Friday, 1 June 2018

Revealed: The huge financial pressures facing two west London hospitals

The trust that runs Charing Cross Hospital and St Mary's Hospital is planning to make £48 million in savings in the coming financial year


The trust that runs Charing Cross Hospital is under pressure to make millions of pounds of savings to overcome a £20.6 million deficit.
Imperial College Healthcare NHS Trust is planning to make £48 million in savings for the coming financial year and will be able to access a portion of an NHS Improvement fund to help with its budget.
However, to be eligible for the money Imperial's hospitals must meet four-hour A&E waiting time targets 95 per cent of the time; a requirement labelled "illogical" by the British Medical Association (BMA).
The trust's healthcare facilities include St Mary's Hospital, in Paddington, and Charing Cross Hospital, in Hammersmith, which both have A&E departments the trust is expanding.
Charing Cross Hospital 
A campaign is under way to "Save Charing Cross Hospital" from an eventual proposed partial demolition.
Imperial says the cost improvement plan would not affect its £7.2m investment in the Charing Cross A&E redevelopment, due for completion by next June.
At its board meeting last week the trust unveiled a £20.6m deficit before funding from the NHS Improvement, Sustainability and Transformation Fund (STF) for the new financial year is taken into account.
The trust is optimistic about successfully implementing its cost improvement plan, a spokeswoman said.
"We expect to meet our financial target, as we have for the past two years, despite significant external cost pressures." she added.
The goals it has set itself gives it access to £34.2m from the STF pool.
The size of its slice from the STF is two-thirds contingent on the trust meeting its financial targets, and one-third on meeting the A&E targets.
As of this April, it was meeting the A&E target 84.6 per cent of the time.
It did not achieve it in the last financial year either, meaning it missed out on a £6.2m portion of the STF.
In its report to the board, the trust described increased demand on its emergency services, more ambulance and daily trauma patients at St Mary's, and bed pressures.
The Government launched the £1.8 billion STF pool in its 2015 spending review.
A share of the cash is contingent on providers achieving financial and performance targets.
Health Secretary Jeremy Hunt last March told providers they must take action to meet the A&E targets. NHS England and NHS Improvement then tagged the targets to its STF criteria.
BMA council chair Dr Chaand Nagpaul said this placed a burden on "overstretched" trusts.
"It is illogical and counter-productive that funding to support and improve hospital services should come with the precondition to achieve government targets first," he said.
"The government must recognise that with pressure on NHS services increasing year-on-year and national A&E waiting times consistently falling below the 95 per cent target, the problem lies not in the financial management of individual trusts but rather in years of chronic underinvestment."
Imperial did achieve its financial targets against a much smaller deficit plan in the last financial year, despite missing out on the STF portion for A&E targets.
Its planned £4.5m deficit benefited from a winter pressures top-up of £2.5m, with the trust ending 2017/18 with a £3m surplus.
The trust had set itself a cost improvement plan of £54.4m in 2017/18, but missed that target by £11.3m, which it partly blamed on winter pressures.
It made savings last year through clinical income, including from private patients, and also from saving on drugs, procurement and facilities, and reducing staffing costs like overtime and agency temps.
It planned to make similar savings this financial year, the spokeswoman said.
The trust planned to move patients through its urgent and emergency pathways "as effectively, as quickly and as safely as possible," its spokeswoman said.
Imperial's programme includes offering better alternatives to hospital admission, improving emergency department processes, specialist decisions and pathways, as well as bed management, ward and discharge processes.
Charing Cross Hospital's £7.2 million A&E expansion plans
• Increase the number of rooms in the urgent care centre from seven to nine.
• Increase the number of "majors" cubicles in the emergency department from 12 to 15.
• Increase the number of resuscitation bays in the emergency department from five to eight.
• Create two dedicated mental health rooms.
• Expand capacity for ambulatory emergency care, with same-day consultant review for patients with urgent or emergency health problems without the need for hospital admission.
By
  • 17:33, 30 MAY 2018
  • UPDATED17:36, 30 MAY 2018
    • https://www.getwestlondon.co.uk/news/west-london-news/revealed-huge-financial-pressures-facing-14725929

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