This week, the Health Service Journal reported that Liverpool Women’s Hospital and Liverpool University Hospitals Trust (The Royal, Aintree, and Broadgreen) have been issued warnings about their licences.
The NHS describes a hospital’s licence as “The NHS provider ( A provider in this situation is a hospital, our edit) licence forms part of the oversight arrangements for the NHS. It sets out conditions that providers of NHS-funded healthcare services in England must meet to help ensure that the health sector works for the benefit of patients, now and in the future.
All NHS foundation trusts and NHS trusts are required to hold a licence. NHS controlled providers and independent providers of NHS services are required to hold a licence unless exempt.
Save Liverpool Women’s Hospital campaigners first saw mention of a threat to the Hospital’s Licence in the Hospital group papers at its January 2026 board meeting. These papers are available to the public on their website. The papers are lengthy and technical. We wrote to the hospital board to ask what it meant. This is our question.
“Question re page 31 “NHSE notified LWH of draft enforcement undertakings concerning breaches of licence conditions for financial sustainability/governance and performance.”
What should the public understand this to mean? We have read the documents that are easily available on this matter, but we cannot find answers.
What are the risks to the Hospital’s finances? What are the risks to patient care? What are the risks to jobs?
We received this reply:
“Thank you for your enquiry and apologies for the delay in issuing a response.
NHS England (NHSE) has shared draft enforcement undertakings with Liverpool Women’s NHS Foundation Trust. This is a formal process used when NHSE believes a Trust needs to strengthen its financial planning, governance, or operational performance. It is designed to support improvement and ensure the Trust is on track, not to signal that services are unsafe.
The draft undertakings referenced at the Board of Directors meeting reflect that the Trust has financial and performance challenges and needs to make improvements in areas such as waiting times and financial sustainability. ( our emphasis) The challenges and the work being undertaken to mitigate the associated risks have been set out within the Integrated Performance Report and Hospital Management Board assurance reports which form part of the Trust’s reporting arrangements. These are available to members of the public via the Trust’s website. NHSE and the Trust are currently agreeing the final details which are expected to be finalised in early February 2026.
No immediate risk to the Trust’s financial stability has been identified. The undertakings simply ensure that the Trust has a clear, credible plan to improve its financial position which is reported through the Board of Directors along with the associated risks to delivery. There is no suggestion that care is unsafe. The purpose of the undertakings is to improve performance for patients—for example, by improving 18 week elective and Faster Diagnosis Standard (FDS) performance together with the 62 day Cancer Standard. The Trust remains regulated by the Care Quality Commission, which would intervene if there were any concerns about safety.
The undertakings specifically do not refer to job reductions but focus is on better planning, governance and performance.
Finally, the undertakings require the Trust to report progress on a regular basis to NHSE and arrangements are in place for this to take place. This progress will be reported through the Board of Directors.”
Then on the 10th February, The Health Service Journal posted an article about the outcome of these licence issues with this headline: “Liverpool University Hospitals FT and Liverpool Women’s Foundation Trust told to improve finances“
In March of last year, 2025, the Health Service Journal reported that Liverpool Women’s Hospital and Liverpool University Hospitals Trust (The Royal, Aintree, and Broadgreen) had been issued warnings about their licences.
The letter to Liverpool Women’s Hospital is also about improving waiting times for Gynaecology treatment. Our campaign strongly agrees that Liverpool Women’s Hospital and all hospitals need to improve gynaecology treatment waiting times. In March of last year, Dr Ranee Thakar, President of the RCOG, said, “As a gynaecologist, my clinic lists continue to grow, and the women and people I see are experiencing worsening conditions and more severe symptoms. There are still over 580,000 women and people in England waiting to see a gynaecologist, and this number isn’t falling quickly enough.” To improve waiting times, they need staff and funding, not more cuts.
Liverpool Women’s Hospital has long waiting lists for gynaecology. It is not advertising for more gynaecology doctors on its website. The reality is that there is not enough money to clear this backlog. It’s only women after all!
The whole Integrated Care Board for Cheshire and Merseyside is expected to make huge cuts (CIPS) this year. The ICB funds hospitals and primary care, so cuts to them are reflected in large reductions in hospital funding. The ICB itself was issued a similar order in November, similar to the one sent to Liverpool Women’s and Liverpool University Hospitals Trust. It can be found here.
Campaigners attending ICB meetings as members of the public have seen disgraceful cuts to many services being implemented by the ICB, including those to Fertility Services and to coeliac patients’ access to gluten-free products, and even worse,children’s waiting lists. Meanwhile, £5 million has been paid to Price Waterhouse Coopers for consultancy services on implementing these policies. The letter to Liverpool Women’s Hospital has one section which shows the nonsense of what is happening.
Quoted from the letter to Liverpool Women’s Hospital from Louise Shepherd from NHSE North West
Financial Sustainability and Governance
3.1 In particular:
3.1.1 the Licensee reported a £28.4m deficit (excluding deficit support funding
(DSF)) for the financial year (FY) 24/25, which was in line with plan.
3.1.2 the Licensee had a Cost Improvement Programme (CIP) Plan of £5.9m in
FY24/25 with a 77.2% recurrency target. Whilst the Licensee delivered
£5.9m CIP in FY24/25, only 40.9% of schemes were delivered recurrently. (“recurrently” means that they will make the same savings next year on a service they cut this year)
3.1.3 the exit underlying position of the Licensee at 31st March 2025 was reportedas a £34.3m deficit.
3.2 The PricewaterhouseCoopers FY25/26 Rapid Financial Diagnostic carried out across the Cheshire and Merseyside Integrated Care System in June 2025, highlighted the following issues and financial risks at the Licensee:
3.2.1 the National Maternity Tariff does not meet the full cost of maternity services at the Licensee which include increased patient complexity and acuity which is driving changes in the case mix (for example, growth in deliveries by caesarean section in recent years) and interventions. Our Emphasis
3.2.2 continued reliance on non-recurrent savings, and the risk-adjusted natureof the CIP portfolio.
3.2.3 system stretch risk remains significant, with limited scope for further system-wide support. (This means other hospitals can’t help.)
The letter to Liverpool Women’s Hospital is available here. We will post the full letter at the end of this post as requested, but this link may be a more efficient way to access it, if you are reading on a phone or tablet.
So LUFT, the ICB, and Liverpool Women’s Hospitals. Mid Cheshire Foundation Trusts and the Countess of Chester all have these licence warning letters.
Liverpool University Hospital Trust has yet another obligation imposed on them. They were already in a similar position to the one now imposed on LWH. This letter can be seen here
https://www.england.nhs.uk/wp-content/uploads/2019/04/app-c-section-111-notice-of-imposition-luhft.pdf. Again, it is to do with delivering services without adequate funding. It is imposing further cuts. It is addressed to the Hospital with the highest level of deprivation in the country. Our Hospitals, our people cannot take this.
The letter from NHSE England to Liverpool Women’s Hospital can be foundon this link.
Liverpool Women’s Hospital has long waiting lists for gynaecology, yet it is not advertising for more gynaecology doctors on its website. The reality is that there is not enough money to clear this backlog. There are doctors looking for posts. The problem is solvable. But it’s only women after all.
The whole Integrated Care Board for Cheshire and Merseyside is expected to make huge cuts (CIPS) this year. The ICB funds hospitals and primary care, so cuts to them are reflected in large reductions to hospitals.
The ICB itself was issued a similar order in November, similar to the one sent to Liverpool Women’s and Liverpool University Hospitals trust. It can be found here.
Campaigners attending ICB meetings, as members of the public, have seen disgraceful cuts to many services being implemented by the ICB, including those to Fertility Services and to coeliac patients’ access to gluten-free products, and children’s waiting lists. Meanwhile, £5 million has been paid to Price Waterhouse Coopers for consultancy services on implementing these policies. The letter to Liverpool Women’s Hospital has one section which shows the nonsense of what is happening.
The letter to Liverpool Women’s Hospital is available here. We will post the full letter at the end of this post, as requested, but this link may be a more efficient way to access it, especially if you are reading on the phone.
The letter from NHSE England to Liverpool Women’s Hospital
Note that the sender, Louise Shepherd, used to run Alder Hey Hospital, so she knows Liverpool Women’s Hospital and the other Liverpool Hospitals.
We object to any NHS organisation wasting money, especially on privatisation, outsourcing, or insourcing, or on millions spent on financial consultants and PR firms. The issue is that the NHS lacks the funding it needs to provide crucial services.
Please remember to sign our petition, or, if you have already signed, ask friends to sign as well. If you can help our campaign to save Liverpool Women’s Hospital, please get in touch.
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