Key findings

  1. Trust leaders are particularly concerned about the resilience and wellbeing of their staff after the first wave, with 99% either extremely or moderately concerned about the current level of burnout across the workforce.

  2. 94% of trust leaders are extremely (56%) or moderately (38%) concerned about the impact of seasonal pressures over winter on their trust and local area.

  3. 56% of trust leaders say that they are worried or very worried that plans and activities from the national NHS leadership (the Department of Health and Social Care and its arms-length bodies, including NHS England and NHS Improvement and its regional teams) are not effectively supporting the delivery of a sustainable service. Only 11% of trust leaders are confident in the activities from the national leadership and 31% are neither confident nor worried.

  4. 83% of trust leaders are worried or very worried that sufficient investment is not being made in social care in their local area.

  5. 68% of trust leaders say that the healthcare currently being provided in their local area is of a high or very high quality. 29% said services are an average quality and 3% said low or very low quality. Trust leaders expect the quality to fall over the next year but improve slightly in year two. However, they predict that the quality in two years will be lower than current levels.

  6. 92% of trust leaders say that the pandemic accelerated better partnership working and collaboration in local systems.

  7. In response to the uncertain external environment, trust leaders said the biggest risk is the 'perfect storm' of workforce shortages, staff burnout, second wave of coronavirus and a potentially difficult winter.