following a £150m national historic debt write-off, Devon ended the year with a £64.3m deficit and a £286.4m underlying gap. To present balanced 2026/27 financial plans to NHS England, providers are relying on historic, unprecedented Cost Improvement Programme (CIP) targets (£281m system CIP in Devon, including £91.6m at UHP, £80.7m at Royal Devon, £54.4m at Torbay, and £26.5m at DPT). These targets are heavily supported by non-recurrent deficit support funding, property transactions, and aggressive headcount cuts through voluntary redundancies and 28-50% running cost reductions at the ICB level.

Most financially pressured: University Hospitals Plymouth NHS Trust (UHP) & Torbay and South Devon NHS Foundation Trust (TSDFT). UHP carry an underlying deficit of £110m, submitted a nationally non-compliant plan requiring PwC intervention, and must deliver a £91.6m CIP (~8% of turnover). Torbay carry a £99.5m underlying deficit and were forced to terminate their £35m/yr Section 75 social care contract to halt structural losses.

Most stable: South Western Ambulance Service NHS Foundation Trust (SWAST). SWAST successfully delivered a £29.9m CIP in 2025/26, completely eliminated agency staffing spend, maintained a breakeven outturn, and operates without the severe structural estate/bed deficit plaguing the acute trusts.

Rejection or Pullback from the National Federated Data Platform (FDP)

Multiple Trusts across the footprint are actively opting out of, pausing, or terminating national FDP/Palantir deployments in favor of native Epic workflows or local data warehouse architecture. Royal Devon formally terminated its Palantir/FDP theatre scheduling project to build natively within Epic; Torbay explicitly confirmed non-adoption of FDP; and DPT deliberately bypassed national FDP to build an internal SystmOne, Power BI, and QVERA analytics stack.

Involves: Royal Devon, Torbay and South Devon NHS Foundation Trust, DPT

Significance: Highlights a major regional shift where Trusts prioritize deep native integration within existing core systems (like Epic or local Power BI environments) over overlaying national software products that add licensing or operational overhead.

Post-EPR Go-Live Data Quality and Reporting Crises

While successful Epic EPR deployments were achieved across Torbay (April 2026) and UHP (July 2026) under the 'One Devon' platform, both Trusts face severe post-go-live data stabilization issues. Torbay escalated Corporate Risk 570 (score 20) due to RTT clock counting, activity reporting, and contract income errors, while UHP reported 57-72% error rates in readmission coding and SHMI distortions driven by low baseline clinical data literacy.

Involves: Torbay and South Devon NHS Foundation Trust, UHP, Royal Devon

Significance: Demonstrates that EPR go-lives create acute secondary operational risks around statutory reporting compliance, contract income reconciliation, and board assurance if post-implementation data validation and training are under-resourced.

Aggressive ICB Downsizing and Corporate Headcount Cuts

The formal clustering of NHS Devon ICB and NHS Cornwall & Isles of Scilly ICB into the SWP Board ahead of a planned April 2027 merger has triggered a 28% to 50% cut in running costs to meet the national £19/head ceiling. This has trickled down to constituent acute and mental health trusts, forcing Voluntary Redundancy (VR) schemes at DPT, Torbay, and Royal Devon targeting non-clinical, administrative, and corporate analytics posts.

Involves: SWP Board, NHS Devon ICB, DPT, Torbay and South Devon NHS Foundation Trust, Royal Devon

Significance: Massive corporate headcount reductions create severe risks to statutory safeguard capacity, information governance, and business-as-usual reporting, prompting formal trade union disputes over clinical safety.

Rapid Adoption and Governance Escalation of Clinical AI

Trusts across the region are rapidly deploying AI technologies—such as Ambient Voice Technology (AVT) for outpatient documentation (Royal Devon, SWAST, DPT), Brave AI for primary care risk stratification (Devon ICB, SWP, UHP), and Microsoft Copilot (DPT, Torbay, UHP). In response, SWAST has formally added AI Governance to its Corporate Risk Register (score 15) to manage data privacy, clinical safety, and hallucination risks.

Involves: SWAST, Royal Devon, DPT, UHP, NHS Devon ICB

Significance: Reflects a transition from AI experimentation to operational deployment, driving an urgent need for formal AI safety frameworks, algorithmic audit trails, and data privacy governance.

Shared risks across Trusts:

  • System Financial Sustainability and Recurrent Deficit Delivery (Scored 16-25 across all 7 Trusts)
  • Urgent & Emergency Care Flow, ED Overcrowding, and High No Criteria to Reside (NCTR) Rates (SWP, Devon ICB, UHP, Torbay, Royal Devon, SWAST)
  • Workforce Restructuring and Capacity Risks during ICB Clustering / Running Cost Reductions (SWP, Devon ICB, DPT, Torbay, Royal Devon)

Rare/distinctive risks:

  • Unmonitored Local Databases & Shadow IT (DPT Risk 3481, score 16)
  • Formal Artificial Intelligence Operational Governance & Hallucination Risk (SWAST, score 15)
  • Tower Block Fire Safety in Higher Risk Building / £120m Estate Backlog (Torbay Risk 2801, score 25)
  • Medicines Safety During EPMA Network System Outages (DPT POT043, score 20)
  • Section 75 Adult Social Care Agreement Disaggregation (Torbay BAF-OT, score 20)
SWAST (positive outlier): Achieved significant operational and digital turnaround, completely eliminating agency spend, delivering a £29.9m CIP, saving £140k/yr by migrating Tableau to live Power BI, and reducing Category 2 ambulance response times from 57 to 30 minutes.
Torbay and South Devon NHS Foundation Trust (unusual): Took the unprecedented structural step of terminating its 20-year integrated Section 75 Adult Social Care agreement with Torbay Council due to an unfunded £35m annual shortfall, forcing a complex 12-month data and service disaggregation.
UHP (negative outlier): Flagged as 1 of only 16 NHS trusts nationally submitting a non-compliant financial plan, requiring PwC intervention to baseline an unprecedented £91.6m CIP (~8% of turnover), while suffering from up to 72% clinical coding error rates.
DPT (unusual): Operating with an explicit corporate risk for Shadow IT / Unmonitored Local Databases (Risk 3481) while maintaining a complete opt-out from the national Federated Data Platform in favor of internal SystmOne/Power BI architecture.

2. Report Quality Ranking

  1. SWAST: 7.3/10 — Consistently exemplary Integrated Performance Reports featuring Making Data Count SPC charts with explicit special cause variation icons and national 10-trust peer benchmarking.
  2. DPT: 7.1/10 — High quality board packs with thorough Statistical Process Control application, clear risk heatmaps, and structured executive narratives.
  3. UHP: 7.1/10 — Demonstrates high analytical rigor with three-sigma SPC limits and national benchmarking, though acknowledged by executives to be hampered by low underlying data entry quality.
  4. SWP Board: 5.5/10 — Provides structured performance metrics and quality SPCs, but narrative packs frequently omit visual data tables, prompting demands from the Chair for data-focused reporting.
  5. NHS Devon ICB: 5.5/10 — Highly bifurcated quality; standard IQPR reports score high (7-8) with robust SPC charts, but governance packs and minutes score very low (1-3) due to illegible spreadsheets and narrative density.
  6. Royal Devon: 5.0/10 — Full board packs achieve high scores (8/10) with detailed site-level SPC breakdowns, but meeting minutes drop to 3-5/10 due to heavy reliance on qualitative text.
  7. Torbay and South Devon NHS Foundation Trust: 4.7/10 — Varies widely from top-tier IQPR packs with multi-year SPC trends (7-8) to low-scoring public governance packs and transcripts (1-3).

3. Top Opportunities

  • HIGH Torbay and South Devon NHS Foundation Trust: Provide urgent post-EPR data recovery diagnostic and technical validation for RTT clock counting and waiting list reporting (Corporate Risk CRR 570). — Torbay is facing an active post-Epic data quality crisis directly threatening statutory reporting and contract income, while explicitly rejecting FDP adoption.
  • HIGH UHP: Deliver a clinical data literacy and post-Epic coding governance framework to fix readmission and SHMI coding error rates (57-72%). — CEO Neil Macdonald explicitly called out low data literacy and coding errors as major corporate risks post-Epic go-live, making senior data governance advisory highly receptive.
  • HIGH SWP Board: Advise on single-cluster IM&T data architecture, live executive BI dashboarding, and DCCR re-procurement strategy ahead of the April 2027 formal ICB merger. — The SWP cluster faces a 28% running cost cut and requires lean, live data integration without purchasing additional expensive software vendor licenses.
  • MEDIUM SWAST: Develop an independent AI Governance Framework and Master Data / Role Alignment diagnostic across CAD, GRS, and ESR systems. — SWAST has formally escalated AI Governance (score 15) and System Identity/Role Alignment (score 16) to its Corporate Risk Register following AVT trials and Tableau-to-Power BI migration.
  • MEDIUM Royal Devon: Provide strategic advisory on Epic-native data architecture and digital capacity governance (BAF Risk 11) following the termination of their Palantir/FDP project. — The Trust explicitly chose native Epic development over Palantir FDP, directly matching Tom Bartlett's background in FDP engineering and NHS data architecture.
  • MEDIUM DPT: Conduct a Shadow IT audit and local database governance diagnostic to address Corporate Risk 3481. — DPT opted out of national FDP to build local Power BI/SystmOne architecture but suffers from high unmonitored departmental database risk outside IT control.

4. Trust Dossiers

DPT (November 2023 to July 2026) MEDIUM

Devon Partnership NHS Trust (DPT) is undergoing a major structural and operational transition, balancing severe long-term financial deficits against ambitious digital modernisations and ongoing regulatory scrutiny. Following a successful transition from CareNotes to TPP SystmOne in late 2023, the Trust has systematically expanded its digital tooling—rolling out EPMA, a Core Care Record, AI-enabled First Response Service telephony, and trialling Microsoft Copilot—while firmly opting out of the national Federated Data Platform (FDP) in favour of internal data architecture. However, underlying financial deficits exceeding £11m, escalating CIP targets reaching £26.5m in 2026/27, acute bed occupancy routinely above 100%, and a CQC Section 29A Warning Notice in Secure Services have forced severe headcount controls, including voluntary redundancies. For Bartlett Data, DPT represents a high-value advisory prospect for data architecture, shadow IT mitigation, and board-level digital governance, particularly given Tom Bartlett's South West location and NHS data platform expertise.

Financial

DPT's financial position has transitioned from delivering fragile break-even control totals backed by heavy non-recurrent savings to facing structural deficit pressures that require permanent workforce reductions. In 2023/24, the Trust achieved its £3.3m surplus target against an £18.4m CIP, though 80% of savings were non-recurrent and agency spend (£12.1m) doubled its £6.2m ceiling. In 2024/25, DPT met its £3.591m pre-impairment surplus plan and £14.57m CIP target, but closing underlying deficits reached £11.1m. By 2025/26, despite a planned break-even position supported by £10.3m in reserve drawdowns and £21.46m in delivered CIPs, the underlying structural deficit widened to £12.58m while agency spend was successfully halved to £5.8m. Heading into 2026/27, with an escalating CIP target of £26.5m (~7% of budget) and bank spend threatening to exceed budgets by £2m, the Trust initiated two phases of Voluntary Redundancy and formal staff consultations to align headcount with available revenue.

Digital

DPT's digital investment story centers on replacing legacy infrastructure with integrated clinical systems while deliberately bypassing the national FDP in favor of local data architecture. Following the go-live of TPP SystmOne in November 2023 under a 10-year £4.2m contract, the Trust launched an aggressive optimization program alongside System C EPMA and Omnicell smart cabinets. Throughout 2024 and 2025, digital maturity improved—reaching a Digital Maturity Assessment score of 2.3/5.0 and Data Quality Maturity Index scores above 95%—supported by the rollout of the Brigid app, CareLoop relapse prevention DTx, and a new Wavenet telephony system with AI transcription for the First Response Service, which cut call abandonment rates from 21% to under 9%. By 2026, CIO Raf Sorribas was elevated to a non-voting Board member as the Trust launched its Core Care Record, expanded Microsoft Copilot to 500 users, and rolled out the Electronic Prescribing Service to community teams. However, digital delivery is constrained by persistent Shadow IT risks (Risk 3481), IT disaster recovery gaps, and regulatory pauses, such as holding the activation of installed Oxevision optical sensors at Langdon pending ICO/DPIA reviews.

Risk

The Trust's corporate risk profile has remained dominated by systemic operational and financial pressures, supplemented by acute regulatory interventions in secure care. Long-term Financial Sustainability (CAF033/SR3), Bed Availability (CAF054), Consultant Psychiatrist Recruitment (CAF041), and Complex Placement Discharge Barriers (CAF091) have remained locked at maximum risk scores of 20 (Extreme) across the entire 2024–2026 period. In mid-2025, the risk landscape escalated following a CQC Section 29A Warning Notice and HSE Notice of Contravention in Secure Services (Langdon/Holcombe ward), establishing Gold Command oversight. Additionally, GP Collective Action (POT042) escalated to a score of 20 due to hand-backs of psychotropic prescribing and SMI physical health monitoring. While First Response Service call abandonment risks (Risk 3088) were de-escalated following telephony overhauls, new corporate risks emerged around EPMA network outage safety (POT043, score 20) and Cultural Resistance to Change (SR1, escalated from 9 to 12).

Operational

Operational pressures across DPT have been defined by persistent inpatient bed overcrowding, high workforce unavailability, and severe neurodiversity waiting lists, partially offset by improvements in crisis triage and nurse recruitment. Adult acute bed occupancy has remained continuously above target at 101%–107%, driving length of stay to ~66 days (against a 53-day target) and forcing high reliance on spot-purchased out-of-area private beds costing £8m–£13m annually. Inpatient nurse vacancies, which exceeded 40% in late 2023, improved to 16%–19% by 2025/26 following the arrival of over 80 international nurses and preceptees. However, substantive staff unavailability (31%–40%, driven by sickness rates over 10%) maintained high temporary staffing fill rates above the 30% NHSE target. While TALKWORKS psychological therapies consistently hit recovery targets (>50%) and First Response call abandonment dropped dramatically, neurodiversity access degraded significantly, with adult Autism and ADHD wait times exceeding 3 and 9 years respectively.

Data & digital timeline:

  • 1 November 2023 — Go-live of TPP SystmOne EPR under a 10-year £4.2m contract, replacing legacy CareNotes.
  • 22 January 2024 — Soft launch of NHS 111 Mental Health Crisis option within First Response Service; transition to Power BI legacy reporting underway.
  • 19 March 2024 — DPT designated system lead for the implementation of the Devon Shared Care Record.
  • 21 May 2024 — SystmOne Optimisation Phase 2 launched alongside inpatient rollout of the Brigid mobile app for physical health checks.
  • 1 July 2024 — Complete elimination of off-framework agency supply across all nursing and HCA staffing.
  • 17 September 2024 — Launch of new Health Inequalities Dashboard analyzing patient demographics, MH Act detentions, and physical health checks.
  • 19 November 2024 — One-year anniversary of SystmOne; Data Quality Maturity Index (DQMI) score reaches 95.4%, exceeding national target.
  • 20 May 2025 — CIO Raf Sorribas appointed non-voting Trust Board member; Digital Improvement Plan 2025/26 approved, including Microsoft Copilot, CareLoop, and Ambient Voice Technology trials.
  • 5 June 2025 — CQC issues Section 29A Warning Notice for Secure Services; Oxevision optical sensor deployment at Langdon paused pending DPIA/ICO review.
  • 16 September 2025 — CareLoop Relapse Prevention App goes live in North Devon STEP; new Wavenet telephony platform deployed for First Response Service.
  • 16 December 2025 — First Response Service Clinical Assessment Service (CAS) goes live with AI transcription and 'Hear and Treat' call model.
  • 20 January 2026 — Core Care Record (CCR) build finalised for rollout; complete ban on Band 2 and Band 3 agency HCA shifts enacted.
  • 18 February 2026 — Voluntary Redundancy Scheme opened to address structural financial deficit, impacting admin, nursing, and AHP posts.
  • 1 April 2026 — Single provider transfer of Children and Family Health Devon (CFHD) completed, transferring 300 WTE physical health staff into DPT.
  • 21 July 2026 — Rollout of Electronic Prescribing Service (EPS) across community teams; expansion of Microsoft Copilot to 500 licenses and EOI for Ambient Voice Technology.

Key risk trends:

  • Underlying Long Term Financial Sustainability (CAF033 / SR3) (→ stable) — Locked at maximum score 20 throughout. Driven by underlying structural deficit (£12.58m in 2026) and reliance on non-recurrent CIPs, leading to voluntary redundancies.
  • Bed Availability Across Acute and Urgent Pathways (CAF054) (→ stable) — Sustained score 20. Caused by adult acute bed occupancy exceeding 100%, discharge delays, and high spot-purchase costs for independent sector out-of-area beds.
  • Digital Transformation and Maturity (SR4) (deteriorating) — Escalated from 9 to 15 as prioritised digital ambitions (EPR, Copilot, CareLoop) began outstripping human and financial resource capacity.
  • Unmonitored Local Databases & Shadow IT (Risk 3481) (→ stable) — High-level risk rating retained due to departmental patient databases operating outside IT oversight, lack of Network Access Control (NAC), and reliance on Darktrace.
  • Medicines Safety During EPMA System Outages (POT043) (→ stable) — Captured as top corporate risk (score 20) due to patient safety hazards and manual paper workarounds required when electronic prescribing systems experience network outages.
  • First Response Service Call Abandonment (>60s) (Risk 3088) (↓ de-escalated) — Successfully de-escalated off the Corporate Risk Register following the procurement and go-live of the Wavenet telephony system and CAS 'Hear and Treat' model.
Cross-trust outlier (unusual): Operating with an explicit corporate risk for Shadow IT / Unmonitored Local Databases (Risk 3481) while maintaining a complete opt-out from the national Federated Data Platform in favor of internal SystmOne/Power BI architecture.

Report quality: 7.1/10 (range 4 to 8, improving) — Board pack quality is high, driven by the consistent application of Making Data Count Statistical Process Control (SPC) charts across Integrated Performance Reports. Data presentation clearly distinguishes common cause from special cause variation, supported by thorough executive narratives and risk heatmaps, though supplementary governance packs occasionally lack statistical trend visualisations.

Key people:

  • Phill Mantay (Chief Executive Officer (former Acting CEO & CFO)) — Key executive leader driving the Trust's financial restructuring, Voluntary Redundancy strategy, and overarching organisational change.
  • Raf Sorribas (Chief Information Officer) — Primary digital decision-maker, elevated to non-voting Board member in May 2025; oversees IM&T, cyber governance, EPR optimisation, and local data platform strategy.
  • Aideen Tucker (Chief Finance Officer) — Executive lead for financial recovery, CDEL capital allocation, and CIP delivery; key target for business cases demonstrating financial ROI and productivity.
  • Teresa Maclennan (Head of Data and Analytics) — Direct operational lead for the Central Information Team, local data warehousing, Power BI analytics deployment, and secondary data use governance.
  • Daniel Maldonado (Data Architecture Manager) — Technical lead for data infrastructure, system integration pipelines, and database architecture.
  • Emma Tucker (Chief Nursing Information Officer / Programme Director) — Bridge between clinical practice and digital systems; leads clinical engagement for Core Care Record and SystmOne usability.
  • Hazel Powell (Chief Nursing Officer and Allied Professions Lead) — Executive lead for clinical quality, safer staffing tools (SafeCare/MHOST), and addressing CQC Section 29A regulatory notices.

Opportunity assessment (high relevance): DPT presents an ideal engagement candidate for Bartlett Data Ltd. The Trust has modernised its core systems (SystmOne, EPMA, Power BI) and explicitly rejected national FDP adoption in favour of local data infrastructure, while simultaneously struggling with high-rated corporate risks around Shadow IT (Risk 3481), unmonitored patient databases, and IT disaster recovery. Tom Bartlett's background as former NHSE Director of Data Engineering and FDP lead, combined with his Devon location and deep expertise in NHS data platforms and governance, positions him perfectly to offer strategic diagnostic assessments and data platform advice without competing as a software vendor or large consultancy.

Specific angles:

  • Shadow IT & Local Database Governance Diagnostic: Independent audit and risk mitigation strategy to address Corporate Risk 3481 (unmonitored local databases holding patient data outside IT control) and establish automated data asset registers.
  • Data Platform & Architecture Strategy Review: Strategic advisory evaluating DPT's internal data warehouse, Power BI reporting ecosystem, and QVERA integration engine against regional One Devon ICS data strategy, validating their decision to bypass FDP.
  • Core Care Record & DQMI Data Quality Assurance: Technical data engineering guidance to ensure high Data Quality Maturity Index (DQMI) scores and seamless secondary data ingestion from SystmOne and EPMA into executive analytics dashboards.
  • Board-Level Digital Governance Coaching: Executive advisory for CIO Raf Sorribas and Chief Finance Officer Aideen Tucker on establishing lean, compliant data governance frameworks that support cost improvement tracking without adding administrative overhead.

Who to approach:

  • Raf Sorribas (Chief Information Officer) — To offer high-level strategic advisory on data platform maturity, bridging internal data architecture with One Devon ICS mandates, and mitigating Shadow IT risks.
  • Teresa Maclennan (Head of Data and Analytics) — To provide expert technical coaching on data warehouse architecture, Power BI governance, and automating information asset registers.
  • Aideen Tucker (Chief Finance Officer) — To propose a data quality and CIP analytics diagnostic that validates cost savings, Service Line Reporting (SLR), and corporate productivity metrics.

NHS Devon ICB (February 2024 – May 2026) CRISIS

NHS Devon ICB remains trapped in Segment 4 (NOF4) of the NHS Oversight Framework under national Recovery Support Programme intervention, attempting to manage severe underlying deficits alongside continuous reorganisation. Although an £80m non-recurrent NHSE bailout artificially delivered a breakeven outturn in 2024/25, escalating financial pressures—including annual Cost Improvement Programme (CIP) targets exceeding £250m and running cost reduction requirements expanding from 30% to 50%—have forced a formal clustering with NHS Cornwall & Isles of Scilly ICB ahead of a planned 2027 merger. Operationally, severe acute pressures and systemic failings in children's neurodevelopmental and SEND services (triggering Ofsted/CQC 'Inadequate' ratings) present persistent clinical and regulatory risks. Consequently, the ICB has explicitly halted new digital technology spending to focus on optimizing existing architecture and improving real-time BI and data governance.

Financial

The financial narrative spans a transition from heavy operating losses to engineered balance and back to acute cash constraints. In early 2024, the system reported a 2023/24 deficit of £46.9m against an original breakeven plan, driven by £25m+ in prescribing overspends and £53m in agency costs. For 2024/25, the ICB resubmitted an £80m deficit plan with a £213.3m system CIP target; at Month 6, NHSE injected £80m in non-recurrent deficit support funding to pull the system forecast back to breakeven (£0), though this funding remains repayable. By mid-2025, cash crises escalated as NHSE withheld £8.97m in deficit support due to off-plan performance, while the 2025/26 CIP target was raised to £256.7m (7.8% of allocation). Facing a 50% mandated reduction in ICB running costs (£12.4m further savings needed in Devon), the board formed a joint cluster with NHS Cornwall ICB in 2026 to pare down executive and corporate management overheads.

Digital

Digital strategy evolved from active procurement of fragmented local projects to an explicit, finance-driven freeze on new systems in favor of extraction and optimization. Throughout 2024, the ICB pursued multiple point solutions, including primary care cloud telephony, NetCall waitlist validation, Peninsula LIMS/PACS procurement, and Epic EPR sign-off for UHP and Torbay. However, internal audit repeatedly flagged a lack of strategic alignment between digital plans and NOF4 recovery. By May 2025, board leadership formally agreed to scale back digital investment and focus solely on maximizing existing tools (such as the Devon & Cornwall Care Record, Joy App, and Brave AI). By May 2026, focus shifted toward governance, cyber security in Standing Financial Instructions, and internal audit calls for real-time live data dashboards to support cluster-wide board oversight.

Risk

The risk profile migrated from operational waiting times toward organizational survival and statutory compliance. Board Assurance Framework (BAF) scores for Finance (Risk 3) and Population Health (Risk 2) escalated from 12 to 16 in mid-2024 following a £3.7m clawback of health inequality funding and growing CIP delivery risks. In 2025, two major strategic risks scored at 20 (high) were added to the BAF specifically addressing the threat of the 50% running cost reduction and the risk of failing to maintain 'business as usual' during ICB reorganisation and clustering. Concurrently, regulatory risk peaked in children's services, following Ofsted 'Inadequate' ratings for Devon County Council Children's Services and Torbay SEND, where over 7,800 children faced neurodevelopmental waitlists with maximum waits reaching 202 weeks.

Operational

Urgent and Emergency Care (UEC) and children's pathways suffered continuous strain, while elective recovery achieved isolated progress on long waits. Throughout 2024 and 2025, Category 2 ambulance response times consistently missed the 30-minute target (ranging from 39 to 61 minutes), and acute trusts faced severe handover delays, leading to CQC Section 29A and Section 31 warning notices at UHP and Devon Partnership Trust. Conversely, elective recovery successfully eliminated 104-week waitlists and reduced 65-week waitlists from 3,985 in late 2023 to 434 by early 2025. However, community waiting lists, S117 mental health registers, and children's autism/ADHD assessments degraded markedly, forming a primary focus for regulatory enforcement.

Data & digital timeline:

  • February 2024 — Deployment of SHREWD (Single Health Resilience Early Warning Dashboard) and XCAD in emergency departments to capture live UEC data and track ambulance handovers.
  • March 2024 — 100% rollout of cloud-based telephony across Devon GP practices completed; Internal Audit flags lack of strategic clarity in Digital Strategy under NOF4 constraints.
  • May 2024 — Procurement initiated for Peninsula LIMS and PACS solutions across the peninsula clinical network.
  • July 2024 — Electronic Treatment Escalation Plan (e-TEP) goes live on the Devon and Cornwall Care Record (DCCR) across Plymouth and West Devon.
  • November 2024 — DCCR connection targets for Torbay and RDUH delayed to December 2024 due to project management capacity constraints.
  • December 2024 — Centralized '4Risk' corporate risk management system rolled out across the ICB.
  • January 2025 — Implementation of Brave AI in primary care to identify high-risk patients; Epic EPR contract signed for UHP.
  • May 2025 — Board formally resolves to scale back new digital investment and prioritize extraction of value from existing assets; Digital Partnership formed with NHS Shared Business Services (SBS) for finance and procurement.
  • August 2025 — Digitising Social Care programme reaches 92% adoption across care providers; Full Business Case approved for joint UHP/TSDFT EPR.
  • May 2026 — Internal audit recommends adoption of live/real-time data dashboards for cluster board reporting; Standing Financial Instructions updated to incorporate Digital and Cyber Security governance.

Key risk trends:

  • Preventing Ill-health and Reducing Health Inequalities (BAF Risk 2) (escalated and persistently high) — Escalated from 12 to 16 in July 2024 when £3.7m was reallocated from the health inequalities budget into bottom-line financial recovery.
  • Finance and Use of Resources (BAF Risk 3) (↑ escalated) — Maintained artificially at 12 during 2024/25 due to £80m NHSE deficit support, but escalated to 16 in mid-2025 as underlying deficit and cash shortages returned.
  • Reducing ICB Running Costs & Transition (New BAF Risk) (new high risk) — Introduced in May 2025 following national mandate to reduce ICB running costs by 50% and cluster functions with NHS Cornwall ICB.
  • Leadership and Capability (BAF Risk 5) (variable) — De-escalated in late 2024 following permanent CEO appointment, but escalated back to 16 in July 2025 amid ICB clustering and executive restructuring.

Report quality: 5.5/10 (range 1.0 to 8.0, deteriorating) — The quality of documentation is highly bifurcated. Standard Integrated Quality, Performance and Finance Reports (IQPR) score consistently high (7-8) due to robust Statistical Process Control (SPC) charts, granular provider breakdowns, and NOF4 exit matrices. However, governance-only board packs and meeting minutes score extremely low (1-3) due to dense narrative, unformatted spreadsheets, and a complete absence of live operational or financial data displays.

Key people:

  • Mark Hackett (Interim Chief Executive, NHS Cornwall and Isles of Scilly & NHS Devon Cluster) — Key decision-maker for cluster-wide operational transformation, corporate restructuring, and high-level data advisory requirements.
  • Steve Moore (Chief Executive Officer, NHS Devon ICB (former)) — Led the ICB through NOF4 recovery, 30% running cost restructures, and initial clustering conversations.
  • Simon Gittoes-Davies (Chief Finance Officer, NHS Cornwall and Isles of Scilly & NHS Devon Cluster) — Oversees Joint Standing Financial Instructions, financial recovery, CIP tracking, and digital scaling efficiencies across both ICBs.
  • Libby Ryan-Davies (Chief Strategic Planning and Commissioning Officer, Cluster) — Sponsor for pathway redesign, CHC digital transformation, and business-as-usual delivery during organizational transition.
  • Dr Peter Collins (Chief Population Health Officer, Cluster (former CMO)) — Sponsor for population health management data analytics, health inequalities strategy, and Brave AI rollout.
  • Graham Clarke (Independent Non-Executive Member (Audit and Risk Chair)) — Champion for improved board paper quality, real-time live reporting dashboards, and internal audit compliance.

Opportunity assessment (high relevance): Devon ICB has explicitly halted capital expenditure on new digital applications, redirecting its strategy toward optimizing existing architectures (DCCR, FDP integration, SHREWD, Epic) and improving live BI reporting. Tom Bartlett's local Devon presence, 22 years of NHS data experience, ex-NHSE leadership of the FDP team, and non-vendor strategic advisory model align perfectly with an ICB needing expert data governance, real-time board dashboard architecture, and cluster data integration without purchasing expensive software.

Specific angles:

  • Real-time Board & Committee Dashboard Strategy: Implementing internal audit recommendations to replace massive, static, spreadsheet-heavy packs with live, low-cost BI reporting.
  • Devon-Cornwall Cluster Data Integration & Governance: Advising on data architecture, governance, and financial reporting consolidation during the ICB clustering and 2027 merger.
  • Maximizing FDP and DCCR Asset Value: Technical advisory on getting full clinical and operational value out of the Devon & Cornwall Care Record and FDP without buying additional software modules.
  • Continuing Healthcare (CHC) Data Quality Diagnostic: Addressing persistent CHC data quality and capacity issues flagged in board papers to secure financial control.

Who to approach:

  • Mark Hackett (Interim Chief Executive, Cluster) — Position Bartlett Data as an independent, local strategic advisor to help navigate cluster data integration and executive dashboarding during the 50% running cost reduction.
  • Simon Gittoes-Davies (Chief Finance Officer, Cluster) — Offer a fast diagnostic assessment on live financial/CIP reporting and CHC data quality to prevent NHSE deficit support clawbacks.
  • Graham Clarke (Chair of Audit and Risk Committee) — Directly address internal audit findings regarding unreadable spreadsheets and board reporting gaps by proposing a lean real-time dashboard framework.

Royal Devon (9 January 2026 to 29 July 2026) MEDIUM

Royal Devon is navigating severe financial and operational distress, moving from an initial 2025/26 breakeven plan to a £44m actual deficit, which triggered NHS England regional intervention and a Red Board Capability rating. For 2026/27, the Trust has reset to a breakeven plan requiring an extraordinary £80.7m (6% of operating costs) savings target alongside voluntary redundancy schemes. Operationally, persistent high No Criteria to Reside (NCTR) rates (15-20%) and severe consultant vacancies in Northern services have forced the temporary suspension of births at North Devon District Hospital. On digital, the Trust successfully supported regional Epic EPR go-lives and wide ambient voice AI rollout, notably choosing to terminate a Palantir/FDP incubator scheme to focus on native Epic development.

Financial

The Trust's financial position degraded rapidly in early 2026, transitioning from a planned breakeven to a formal £44m deficit outturn for 2025/26, backed by £38.7m in revenue cash support and regional NHSE intervention. Only 26% of delivered savings were recurrent, creating a structural deficit entering 2026/27. The 2026/27 plan was reset to breakeven but hinges on delivering an unprecedented £80.7m Delivering Best Value (DBV) CIP, mitigated by a Voluntary Redundancy scheme cutting ~82 WTE (£4m recurrent savings). At Q1 2026/27, Month 3 deficit stood at £9.6m on trajectory, but net unmitigated financial risk remains high at £13.7m.

Digital

Digital strategy is centered around maximizing the One Devon Epic EPR platform (supporting Torbay's April 2026 and Plymouth's July 2026 go-lives) and rapid adoption of Ambient Voice Technology (AVT) across outpatients, which reduced consultation documentation time by 30%. Crucially, the Trust terminated a Palantir/FDP theatre scheduling project to build functionality natively within Epic. Despite restoring £1.4m to recruit 36 WTE digital roles, digital capacity governance remains a high risk (BAF Risk 11), and severe SAR backlogs led to an expected 'Standards Not Met' DSPT submission.

Risk

The financial revenue risk (BAF Risk 4) score was de-escalated from 25 to 20 once the £44m deficit baseline was formally accepted by NHSE, though the Trust's Board Capability was downgraded to Red. Digital capacity governance (BAF Risk 11) and capital/estates fragility (BAF Risk 9) remain persistent high-level risks, exacerbated by the national deferral of the main NDDH hospital rebuild to 2035–2038. Extreme consultant staffing deficits in Northern services escalated clinical risk, forcing the suspension of acute maternity services at NDDH in August 2026.

Operational

Urgent and emergency care pressures remained acute throughout the period, with ED 4-hour performance hovering between 50-57% for Type 1. Operational flow was severely compromised by high No Criteria to Reside (NCTR) bed occupancy (15–20% vs 8% target), costing £1.4m per month. Elective backlogs showed modest RTT improvements, but 52-week waiters remained above 1,300. Structural workforce shortages in North Devon culminated in operational fragility across maternity, pharmacy, and emergency care.

Data & digital timeline:

  • 9 January 2026 — Executive controls enacted non-clinical overtime sign-off requirements for digital and estates out-of-hours activity.
  • 28 January 2026 — Business case initiated for an additional cyber security specialist following work to reduce the original £6m digital capital request.
  • 25 March 2026 — Board confirmed termination of Palantir FDP theatre scheduling project to develop natively within Epic; £1.4m restored to recruit 36 WTE digital staff.
  • 27 May 2026 — Epic EPR go-live completed at Torbay & South Devon over Easter; SAR backlog identified as a primary blocker to DSPT compliance.
  • 29 July 2026 — Epic EPR successfully launched at Plymouth (23 July); Patient Privacy Monitoring System went live; AVT expanded Trust-wide across outpatient clinics.

Key risk trends:

  • BAF Risk 4: Finance Revenue / Non-Delivery of Financial Plan (↓ de-escalated) — Reduced from 25 to 20 after formal NHSE approval of the £44m deficit forecast outturn and provision of cash support.
  • BAF Risk 11: Digital Capacity Governance (→ stable) — Target risk score increased from 6 to 9 due to system-level demand and capacity governance imbalances across Devon ICS.
  • BAF Risk 9: Our Future Hospital / Northern Estates Infrastructure (→ stable) — Sustained high risk driven by national rebuild deferral to 2035–2038 and failing NDDH theatre/chiller infrastructure.

Report quality: 5.0/10 (range 3 to 8, stable) — Full board packs consistently achieve high quality scores (8/10) with detailed SPC charts, site-level disaggregation, and clear financial bridges. Meeting minutes score lower (3-5/10) due to reliance on narrative summaries without visual data tables.

Key people:

  • Professor Adrian Harris (Chief Medical Officer for Research and Digital) — Key executive lead for digital transformation, Epic adoption, AI/AVT rollout, and platform choices (including FDP vs Epic decision).
  • Richard Potter (Non-Executive Director and Chair of Digital & Transformation Committee) — Non-executive lead overseeing digital governance, BAF Risk 11, and strategic digital investments.
  • Sam Higginson (Chief Executive Officer) — Leads organizational restructuring, voluntary redundancy programs, and system negotiations with NHSE/ICB.
  • Angela Hibbard (Chief Finance Officer) — Manages the £80.7m CIP target, NHSE cash support mechanisms, and digital establishment budget allocations.
  • Melanie Holley (Director of Governance) — Sponsor for DSPT compliance, SAR backlog recovery, and information governance risk management.

Opportunity assessment (high relevance): Royal Devon's explicit decision to drop a Palantir FDP incubator project in favor of native Epic development directly aligns with Tom's expert background leading the NHSE FDP team and his knowledge of Epic/NHS data architectures. Furthermore, the Trust's unmitigated digital capacity governance risks (BAF Risk 11) and severe DSPT non-compliance due to SAR backlogs create an immediate need for senior, non-vendor advisory guidance.

Specific angles:

  • EPR vs. FDP Data Architecture Advisory: Guiding leadership on optimal data layer choices between native Epic workflows and regional FDP/Foundry integration following the FDP incubator termination.
  • Digital Capacity & Prioritisation Governance Diagnostic: Helping the Digital Committee restructure capacity and workload allocation to resolve BAF Risk 11 following the 36 WTE digital recruitment drive.
  • Information Governance & DSPT Remediation Strategy: Providing an independent assessment to streamline SAR processing workflows and data access governance to restore DSPT compliance.

Who to approach:

  • Professor Adrian Harris (Chief Medical Officer for Research and Digital) — Senior executive sponsor for digital strategy, platform selection, and clinical AI implementation.
  • Richard Potter (NED and Chair of Digital & Transformation Committee) — Leads committee oversight on digital governance risks (BAF Risk 11) and independent strategic assurance.
  • Melanie Holley (Director of Governance) — Directly responsible for resolving information governance backlogs and DSPT compliance failures.

SWAST (July 2024 to September 2026) MEDIUM

South Western Ambulance Service NHS Foundation Trust (SWAST) has undergone a major operational and digital turnaround between 2024 and 2026. Recovering from a severe 12-hour CAD outage in August 2024 and crippling hospital handover delays exceeding 70 minutes per patient, the Trust delivered a £29.9m CIP in 2025/26 and achieved record non-conveyance (59%) and Hear & Treat (22.7%) rates while eliminating agency staffing spend. SWAST has modernised its digital core by migrating reporting from Tableau to live Power BI, moving GRS to the Cloud, replacing its Control Room Solution, and progressing major re-procurements for CAD (go-live October 2026) and EPR. Following the retirement of long-serving CDIO Tim Bishop in March 2026, Acting CDIO Janet Bayet is overseeing digital delivery amid newly emerging corporate risks around AI governance, system identity/role alignment, and fuel cost inflation. The Trust represents a high-value advisory prospect for data architecture, AI governance, and master data alignment.

Financial

SWAST's financial position moved from severe in-year deficit pressure in mid-2024 (£3.87m deficit at Month 5) to stable breakeven outturns through rigorous cost improvement. After delivering a £16m CIP in 2024/25 with the help of £5m non-recurrent operational funding, the Trust successfully absorbed a massive £29.9m CIP target in 2025/26. This was achieved through corporate role reductions (£5m savings), eliminating agency spend, shared procurement, and IT license/tool optimisations (£140k/yr from migrating Tableau to Power BI and £150k/yr from M365 F3 licensing). Entering 2026/27, the Trust faces a £20.2m CIP requirement alongside a £2.5m cost pressure from fuel inflation (£1.87/L vs £1.37 baseline), relying on a Mitigation Escalation Action Plan (MEAP) to maintain its forecast breakeven outturn while maintaining zero agency spend.

Digital

The Trust's digital landscape has evolved from stabilizing legacy infrastructure following a catastrophic 12-hour CAD outage in August 2024 to delivering an integrated, cloud-first architecture. SWAST successfully replaced its legacy ICCS with LifeX CRS in September 2024, migrated GRS to Totalmobile Cloud, completed MDVS deployment across 647 vehicles, and decommissioned Tableau in favour of live Power BI performance dashboards embedding Making Data Count (MDC) SPC standards. Major transformational procurements advanced significantly, with the new CAD system scheduled for October 2026 go-live and EPR contract awarded alongside 500 new tablet deployments. Following CDIO Tim Bishop's retirement in March 2026, Acting CDIO Janet Bayet has assumed digital leadership, establishing formal AI Governance on the Corporate Risk Register (score 15) to manage hallucination and data privacy risks following ambient voice technology trials.

Risk

The Trust's risk profile reflects a shift from extreme operational crisis to strategic digital and system complexity. System Activity and Flow (CRR 02/0224) dropped from its maximum score of 25 (Consequence 5 x Likelihood 5) throughout 2024 down to 16 in early 2026 following the implementation of the 45-minute Timely Handover Process standard operating procedure, though it briefly re-escalated to 25 during unprecedented summer 2026 heatwaves (>4,200 calls/day). BAF 4 (Data, Digital & Financial Sustainability) de-escalated from 25 to 20 as financial recovery plans delivered. Key new technical and corporate risks escalated onto the register include Inconsistent Role Alignment across CAD, GRS, and ESR (CRR 24/0925, score 16), AI Governance (score 15 in 2026), Fleet Mechanical Reliability (CRR score 16), and Fuel Price Volatility (CRR 27/0326, score 20).

Operational

Operational delivery saw dramatic structural recovery between 2024 and 2026. In late 2024, acute hospital handover delays averaged over 70 minutes per patient, absorbing over 1,100 ambulance hours per day and pushing Category 2 response times above 57 minutes. Collaborative implementation of the 'Timely Handover Process' across South West acute trusts in late 2025 reduced average handovers to 24–30 minutes, driving Category 2 response times down to 30–31 minutes (the best in 3 years). Operational efficiency was further reinforced by expanding clinical triage, driving Hear & Treat rates from 13.7% to 22.7% and ED non-conveyance to 59.4%. However, frontline stability remains challenged by persistent Emergency Operations Centre (EOC) dispatcher turnover (25–32%) and extreme climate-driven demand surges.

Data & digital timeline:

  • 2024-06-30 — Achieved full compliance with NHS England Multi-Factor Authentication (MFA) Policy across 92 web-accessed applications.
  • 2024-08-26 — Experienced a 12-hour Computer Aided Dispatch (CAD) system outage over bank holiday weekend, forcing paper business continuity plans and accelerating re-procurement.
  • 2024-09-25 — Successfully went live with hosted LifeX Control Room Solution (CRS) across Exeter and Bristol EOCs, replacing legacy Capita DS2000 ICCS.
  • 2024-11-28 — Approved 2-year extension for InPhase risk and incident management software and launched UK-first Virtual Reality Command Training Programme.
  • 2025-01-30 — Completed server virtualization refresh with Dell Technologies, successfully migrating 272 locally hosted servers to a modern platform.
  • 2025-03-31 — Migrated Global Rostering System (GRS) to Totalmobile Cloud platform and completed migration of top 45 gold-standard reports from Tableau to Power BI (£140k/yr savings).
  • 2025-05-01 — Completed testing of Robotic Process Automation (RPA) for driver licence verification and awarded contract for new digital Inventory Management System (IMS).
  • 2025-06-30 — Completed deployment of Mobile Data and Vehicle Solution (MDVS) across 647 Rapid Response Vehicles and Double Crewed Ambulances.
  • 2025-09-11 — Escalated Corporate Risk 24/0925 (score 16) regarding inconsistent staff role and access alignment across CAD, GRS, ESR, and physical security systems.
  • 2025-11-06 — Rolled out Windows 11 to 95%+ laptops, adopted M365 F3 licensing (£150k/yr savings), and established test environment for new CAD system.
  • 2026-03-31 — Chief Digital Information Officer Tim Bishop retired; Janet Bayet appointed Acting CDIO / Digital Lead.
  • 2026-05-07 — Implemented WorkInConfidence two-way anonymous Freedom to Speak Up platform and progressed EPR Outline Business Case.
  • 2026-07-02 — Awarded HSCN contract, deployed GoodSAM Video across EOCs, and published refreshed Trust-wide Data Quality Framework.
  • 2026-09-10 — Approved Electronic Patient Record (EPR) contract award with 500 iPad deployments and added AI Governance as a Corporate Risk (score 15) following Ambient Voice Technology trials.

Key risk trends:

  • System Activity and Flow / Hospital Handover Delays (CRR 02/0224) (improving overall with seasonal spikes) — De-escalated from 25 to 16 following implementation of the 45-minute Timely Handover Process backstop across acute hospitals; temporarily spiked back to 25 during extreme July 2026 heatwaves.
  • BAF 4: Failure to create a sustainable organisation that is data & digitally driven / Financial Sustainability (stable at elevated level) — Escalated to 25 in late 2024 due to revenue deficits and CAD outages. Reduced to 20 following successful delivery of £16m CIP in 24/25 and £29.9m CIP in 25/26, remaining at 20 due to multi-year CIP requirements, estate backlog (£15.7m), and CDIO transition.
  • Inconsistent Access / Role Alignment across CAD, GRS, ESR & Security (CRR 24/0925) (new risk / stable) — Escalated in late 2025 to capture system-wide data inconsistencies in Joiners, Movers, Leavers (JML) processes impacting user access control across core systems.
  • Artificial Intelligence Governance & Operational Risk (new risk) — Added to the Corporate Risk Register in mid-2026 following trials of Ambient Voice Technology (AVT) and Copilot to manage data privacy, clinical safety, AI hallucinations, and lack of human oversight.
Cross-trust outlier (positive outlier): Achieved significant operational and digital turnaround, completely eliminating agency spend, delivering a £29.9m CIP, saving £140k/yr by migrating Tableau to live Power BI, and reducing Category 2 ambulance response times from 57 to 30 minutes.

Report quality: 7.3/10 (range 3.0 to 8.0, stable) — Board papers consistently demonstrate exemplary reporting standards. Integrated Corporate Performance Reports (ICPR) feature extensive Statistical Process Control (SPC) charts with explicit special vs common cause variation icons, paired with robust peer benchmarking across all 10 English ambulance trusts.

Key people:

  • Janet Bayet (Acting Chief Digital Information Officer) — Key contact for digital strategy and data architecture following Tim Bishop's retirement in March 2026. Overseeing CAD go-live, EPR rollout, and AI governance.
  • Andrew Rosser (Executive Director of Finance and Infrastructure) — Executive lead for digital infrastructure, capital expenditure, and cost improvement plans. Key decision-maker for consultancy engagements targeting efficiency and data platform ROI.
  • Amy Beet (Executive Director of People and Deputy Chief Executive) — Leads workforce transformation, workforce data strategy, and organizational redesign (One Team model).
  • Raz Akbar (Non-Executive Director / Chair of Audit and Risk Committee) — Leads risk governance oversight; highly relevant regarding BAF 4, AI governance risk oversight, and system identity/data accuracy risks.
  • Tina Cantelo (Executive Director of Strategy, Transformation and Communications) — Drives strategic transformation programmes, PMO governance, and benefits realisation tracking.

Opportunity assessment (high relevance): SWAST has transitioned its core analytics architecture from Tableau to Power BI, published a refreshed Data Quality Framework, and introduced specific corporate risks around AI Governance and Identity/Master Data Alignment across CAD, GRS, and ESR. Tom Bartlett's deep expertise in NHS data architecture, CDMP certification, ex-NHSE FDP leadership, and regional South West footprint position him uniquely to provide independent strategic advice on data governance, AI safety frameworks, and master data integration without selling software.

Specific angles:

  • AI Governance & Safety Assessment: Independent diagnostic and governance framework development following SWAST adding AI Governance (hallucinations, privacy, oversight) to its Corporate Risk Register after Ambient Voice Technology trials.
  • Master Data & Identity Alignment Diagnostic: Strategic review to resolve Corporate Risk 24/0925 (Inconsistent role and data alignment across CAD, GRS, ESR, and access control systems).
  • Power BI & MDC Data Quality Assurance: Expert advisory to review and validate the newly published Trust-wide Data Quality Framework supporting live Power BI SPC reporting.

Who to approach:

  • Janet Bayet (Acting Chief Digital Information Officer) — Interim digital leadership navigating major system transitions (CAD, EPR) and active AI/data quality risk registers.
  • Andrew Rosser (Executive Director of Finance and Infrastructure) — Controls digital budget and CIP delivery; interested in data platform efficiency and risk mitigation.
  • Raz Akbar (Chair of Audit and Risk Committee) — Oversees corporate risk mitigations regarding AI governance, cyber security, and data accuracy.

SWP Board (October 2025 to July 2026) HIGH

The South West Peninsula (SWP) Board, uniting NHS Devon and NHS Cornwall & Isles of Scilly ICBs into a single cluster ahead of a planned April 2027 merger, is operating under extreme structural financial pressure, rapid executive restructuring, and dual major EPR rollouts. While Cornwall achieved a balanced 2025/26 outturn (supported by a £150m NHSE historic debt write-off), Devon ended 2025/26 with a £64.3m deficit and a £286.4m underlying gap, necessitating an unprecedented £281m system efficiency target for 2026/27. Simultaneously, the cluster is executing an aggressive 28% staffing cut to hit the national £19/head running cost ceiling, triggering formal trade union disputes over clinical safety and statutory capacity. Operationally, acute sites remain severely constrained by Emergency Department corridor care and high No Criteria to Reside (NCTR) rates, while digital strategy centers on Epic EPR deployments at Torbay and Plymouth alongside the re-procurement of the Devon & Cornwall Care Record (DCCR).

Financial

In late 2025, the peninsula faced a Devon deficit challenge of £229m and an underlying system gap of over £200m. By January 2026, Devon's full-year deficit forecast expanded to £64.4m as Royal Devon Healthcare reported a £44m variance, triggering the loss of £26.9m in Deficit Support Funding across Torbay and Plymouth. The 2025/26 financial year closed with Cornwall achieving breakeven (helped by a £150m debt write-off) and Devon delivering a £64.3m deficit with an underlying deficit of £286.4m. Entering 2026/27, the cluster submitted a balanced plan backed by £38m in NHSE financial support for Devon, but this relies on a record £281m system CIP target in Devon (including £91.6m at Plymouth and £80m at Royal Devon) and a £131.7m combined ICB efficiency requirement, while delays in ICB restructuring add £1m per month in unbudgeted running cost pressures.

Digital

Digital investment throughout late 2025 concentrated on shared infrastructure—expanding the Devon and Cornwall Care Record (DCCR) to 93% GP coverage, pushing One Devon Dataset coverage to 75%, and preparing for DCCR re-procurement. The year 2026 marked a major dual EPR transition across the peninsula: Torbay successfully went live with Epic over Easter 2026 (replacing 100+ legacy systems), and University Hospitals Plymouth followed on 23 July 2026. Conversely, Royal Cornwall Hospitals (RCHT) paused its eCare EPR go-live in May 2026 following a 60-day gateway readiness review, formally resetting its deployment target to April 2027. Meanwhile, escalating GP collective action in mid-2026 threatened data-sharing agreements and OptimiseRx technology, prompting the establishment of a joint Primary Care and Digital Task Group.

Risk

The risk profile shifted dramatically from operational delivery concerns toward corporate merger stability and statutory governance. Cyber security and digital infrastructure remained persistently elevated at Red (16-20) on BAF registers across both ICBs. By early 2026, ICB running cost reduction and cluster capacity risks escalated to maximum levels (20) as mandated cuts to £19 per head forced voluntary redundancy schemes. By mid-2026, recognized trade unions formally warned the Board of statutory safety breaches and equal pay liabilities stemming from a 28% workforce reduction. Consequently, while some quality and financial risks were de-escalated on paper through shared governance oversight, reconfiguration and service change risks remained at maximum (20) due to political and local authority pushback in Cornwall regarding the dilution of local accountability in a single peninsula ICB.

Operational

Operational pressures across the period were dominated by severe exit block, Emergency Department overcrowding, and widespread corridor care across all four acute trusts (RCHT, UHP, TSD, RDUH). No Criteria to Reside (NCTR) rates hovered between 12% and 14% (against targets of 5-7%), heavily suppressing Type 1 A&E performance (RCHT dropping to 51.1% and Plymouth to 37.4%). Elective RTT 18-week compliance suffered productivity dips during EPR deployments (falling to 57-63% in Devon trusts), while mental health out-of-area placements (OOAPs) remained a persistent quality and financial drain, driving a £3.6m OOAP budget delegation to Cornwall Partnership FT for community pathway redesign. Secondary pressures included extreme neurodivergence diagnostic wait times (up to 11 years for adult autism) and CQC regulatory intervention (Section 29A Notice at CPFT).

Data & digital timeline:

  • 16 October 2025 — Preparation initiated for the business case and re-procurement of the Devon and Cornwall Care Record (DCCR); £300k awarded from Respiratory Pathway Transformation Fund.
  • 27 November 2025 — One Devon Dataset coverage reaches 75% toward an 80% target; Joy App social prescribing adoption reaches 71% of PCNs.
  • 29 January 2026 — Torbay & South Devon EPR (Epic) go-live confirmed for Easter 2026; RCHT eCare (Oracle) initiates integration testing and trial data migration.
  • 26 March 2026 — Brave AI risk stratification operationalized across PCNs and Integrated Neighbourhood Teams; DCCR re-procurement business case endorsed.
  • 28 May 2026 — Torbay successfully goes live with Epic EPR over Easter 2026; RCHT pauses eCare go-live following a 60-day gateway review; 12 Cornwall GP practices notify withdrawal from data-sharing agreements under collective action.
  • 30 July 2026 — University Hospitals Plymouth goes live with Epic EPR on 23 July 2026; RCHT Board approves revised eCare go-live date of 4 April 2027; options appraisal underway for shared/single cluster IM&T corporate infrastructure.

Key risk trends:

  • Digital, Data and Analytics Capability (Incl. Cyber Security) (→ stable) — High inherent cyber threat across trusts; infrastructure vulnerability noted during dual Epic/eCare EPR rollouts and ICB merger planning.
  • System Financial Sustainability (→ stable) — Driven by an underlying Devon deficit of £286.4m, requiring an unprecedented £281m system CIP in 2026/27 and £131.7m combined ICB savings.
  • ICB Running Cost & Cluster Restructuring (↓ de-escalated) — Mandated cuts to £19/head running cost target forced voluntary redundancies and a 28% staffing reduction, triggering formal Trade Union dispute over statutory safety.
  • Reconfiguration and Service Change / ICB Merger (→ stable) — Persistent extreme risk regarding stakeholder engagement and political pushback from Cornwall Council over loss of local accountability in a single peninsula ICB.

Report quality: 5.5/10 (range 2 to 8, stable) — Board packs regularly provide structured financial and performance metrics, with excellent SPC usage for quality and infection indicators. However, narrative briefings and minutes frequently omit quantitative tables, leading the Chair to explicitly demand a shift toward succinct, data-focused reporting.

Key people:

  • Mark Hackett (Interim Chief Executive Officer, SWP Cluster) — SRO leading the ICB merger, running cost reductions, and peninsula-wide commissioning strategy.
  • Simon Gittoes-Davies (Chief Finance Officer, SWP Cluster) — Overseeing the £281m system CIP target, £131.7m ICB savings, and financial convergence across Devon and Cornwall.
  • Andrew Abbott (Director of Digital Development) — Direct executive lead for cluster IM&T strategy, single corporate digital infrastructure, and DCCR re-procurement.
  • Kelvyn Hipperson (Chief Information Officer and System Digital Lead (CIOS)) — Key technical operational lead overseeing digital infrastructure, cyber security, and EPR system integration.
  • Susan Bracefield (Chief Clinical Officer / Chief Nursing Officer) — Senior clinical executive responsible for quality governance, clinical safety oversight during ICB downsizing, and primary care digital integration.

Opportunity assessment (high relevance): As a former NHSE Deputy Director of Data Engineering who led the 130-person team building the Federated Data Platform (FDP) and a Palantir Foundry/Fabric expert based in Devon, Tom is uniquely positioned to advise SWP on system data integration, DCCR re-procurement strategy, and single-cluster data architecture. SWP faces an immense £281m CIP requirement and a complex ICB merger, where Tom's strategic advisory can unlock productivity without selling software.

Specific angles:

  • Strategic advisory on single cluster IM&T architecture and data governance ahead of the April 2027 formal ICB merger.
  • Diagnostic assessment and procurement guidance for the Devon and Cornwall Care Record (DCCR) re-procurement and One Devon Dataset expansion.
  • Data-driven CIP diagnostic to identify recurrent productivity savings without compromising statutory safeguard/CHC capacity during 28% staff cuts.
  • Primary care and neighbourhood data governance framework to mitigate GP collective action data-sharing risks and integrate Brave AI pipelines.

Who to approach:

  • Andrew Abbott (Director of Digital Development) — Executive lead for the single cluster IM&T infrastructure appraisal and DCCR re-procurement strategy.
  • Kelvyn Hipperson (Chief Information Officer and System Digital Lead) — Key technical SRO for digital transformation and cyber/data governance across the Cornwall footprint.
  • Simon Gittoes-Davies (Chief Finance Officer) — Requires expert diagnostic guidance to assure data-driven CIP delivery (£281m target) amid corporate analytics restructuring.

Torbay and South Devon NHS Foundation Trust (September 2025 to September 2026) HIGH

Torbay and South Devon NHS Foundation Trust is navigating a high-stakes operational and structural turnaround characterized by NOF Level 4 oversight, a £99.5m underlying financial deficit, and critical estate vulnerabilities including a £120m+ backlog and severe fire safety risks in its Tower Block. In April 2026, the Trust achieved a major strategic milestone by successfully going live with the 'One Devon' Epic Electronic Patient Record (EPR), replacing over 100 legacy systems and the country's oldest PAS. However, the post-go-live phase has introduced significant data quality and validation challenges that are directly impacting RTT clock counting, waiting list reporting, and income reconciliation. To protect core NHS delivery, the Trust took the radical step in March 2026 of terminating its 20-year integrated Section 75 Adult Social Care contract with Torbay Council due to an unfunded £35m annual shortfall, creating a complex 12-month data and operational disaggregation landscape.

Financial

The Trust's financial position deteriorated significantly over the 12-month period, shifting from a 2024/25 outturn deficit of £33.5m (against a £13.6m plan) to an underlying recurrent deficit of £99.5m entering 2026/27. While the Trust achieved its 2025/26 in-year CIP target of £41.5m, over half was non-recurrent, forcing the 2026/27 savings requirement up to £54.4m to hit a planned breakeven position contingent on receiving £57.8m in Deficit Support Funding (DSF). Cash flow remained acutely fragile due to in-year DSF withholding by the ICB, requiring emergency Public Dividend Capital (PDC) drawdowns. To halt structural losses, the Board served 12-month formal notice in March 2026 to end the Adult Social Care Section 75 agreement with Torbay Council—which generated a £35m annual funding gap—and launched an NHSE-approved Voluntary Redundancy scheme targeting 90–150 WTE corporate and administrative posts.

Digital

The digital agenda was dominated by the rollout of the joint 'One Devon' Epic EPR system, which successfully went live across acute and community services on 3 April 2026 (followed by University Hospitals Plymouth in July 2026). The transition retired over 100 legacy clinical systems, introduced the MY CARE patient portal (surpassing 24,000 sign-ups and integrating with the NHS App), and deployed an automated inpatient pharmacy robot ('Spencer'). Parallel digital developments included migrating incident management to Datix DCIQ with Yellowfin reporting, procuring mobile X-ray integration, and rolling out 1,000 Microsoft Copilot licences. However, post-EPR stabilization triggered acute reporting challenges, with data migration and clock-start counting issues corrupting RTT and elective waiting list reporting by late 2026. Crucially, the Trust formally confirmed in August 2026 that it has not yet adopted the NHS Federated Data Platform (FDP).

Risk

The Trust's risk profile evolved from pre-implementation digital deployment risks to severe post-go-live data governance, structural transition, and estate hazards. Corporate risk registers remain dominated by maximum-score (25) threats: Financial Sustainability (£99.5m underlying deficit), Estate Backlog Maintenance (>£120m), and Tower Block Fire Safety (classified as a Higher Risk Building requiring a £126m long-term replacement strategy). Following the April 2026 Epic go-live, a major new risk (CRR 570, scored at 20) was escalated regarding performance data quality and statutory waiting list reporting accuracy. Additionally, organizational disaggregation risks (BAF-OT, scored at 20) rose sharply following the decision to terminate the Section 75 Adult Social Care agreement.

Operational

Operational delivery was severely disrupted by winter pressures, critical incidents, and post-EPR stabilization. Throughout late 2025 and early 2026, the Trust experienced extended periods in OPEL 4 and critical incident status, with Type 1 A&E 4-hour performance hovering between 50% and 67% and average ambulance handovers exceeding 45 minutes alongside persistent corridor care. RTT 52-week wait counts fluctuated and then spiked post-Epic go-live (reaching 1,319 in July 2026), though this was heavily confounded by reporting and data validation lags. Operationally, the Trust began disaggregating its integrated health and social care model, transferring Children and Family Health Devon (294 WTE) to Devon Partnership Trust in April 2026 and re-allocating physical infrastructure, such as securing £4.6m capital to relocate life-expired Cellular Pathology services to Gadeon House in Exeter.

Data & digital timeline:

  • 25 September 2025 — Extra £19.5m capital funding secured for One Devon EPR rollout and infrastructure upgrades; MY CARE patient portal preparation announced.
  • December 2025 — Automated inpatient pharmacy dispensing robot ('Spencer') installed to integrate with Epic EPR.
  • 13 January 2026 — Successful 90-day Epic Go-Live Readiness Assessment (GLRA) completed.
  • 03 April 2026 — Epic EPR successfully goes live at 02:00 across acute and community services, replacing 100+ legacy systems and England's oldest PAS.
  • 30 April 2026 — Trust migrates from Datix Web to Datix DCIQ, with Yellowfin dashboard reporting scheduled for July 2026.
  • 23 July 2026 — University Hospitals Plymouth goes live on Epic, bringing all three Devon acute trusts onto a unified shared platform.
  • 12 August 2026 — Trust confirms via Governor Log that it has not yet adopted the NHS Federated Data Platform (FDP) / Palantir system; MY CARE portal directly linked to NHS App.
  • 03 September 2026 — Post-Epic data quality issues officially escalated as Corporate Risk CRR 570 (score 20) due to impact on RTT clock start validation, activity reporting, and contract income.

Key risk trends:

  • Financial Sustainability (Risk 2996 / BAF-FN) (→ stable) — Underlying deficit escalated from £81.8m to £99.5m due to recurrent CIP slippage; heavily reliant on £57.8m Deficit Support Funding and Section 75 exit.
  • Estates Backlog & Tower Block Fire Safety (Risk 1083 / 2801 / BAF-ST) (↑ escalated) — Critical backlog maintenance exceeds £120m; Tower block classified as Higher Risk Building with fire safety exceeding Board risk appetite.
  • Post-EPR Performance Data & Waiting List Reporting (CRR 570) (↑ escalated) — New corporate risk raised post-Epic go-live due to data quality issues, RTT clock start counting discrepancies, and unvalidated waiting lists.
  • Adult Social Care Transition & Section 75 Disaggregation (BAF-OT) (↑ escalated) — Formal 12-month notice served on Torbay Council in March 2026 due to £35m annual shortfall; complex workforce and service transition risks.
Cross-trust outlier (unusual): Took the unprecedented structural step of terminating its 20-year integrated Section 75 Adult Social Care agreement with Torbay Council due to an unfunded £35m annual shortfall, forcing a complex 12-month data and service disaggregation.

Report quality: 4.7/10 (range 1 to 8, improving) — Reporting quality varies dramatically based on document type, ranging from low-scoring AMM transcripts and public Q&A packs (scores 1-3) to highly sophisticated Integrated Performance and Quality Reports (scores 7-8) that feature multi-year SPC trend visualisations, RAG ratings, national benchmark rankings, and clear data triangulation.

Key people:

  • Dr Martin Beaman (Chair of the Board) — Transitioned from Vice-Chair to Chair in May 2026; key decision-maker oversight for turnaround, NOF4 exit, and major digital/data strategy.
  • Joe Teape (Chief Executive Officer) — Leads overall Trust strategy, Section 75 disaggregation, and board-level accountability for operational and financial recovery.
  • James Corrigan (Chief Finance Officer) — Manages the £99.5m underlying deficit, £54.4m CIP plan, and urgent post-EPR contract income data validation.
  • Sam Wadham-Sharpe (Chief Operating Officer) — Appointed substantive COO in August 2026; responsible for operational flow, waiting list validation, and post-Epic RTT recovery.
  • Simon Tapley (Chief Strategy and Planning Officer) — Leads system-wide transformation, disaggregation of Section 75 adult social care, and long-term service reconfiguration.
  • Kevin Pirie (EPR Operational Director) — Directly oversees the Epic EPR stabilization phase, user adoption, and operational data fixes.

Opportunity assessment (high relevance): Torbay is facing a severe post-EPR data validation crisis (Corporate Risk 570) that threatens statutory reporting and contract income, while explicitly confirming it has NOT yet adopted the NHS Federated Data Platform (FDP). Tom's unique background leading NHS England's 130-person FDP engineering team, combined with his deep technical expertise in post-EPR reporting restoration, Datix/Yellowfin analytics, and Devon presence, makes Bartlett Data the exact expert advisory partner needed for diagnostic data governance and platform readiness.

Specific angles:

  • Post-EPR Data Quality & RTT Reporting Recovery Diagnostic: Expert advisory to audit, clean, and rebuild post-Epic clock start rules and statutory waiting list reporting pipelines.
  • FDP Readiness & Data Architecture Strategy: Independent assessment evaluating whether Torbay should adopt FDP/Palantir versus local Microsoft Fabric/Foundry integrations, leveraging Tom's national FDP lead background.
  • Data Governance & Section 75 Disaggregation Architecture: Strategic advice on uncoupling adult social care data flows and analytics pipelines during the 12-month transition back to Torbay Council.

Who to approach:

  • Joe Teape (Chief Executive Officer) — Requires immediate board-level confidence in performance data accuracy to satisfy NHSE NOF4 oversight and defend financial recovery plans.
  • James Corrigan (Chief Finance Officer) — Needs urgent data validation expertise to prevent contract income loss and verify CIP delivery post-Epic implementation.
  • Simon Tapley (Chief Strategy and Planning Officer) — Leads long-term system analytics, digital strategy, and data architecture for the Section 75 social care separation.

UHP (September 2024 to July 2026) HIGH

University Hospitals Plymouth NHS Trust (UHP) enters mid-2026 in National Oversight Framework (NOF) Segment 4, carrying an underlying deficit of £110m and an unprecedented £91.6m cost improvement target. Operationally, the Trust remains severely bottlenecked by an ageing estate operating at 'half the size required', driving widespread corridor care and CQC regulatory scrutiny while construction proceeds on its £247m Emergency Care Building. Digitally, UHP achieved a major milestone on 23 July 2026 by going live with Epic as part of the shared One Devon EPR platform alongside Torbay and Royal Devon. However, CEO Neil Macdonald has explicitly highlighted low baseline data literacy and widespread clinical coding inaccuracies across the Trust, creating a critical need for post-EPR data governance, analytical validation, and operational data transformation.

Financial

UHP's financial position deteriorated significantly from late 2024 through mid-2026. In 2024/25, a planned £54.6m deficit was offset by £38.9m in non-recurrent national support to outturn between £8.6m and £21.1m adverse. For 2025/26, the Trust targeted breakeven via a £68.3m Financial Improvement Plan (FIP); while delivering £69.4m gross savings, over-reliance on non-recurrent mitigations carried a £30.2m recurrent deficit shortfall into 2026/27. By early 2026, UHP was flagged as 1 of only 16 NHS trusts nationally submitting a non-compliant financial plan, triggering NHSE and PwC intervention across Devon ICS. To agree a restated 2026/27 breakeven plan, UHP raised its CIP target to £91.6m (~8% of turnover), relying on £35m in non-recurrent system funding, a £25m property sale-and-leaseback transaction, and drastic temporary staffing cuts.

Digital

The digital story is anchored by the multi-year mobilisation and deployment of the Epic Electronic Patient Record (EPR) under the One Devon programme. Moving from FBC gateway review approvals in late 2024 and contract execution in January 2025, UHP completed joint orientation, 90-day, and 60-day readiness milestones to successfully achieve Go-Live on 23 July 2026. Concurrently, UHP delivered core infrastructure refreshes (datacentre renewals, cloud ePMA transition, DSPT CAF v7 compliance), pathology automation (£5.5m Peninsula cellular pathology investment), and digital inclusion tools like the Hospital Passport App. As Epic went live, digital focus rapidly pivoted toward AI adoption (M365 Copilot, AI Stroke prediction, AI Innovation Lab) alongside an urgent executive focus on remediating pervasive data entry and coding errors.

Risk

UHP's Board Assurance Framework (BAF) reflects persistent operational, cultural, and financial distress. Urgent & Emergency Care safety risks remained capped at the maximum score of 20 throughout, driven by acute flow blockages and corridor care averaging 17–20 patients daily. Financial sustainability risks (S1/S3) fluctuated between 16 and 20 as non-recurrent patches were applied to underlying structural deficits. Culture and Wellbeing (W2) escalated from 16 to 20 following severe Freedom to Speak Up (FTSU) reports, CQC ED breaches, and high recorded sexual misconduct (5.5%). Conversely, Digital/EPR Risk (S2d) steadily de-escalated from 20 down to 16 as national business case approvals and go-live criteria were met ahead of the July 2026 launch.

Operational

Operational delivery exhibited a stark divide between emergency crowding and elective wait-list recovery. UEC faced extreme pressure with CQC Section 29a notices and ED overcrowding, although mean ambulance handover delays improved markedly from over 6,000 hours lost down to ~2,000 hours. Elective recovery successfully eliminated 104-week and 78-week waits while drastically curtailing 65-week breaches, but cancer 62-day pathways struggled under a 55% surge in prostate referrals and Plym theatre demolition, placing UHP in Tier 1 national cancer oversight. Operational transformation remains heavily dependent on capital schemes including the £247m Emergency Care Building, the £22m Colin Campbell Court CDC, and the Plymouth Oncology Centre extension.

Data & digital timeline:

  • 25 September 2024 — Kath Potts appointed Chief Digital Officer to lead joint EPR business case finalisation across UHP, RDUH, and Torbay.
  • 30 October 2024 — EPR Full Business Case submitted for regional NHS England gateway review; CAFM system procurement initiated.
  • 27 November 2024 — EPR Full Business Case clears regional review, heading to National Review Board; cloud migration initiated for core clinical applications.
  • 29 January 2025 — EPR contract signed with Epic following national FBC approval; Beacon Oncology Module added to scope.
  • 26 March 2025 — Over 600 staff participate in One Devon Epic Orientation Day; shared regional SharePoint launched.
  • 27 May 2026 — Formal 60-day Go Live Readiness Assessment confirmed for Epic; Generative AI roadmap outlined for non-clinical administration.
  • 23 July 2026 — Epic EPR officially goes live across UHP, creating a unified digital patient record across Devon.
  • 29 July 2026 — Post-EPR enablers launched including M365 Copilot licenses, AI Innovation Lab establishment, and Brave AI risk stratification.

Key risk trends:

  • Safety - Urgent & Emergency Care / Flow (Q1 / Q1a) (→ stable) — Maintained at maximum score throughout due to chronic overcrowding, 12-hour ED breaches, and corridor care averaging 17-20 patients daily (~89 unestablished bed spaces).
  • EPR Implementation & Digital Maturity (S2d / SR5) (↓ de-escalated) — Reduced from 20 to 16 following national FBC approval, secured PDC capital, datacentre refresh, and successful July 2026 Epic cutover.
  • Organisational Culture & Staff Wellbeing (W2 / SR3) (↑ escalated) — Escalated from 16 to 20 following severe FTSU report volumes (highest in England), CQC ED findings, and high recorded sexual misconduct in theatres (5.5%).
  • Financial Plan Delivery & Medium-Term Sustainability (S1 / S3) (↔ fluctuating) — Reflects non-compliant 2026/27 plan submission (1 of 16 national outliers), PwC intervention, and subsequent re-baselining to a £91.6m CIP requirement.
Cross-trust outlier (negative outlier): Flagged as 1 of only 16 NHS trusts nationally submitting a non-compliant financial plan, requiring PwC intervention to baseline an unprecedented £91.6m CIP (~8% of turnover), while suffering from up to 72% clinical coding error rates.

Report quality: 7.1/10 (range 6 to 8, stable) — Board packs demonstrate high analytical rigor with consistent Statistical Process Control (SPC) charts, three-sigma process limits, and national peer benchmarking. However, Board members repeatedly noted that low underlying data quality and clinical coding inaccuracies (e.g., readmission coding errors up to 72% and SHMI distortions) limit board-level assurance.

Key people:

  • Neil Macdonald (Chief Executive Officer) — Appointed in late 2025; explicitly called out UHP's low data literacy and coding quality as key corporate risks requiring senior leadership focus.
  • Sarah Brampton (Deputy Chief Executive & Chief Finance Officer) — Leads financial turnaround, £91.6m CIP delivery, system spend controls, and PDC capital allocations.
  • Kath Potts (Chief Digital Officer) — Key executive contact for digital strategy, joint Epic EPR delivery across Devon, and post-go-live optimization.
  • Adel Jones (Chief Operating Officer) — Joined May 2026; responsible for operational flow, corridor care reduction, and clinical pathway transformation.
  • Herjinder Cleaver (Chief People Officer) — Joined May 2026; leads workforce re-structuring, TOM implementation, and sickness absence reduction (£8m cost).
  • Professor Arunangsu Chatterjee (Non-Executive Director) — Academic and digital background; influential voice on digital strategy, technology adoption, and innovation oversight.

Opportunity assessment (high relevance): UHP has just completed its landmark Epic EPR go-live in July 2026, but CEO Neil Macdonald has openly highlighted that the Trust suffers from 'low data literacy' and unreliable clinical coding (evidenced by 57%-72% error rates in readmission coding and SHMI distortions). Tom Bartlett's background as ex-NHSE Deputy Director who built the FDP, combined with his Palantir Foundry / Microsoft Fabric expertise, CDMP credential, and South West location, makes him uniquely qualified to offer strategic data governance, post-EPR data architecture, and data literacy diagnostics without software sales bias.

Specific angles:

  • Post-Epic EPR Data Governance & Quality Audit: Re-architecting data validation pathways to fix readmission, SDEC, and mortality coding errors highlighted by executive leadership.
  • Data Literacy & Executive Assurance Framework: Designing tailored Board and Care Group data literacy diagnostics to build confidence in operational and financial reporting.
  • Devon ICS Interoperability & FDP Alignment: Strategic guidance on connecting UHP's Epic instance with the Devon and Cornwall Care Record (DCCR) and national Federated Data Platform assets.
  • AI Governance & Analytics Roadmap: Establishing governance, data pipelines, and validation models for UHP's newly formed AI Innovation Lab and M365 Copilot rollout.

Who to approach:

  • Neil Macdonald (Chief Executive Officer) — Directly articulated UHP's low data literacy and lack of data assurance; receptive to expert strategic diagnostic advice.
  • Kath Potts (Chief Digital Officer) — Leads digital strategy post-Epic go-live and requires independent advice on data architecture, FDP integration, and governance.
  • Professor Arunangsu Chatterjee (Non-Executive Director) — Board digital sponsor who can champion an independent data governance and literacy assessment at committee level.

5. LinkedIn Content Angles

  • Why NHS Trusts are rejecting the Federated Data Platform (FDP): Lessons from Royal Devon, Torbay, and DPT on choosing native EPR workflows and local Power BI architecture over national software overlays.
  • The 'Day 90' EPR Reality: Why going live with Epic is only the first step, and how post-implementation data quality issues in clock counting can jeopardize statutory RTT reporting.
  • Unpicking 20 Years of Integrated Care: The hidden data architecture, IG, and operational challenges when an NHS Trust terminates a Section 75 Adult Social Care agreement.
  • How SWAST saved £140k/yr and modernized executive reporting by migrating 45 gold-standard Tableau reports to Microsoft Power BI with Making Data Count (MDC) SPCs.
  • Formally Scoping AI Risk: Why SWAST adding AI Hallucination and Clinical Safety risks to its Corporate Risk Register sets a precedent for NHS trusts deploying Ambient Voice and Copilot technology.
  • Surviving a 50% ICB Running Cost Reduction: How merged health systems can maintain data governance, BI, and statutory oversight when executive headcounts are halved.