NHS England has placed the hospital group running St George’s and Queen Mary’s under formal financial oversight, four months after Putney.news reported the trust could not produce a financial plan its regulator would approve.
The escalation was disclosed verbally at a public board meeting at Queen Mary’s in Roehampton last month, and in a single paragraph of a 528-page board pack published the same day. It has not been reported elsewhere.
“The decision by NHS England to place the Group into enhanced oversight for finance underlines the seriousness of the challenge facing both our organisation and the wider NHS,” the group’s chief executive, Matthew Shaw, wrote in his report to the board.
Enhanced oversight means NHS England now attends the group’s Finance and Performance Committee and other governance meetings directly. Bidesh Sarkar, chair of that committee, told the board it was “first stage” intervention. “When I spoke to NHSE [NHS England], they were very keen to point out this is really about help and support,” he said. “I think we should view it as exactly that.”
The trust says both St George’s and Epsom and St Helier remain “on plan” this year. Its own interim finance director explained what that is resting on. “The plan included around 25% non-recurrent… and we’ve used closer to 45%, and that’s how we’ve managed to be on plan at month two,” Lizzie Alabaster told the board, meaning close to half of this year’s savings so far are one-off measures, not permanent cuts, against a plan that assumed roughly a quarter would be.
‘Very positive’
Chairman Sir Mark Lowcock put it more bluntly straight after. “We have very clean set of accounts, which is very positive,” he said, “but we have quite limited assurance overall, basically because there are big, big questions about the deliverability of the current financial plan.”
The board’s own risk register marks the danger at the maximum possible score, 25 out of 25, rated “Limited” assurance, with a target of getting that down to 15 by March 2028. Two of the controls meant to manage the risk are rated “Weak”.
Putney.news reported on 2 March that St George’s had admitted it could not produce a financial plan its regulator would approve, with £18.2 million unaccounted for even after £90.6 million of promised savings. Wandsworth’s Health Overview and Scrutiny Committee looked at that story and did nothing: it “requested no further action”. NHS England has now stepped in where the council did not.
The trust’s savings plan leans heavily on a Transformation Programme that is itself struggling. Deputy chief executive Michael Pantlin told the board “those transformation schemes are not meeting those expectations yet… and they are going to really struggle this year.” The programme covering Clinical Support Services has no one in charge: its Senior Responsible Owner is listed simply as “TBC”. The consultancy firm helping run the wider workforce changes, PA Consulting, is winding its contract down. Even as that programme keeps being paid for, the trust is holding back on hiring elsewhere to save money, including, its own figures show, in frontline posts.
The trust’s own workforce plan says it will pause hiring wherever it can to cut costs, and St George’s says part of the reason it is running 208 posts short of its staffing plan is the cost of filling them. Even so, the trust keeps paying for the Transformation Programme’s own roles, whose numbers and pay grades have not been made public. At the same board meeting, St George’s managing director Kate Slemeck said the trust is now tracking, for the first time under a new national measure, how many patients spend 45 minutes or more waiting in a hospital corridor rather than a ward bed. The figure is a median of 18 people a day, a position she called “probably better quartile” nationally, meaning around the best fourth of trusts, while saying the trust wants to bring it down to zero.
The board’s own risk assessments go further than the headline score. Its workforce sustainability risk is rated 20 out of a possible 25, with “Partial” assurance. The board’s own papers record that “a substantial proportion of planned workforce reductions and associated savings have yet to be realised.” Alongside the two controls rated “Weak” on the finance risk, five more are rated “Weak-Moderate,” including the group’s process for identifying and delivering transformation savings, its understanding of its own cost structure, and its plan for the group’s future capital needs.
In breach
The finance report for Month 2 shows the strain in numbers too. At Epsom and St Helier, pay costs are £2.4 million over budget, and bank-staff use is 125 whole-time posts above plan, in the trust’s own words “in breach of the bank cap”. At St George’s, the trust is 208 whole-time posts under its staffing plan, a variance its own report attributes partly to “cost pressures not recruited to”. Epsom and St Helier’s total savings target for the year is £63.15 million.
Three of the executives who presented all this were at their final board meeting. Sir Mark Lowcock told the meeting, opening it, that it was “the last meeting for three of our acting or interim colleagues”: interim finance director Lizzie Alabaster, interim chief nursing officer Elaine Clancy, and interim Epsom and St Helier managing director Alex Shaw. A permanent chief financial officer, Azara Mukhtar, joins the group in August.
The board holds a “path to green” deep dive on its financial recovery at the Finance and Performance Committee in the autumn, and Azara Mukhtar’s first board meeting as permanent chief financial officer will follow shortly after.
What you can do
The gesh Group Board meets in public. Questions can be submitted in advance to Board@stgeorges.nhs.uk, up to 24 hours before the meeting. The next meetings are at St George’s Hospital on 3 September 2026, St Helier Hospital on 6 November 2026, and Queen Mary’s, Roehampton on 7 January 2027.
Wandsworth’s Health Overview and Scrutiny Committee can also question the trust. Its secretary is Laura Campbell (laura.campbell@richmondandwandsworth.gov.uk).
Residents can also raise concerns directly with their MP: Fleur Anderson.
