A major foundation trust in the north east of England has been handed a major funding boost as the health service looks to improve treatment in that region of the country.
Northumbria Healthcare NHS Foundation Trust has secured an additional £1.15m of funding boost amid financial difficulties for the health service.
The extra money is intended to support work to take a national lead on radical new options for the future of local hospitals across the country, and thus the foundation trust has asserted that the NHS as a whole will benefit.
NHS chief executive Simon Stevens announced in September that the trust was one of only three organisations selected to spearhead work to develop new ways of working known as ‘multi-hospital chains’.
The funding will be derived from the £200 million fund already earmarked for the NHS to assist such transformational projects.
By creating Northumbria Foundation Group, the work will enable the trust to widen the support and services it provides to other organisations, building on the success of work already taking place.
The Northumbria trust will then be put in the privileged and responsible position of being required to share its clinical knowledge and expertise across the NHS.
Spreading innovation and best practice will be central to this ethos, but the Northumbria trust will also provide corporate services to other similar organisations in the health service.
David Evans, Northumbria Healthcare’s chief executive, commented that the trust was uniquely qualified to take on this responsible new role.
“With many years of successfully running multiple sites within hospital and community settings across a large geographical area, we have vast amounts of experience to share with the wider NHS. Given this experience and our track record of delivering improvements with our work with North Cumbria University Hospitals NHS Trust, we are ideally placed to spearhead this exciting work and form a foundation group.”
Evans also took time to explain how the funding will specifically assist the Northumbria trust in carrying out its duties and vision for the future.
“This funding will help us bring our vision to life and enable us to progress our plans to share our knowledge and expertise, helping to drive up standards across the UK, while creating vast efficiencies through sharing corporate functions.”
Northumbria Healthcare has been in a ‘buddy trust’ arrangement with North Cumbria University Hospitals NHS Trust since 2013.
This has enabled the two organisations to provide an extensive range of clinical and managerial expertise.
And both argue that this has led to a significant improvement in the safety and quality of patient care hospitals in locations such as Carlisle and Whitehaven.
Evidence compiled by the health service in Scotland indicates that the country has a real problem with patients failing to turn up for doctor appointments.
Nearly 17,000 patients in Scotland failed to show up for an NHS hospital appointment on at least five occasions last year.
This issue is said to be costing the NHS in Scotland a significant amount of money, and could lead to an investigation into the topic.
Data indicates that NHS Tayside had the highest number followed by NHS Lanarkshire and NHS Greater Glasgow and Clyde.
In total, in excess of half a million people missed at least one NHS outpatient appointment in 2014/15.
With every missed appointment costing the NHS £120, the total cost of missed appointments last year exceeds £100 million.
The figures were obtained by the Scottish Conservatives through a Freedom of Information request, and the Tories found that nearly 100,000 patients in the Scottish NHS missed two appointments.
With the figures being damning for the health service, it is now possible that sanctions could be taken against those who have failed to attend appointments.
The Scottish Tories have previously suggested those who fail to show for appointments on a certain number of occasions could face some sanction from the health board.
Commenting on the figures, Scottish Conservative leader Ruth Davidson said: “Missing a hospital appointment can happen to anyone, and for a range of reasons. But when you’re getting to the point where you are missing five or more in the space of just a year, something really has to be done. That is costing the NHS thousands of pounds, wreaking havoc with hospital planning, and of course potentially harming the health of the patient involved.”
Davidson also pointed out that the Tories in Scotland were well aware of the problems, and that it was an issue that they had highlighted previously.
“We’ve been critical of the NHS in the past for cancelling appointments and procedures, so it’s only fair we do everything we can to make sure patient no-shows are limited too.”
The leader finally made a call to arms for the Scottish health service to address the issue.
“We need to find ways to ensure people turn up at the appointments that are made and stop showing contempt for our NHS, doctors and nursing staff.”
Responding, Health Secretary Shona Robison pointed to the fact that the percentage of patients missing appointments has decreased slightly over the last five years, but also acknowledged that there are problems.
“It is important that all health boards understand why patients are not attending appointments and look at ways to reduce this. The Scottish government is committed to supporting health boards to deliver secure messaging services, including reminders. Health Scotland also recently published a report looking at those who did not attend appointments over a 10 year period from 2002/03 to 2011/12. We welcome this report which will provide boards with further learning on the issue of non-attendance.”
The annual budget of the Scottish NHS is currently set at £11.9 billion.
According to the Chief Executive of NHS England, the plans of the Chancellor of the Exchequer for the funding of the health service are simply not workable.
George Osborne has already outlined his scheme for NHS funding until the end of the decade, with the forthcoming spending review thought to be of particular importance.
However, ahead of the release of this formal document, Simon Stevens has indicated his belief that negotiations on health funding require considerable progress.
Stevens suggested that the level of funding promised by George Osborne could not be reasonably described as genuinely workable.
With a £30 billion deficit facing the NHS between now and the end of the decade, Osborne had already pledged an increase of £8 billion in spending by 2020.
The further gap in funding is to be achieved via efficiency savings according to the plans of the Conservative government.
However, Stevens has stated his belief that it is a vital for the NHS to pledge extra cash in the short-term in order to kickstart service changes that will lead to desired savings in the longer term.
“As of today, considerably more progress is going to be needed before we can say we have a genuinely workable NHS funding solution for 2016-17 and 2017-18, but spending reviews usually come down to the wire, so hopefully we’ll get there by 25 November,” Stevens stated.
The NHS is merely one department reliant on government spending that will be affected by the forthcoming review.
In a statement in November, the Chancellor of the Exchequer already indicated that the Department of Communities and Local Government will have their budgets cut by 8 per cent on an annual basis.
Similar cuts have also been made with regard to the Department for Transport and Environment.
Meanwhile, Osborne is reportedly still in talks with a raft of cabinet ministers ahead of the key funding information release date.
Work and Pensions Secretary Iain Duncan Smith, Home Secretary Theresa May and Foreign Secretary Philip Hammond have all been in discussion with the Chancellor over potential cuts to the departmental budgets.
Decisions to cut government departmental spending can be seen in the context of the overall economic position of the United Kingdom.
The British government is currently in the region of £1.7 trillion in debt, with the figure inching ever closer to 100 per cent of GDP.
This is compounded by a spending deficit still in the region of £100 billion per year.
Although the £1.7 trillion figure may sound substantial in itself, when unfunded liabilities are taken into consideration the real scale of debt is likely to be somewhere between 3 to 4 times this number.
A massive new hospital project in Brighton has been given the go-ahead after receiving approval from the Chancellor of the Exchequer George Osborne.
The £480 million project has recently been rubber stamped by the Treasury after 18 months of deliberation.
Brighton and Sussex University Hospitals Trust will refurbish and rebuild its hospital buildings, which are some of the oldest in the NHS, using £484.7m from the Treasury.
The trust had been asked to provide further assurance regarding its plans for the hospital project due to its deteriorating financial position.
Building work on the state-of-the-art institution will begin in January next year, at least for the first of the two new buildings involved.
Ahead of this building process, all emergency and cranial neurosurgery work was moved from the Princess Royal Hospital to Royal Sussex County Hospital.
The scale of the project is underlined by the fact that the hospital construction will not be completed until 2024.
But the magnitude of what will be achieved in Brighton by this nearly £1/2 billion project was underlined by Trust chief executive Matthew Kershaw.
Commenting on this exciting redevelopment in the Brighton region, Kershaw suggested that this would provide incredible services for people in the local region that would truly revolutionise healthcare.
“This redevelopment is a once in a generation opportunity to build on the excellent care we currently provide to our patients and truly improve acute healthcare for patients in Brighton and Hove and across the region. Today’s announcement marks a genuine turning point; the 3Ts redevelopment is no longer an ambitious plan, it is the future of this hospital,” Kershaw suggested.
Additionally, Kershaw was keen to show his gratitude for everyone that had been involved in the project, which after all been delayed for a considerable period of time.
“I would like to thank everyone who has contributed to the success of the project so far. A great deal of work has gone into bringing us to this point and there is still much more to be done. The result though, having a better hospital for all our patients and staff in the years to come, is worth all this effort and more,” Kershaw added.
Although the project will not be completed for nearly a decade, residents of the Brighton area will still benefit from the decision to construct this facility in the near future.
With preparation work expected to begin in January 2016, it is hoped that the first new building constructed on the site will be ready to open its doors in late 2019.
The transformation is expected to be so dramatic that few people will ultimately recognise the institution as the hospital that they had visited previously.
The Care Quality Commission (CQC) has suggested that 40 per cent cuts to central government funding of its inspection program could have serious implications.
David Behan of the CQC has stated that the organisation has been asked to incorporate funding cuts of 25-40 per cent into plans for the next financial year.
And Behan warns that this will have a serious impact over the capabilities of the CQC in the forthcoming period.
With this in mind, the regulator has stated that it will defer any decisions related to the delivery of these 2016-17 inspection plan until the spending review has been completed.
The statements of the Care Quality Commission come in the context of the warnings that the Treasury made in redefining the ringfence on NHS spending.
It is particularly expected that some bodies within the organisation will be targeted for efficiency savings.
The Conservative government has set the NHS a target of achieving efficiency savings in excess of £20 billion by the end of the decade.
Yet increasingly a picture is emerging of a conflict between the spending expectations of the government and the reality of delivering acceptable services.
It has already been reported that the Care Quality Commission will miss its deadline to inspect all adult social care, GPs and out of hours services by 30th September next year.
Thus, it is only reasonable to assume that spending cuts will push this deadline back further still.
Commenting on the matter in a board report, Behan writes: “The implications for delivering the [inspection] plan in 2016-17 depend on finalisation of the spending review, CQC receiving a budget allocation for 2016-17, and final agreement on fees for 2016-17. No decisions have been made on these three important influences so I propose that discussing the programme for 2016-17 is deferred until such time it is clear what the decision is in respect of these three issues.”
Treasury officials have already signalled their intention to redefine the ringfence on NHS spending, which would then apply to only NHS England commissioning budgets.
This would mean that numerous Department of Health budgets would be excluded from government commitments to increase NHS spending by £8 billion over the existing Parliament.
Any plans to achieve massive efficiency savings in the NHS can be placed in the context of the recent financial figures related to the health service.
According to these numbers, the NHS will run up a financial deficit of £2 billion during the existing fiscal year.
A CQC spokeswoman commented on the matter: “All government departments have been asked to model scenarios of 25 per cent and 40 per cent of savings from their grant in aid by 2019-20 in real terms. In line with this, the CQC is undertaking an exercise to consider possible implications ahead of the upcoming comprehensive spending review.”
Experts are warning that a series of crucial health services in England could be under threat due to funding issues.
In particular, services aimed at smoking, obesity and sexual health are especially vulnerable.
The news can be placed in the context of a decision by the Chancellor of the Exchequer, George Osborne, to cut the existing public health budget.
Osborne announced that £200 million would be shaved off the overall budget beginning in January.
This fund is currently held by councils, and thus is not part of the government’s overall promise to protect the NHS.
Yet experts operating within the health service believe that the money is vital in order to ensure that pressure is relieved on the NHS as a whole.
A total of 11 groups, including the Academy of Medical Royal Colleges, Royal College of Nursing, NHS Confederation and Faculty of Public Health, have signed a letter to George Osborne urged the Chancellor of the Exchequer to reverse his plans.
The letter particularly suggested that reducing the funding would lead to increased ill-health and inequality in the general population.
Another subject touched upon by the letter was the fact that the Chief Executive of NHS England, Simon Stevens, had called for extra funding for the health service ahead of the general election.
Prof John Ashton, of the Faculty of Public of Health, stated: “The legacy of a decision to cut the public health grant will be major further burdens on the health service within the foreseeable future. Avoidable ill health, heart disease, sexual health problems, unplanned pregnancies – these are the kind of things which are being affected by this irrational cut to funding.”
The letter comes in the light of the recent fiscal results of the NHS that suggest that the publicly funded health service will be £2 billion in deficit by the end of the financial year.
It is clear that the NHS faces massive funding difficulties despite the promise of the Conservative government to increase spending by the end of the decade.
In addition to the financial problems related to this issue, it is also suggested that the spending cuts will significantly exacerbate inequality in the UK.
Rob Webster, chief executive of the NHS Confederation, is particularly concerned about this prospect.
“There is an unprecedented consensus that we can only address the problems facing the NHS if we invest in the future of our nation’s health by helping people to stay well. Open any report from any director of public health in any part of the country and you can see health inequalities and poor health putting pressure on NHS services and blighting people’s lives. We need the upcoming spending review to protect public health budgets,” Webster asserted.
The government responded by stating that the health service is indeed a priority for investment, but also indicated that difficult decisions need to be made across government departments to reduce the overall spending deficit.
A comprehensive financial report from the health regulator Monitor indicates that the NHS faces terminal financial difficulties.
NHS trusts in England managed to accumulate a collective deficit of nearly £1 billion in merely the first three months of the existing financial year.
According to regulators, this represents the worst financial position for the NHS in a generation.
Figures released by Monitor show that NHS Foundation Trusts had a deficit of £445 million for the surveyed period, while other NHS trusts racked up a £485 million deficit for the first three months of the year.
Although the overall picture can be considered alarming, the health regulator was particularly damning regarding the financial position of foundation trusts.
Monitor warned that this sector is “under massive pressure” and simply cannot continue in the same vein for much longer.
The report in question surveyed the financial health of 151 NHS foundation trusts, while Monitor sought the assistance of the Trust Development Authority (TDA) to cover 90 NHS trusts.
It is not merely the quantity of debt that is alarming for the health sector, but also the proportion of bodies suffering from financial difficulties and deficits.
Of 90 trusts in the TDA report, 72 ended the financial quarter in deficit, with 118 foundation trusts also in the red according to the health regulator.
This means that nearly 80 per cent of NHS trusts in England are currently running a deficit. Additionally, 75 per cent of the trusts that were in deficit are acute hospital or specialist trusts.
Although several reasons for the overspend were cited in the Monitor report, it is suggested that higher staff costs than expected and an over-reliance on expensive agency staff particularly contributed to the problems.
In addition, the report also reflects that foundation trusts were unable to meet several national waiting time targets.
Perhaps most critically, the A&E target for people to be seen within four hours was not met. Targets for routine operations and some cancer treatments also went by the wayside.
Commenting on what are unquestionably alarming figures for the health sector, Dr David Bennett, chief executive at Monitor, commented that real change is necessary in order to address the situation.
“Today’s figures reiterate that the sector is under massive pressure and must change to counter it. The NHS simply can no longer afford operationally and financially to operate in the way it has been and must act now to deliver the substantial efficiency gains required to ensure patients get the services they need,” Bennett opined.
However, Unite union national officer Barrie Brown suggested that efficiency savings were in fact the root cause of difficulties for the health sector. Brown instead asserted that increased spending and more extensive funding was required for the NHS to avoid a national emergency.
“The financial chickens are coming home to roost big time. This is what happens when you have growing demand for NHS services and then decide to impose £20 billion of so-called ‘efficiency savings’. Health Secretary Jeremy Hunt needs to start banging the Cabinet table to get more funds in real terms from the Chancellor, George Osborne, otherwise the NHS will go into a financial meltdown,” Brown stated.
This latest deficit follows overspending of £820 million by NHS and foundation trusts over the last twelve months. But it seems likely that the deficit among the same organisations could ultimately top £2 billion for the existing financial year.
The GMB union has indicated its opposition to significant cuts in services at Barnsley Hospital.
Members of the union are said to be extremely concerned about the potential risk to patient safety.
And the hierarchy of the GMB union has issued a statement indicating their view that it is “only a matter of time before there is a serious incident”.
The cuts in question are effectively worth £3.5 million of services at the South Yorkshire hospital.
In particular, services related to women and strokes have been targeted.
With Barnsley Hospital attempting to fulfil the decision made by the NHS regulator, the organisational structure of the hospital is currently assessing the possibility of reducing bed numbers.
This has resulted in the Stroke Ward facing a bed reduction from 20 to 14, with the GMB union warning that patients will have less opportunity to gain access to specialists as a result.
Meanwhile, the Gynaecology Ward will go from a seven-day to five-day service, also with a reduced bed capacity from 20 to 14.
Consequently, potential issues such as ectopic pregnancy, miscarriage and emergency surgery on a weekend will be dealt with by general nurses and not a specialised nursing team.
Pregnancy services and a specialised surgical ward are also affected by the multi-million pounds cuts.
Barnsley Hospital has suffered since financial irregularities were discovered by the regulator Monitor last year.
Monitor has already instructed the hospital to disregard the maximum patient waiting time of four hours for accident and emergency, with other cost-saving targets to be employed instead.
Currently on the cuts, Martin Jackson, GMB Branch Secretary and Staff Nurse at Barnsley Hospital, expressed his concern about the level of care in the hospital declining as a result.
“Members are extremely concerned about the risks to patient’s safety and fear it is only a matter of time before there is a serious incident.”
Jackson also suggested that the cuts were indicative of the lack of realism in the government’s highly publicised seven-day NHS plans.
“So much for the Tory claim to be making the NHS a seven day per week service. Staff are under immense pressure to deliver high quality patient care but are at breaking point. To make matters worse GMB representatives are being denied proper consultation with hospital management to address patient care concerns. Senior NHS managers keep informing GMB that the quality of care is their first priority while their actions speak of the reverse.”
Stacey Booth, GMB Lead Officer for the NHS, suggested that there had been a lack of transparency in this process.
“There has been minimal consultation about the proposals. Hospital management is making changes at a time when the Trust is under severe pressure. The hospital is already stretched and has introduced an Escalation Ward to deal with the high turn-over of patients, but the ward doesn’t have a dedicated medical team and this is leading to a lack of consistency in patient care. Lives are being put at risk,” Booth commented.
GMP is opposing the cuts, and could choose to ballot its members on industrial action in the foreseeable future.
A report in The Guardian newspaper suggests that Government ministers have taken steps to hide damning NHS statistics related to the funding of the organisation.
According to The Guardian report, there is an unprecedented £2 billion deficit in the NHS, and it is suggested that this has been buried in order to ensure that the Conservative party conference is not overshadowed by headline news.
Jeremy Hunt, the health secretary, is under pressure to explain why data that is in effect from the NHS’s own regular health checks has been withheld from publication.
Meanwhile, top NHS figures have suggested that the government is effectively attempting to bury bad news.
In particular, a senior figure at Monitor stated that the organisation had been “leaned on” by Whitehall to delay its report.
The Monitor report indeed confirms that the financial position in the NHS is declining.
Reports from both Monitor and the NHS Trust Development Authority were expected, with the Monitor quarterly report usually published around the time of the organisation’s board meetings last month.
It has been described by NHS insiders as extremely odd and significant that Monitor has departed from its usual practice.
Figures were apparently submitted to Monitor in time for the publication of the reports, and The Guardian quotes one boss of Monitor as stating that the publication was delayed due to political pressure.
“We are being leaned on to delay them and I have a suspicion that the sensitivity would be less after the Tory party conference,” the unnamed individual stated.
Thus, although data is not yet fully available, it is suspected, according to sources close to Monitor, that hospitals in England ended the first fiscal quarter of the financial year over £800 million in the red.
This would represent a gulf similar to last year’s £822 million annual deficit, and indicates that the NHS is on course to lose £2 billion by the end of the fiscal year in March.
Although the government has declined to comment on the subject, the Labour party certainly felt obliged to respond to the issue.
Heidi Alexander, the shadow health secretary, commented: “This appears to be a cynical attempt to suppress bad news ahead of the Tory party conference. It makes a mockery of Tory claims to be committed to transparency in the NHS, and leaves Jeremy Hunt with very serious questions to answer. These figures must now be published in full as a matter of urgency.”
Monitor has officially denied any political pressure related to the publishing of figures.
But the issue once again underlines the funding challenges that the NHS will face in the coming years.