Damning evidence of financially failing trusts was published last week, with 20 NHS trusts not meeting minimum standards in the management of their funds.
The Audit Commission's report found that despite a record surplus of £1.65 billion, one in every 15 NHS trusts is failing financially with 12 of them having had severe problems for the last three years.
Of the 20 failing trusts, 16 of them ran up deficits in 2007/8, and six of them have historical debts that they have failed to make sufficient progress in paying off. Three were said to have poor management arrangements.
Out of the 12 trusts that have been failing for three years, the Department of Health has also listed six of them as 'financially challenged' since 2005. Experts said these six could not work their way out of trouble without outside help and should be considered for take-over or merger, with parts of them possibly being closed down.
The financial woes of the certain trusts means that they tend to provide poor quality patient services and are unable to plan adequately for the future, the report said.
Yet, overall the NHS is in good financial health and 93 per cent of organisations met financial management standards or exceeded them, the report said.
The 302 hospital trusts and primary care trusts investigated were given scores out of four based on a number of criteria including management, financial standing, and value for money. A score of one means the trust has not met the minimum standards expected with four being the top score.
The best and worst trusts in 2007/08 (those in capital letters have failed to meet minimum standards over the past three years)
I found this email very unhelpful as the ratings do not necessarily reflect the work that is being undertaken at a hospital. I think that an NHS website should be motivating and engaging staff not trying to get them to be negative and disparaging about their Trust. As a member of staff at one of the Trust's listed as performing poorly I would like to put on record that the Trust's reputation with its patients remains very high and staff loyalty is at a level to be envied by other Trusts.
Monday, December 15, 2008
i would like to say that i am surprised that MTW are still not in this bottom rating, althought i acknowledge all the hard work that has gone ont to clean up their act over the C diff outbreak and its legacy, things are far from perfect here. Recruitment has peaks and troughs new people come dont like it and move on! why! beause there are still too many people within the organisation from the Rose Gibb establishment - nothing will change for the better until they go.
Having said all that Medway Maritine are no better for a foundation trust their management do things by bullying tactics, so ok things get done in the name of "we are a foundation trust" but staff move on as quickly as they can.
Monday, December 15, 2008
I work in one of the trusts in carital letters too. I'm appalled at the thought of a merger with 2 other 'local' trusts, a sure recipe for disaster, geographically insane, especially with the road network. Are we to have a fully funded air ambulance service then?? I think management should be clinically led and cut at least in half! The trust I work in is definately top heavy, not enough 'workers' and too many 'senior personnel'
sally callaghan, Thursday, November 13, 2008
What an irony to see that the Bromley Primary Care Trust is functioning as Top Establishment and their main Providers is at the lowest point in the table. I wonder who has been sponging from excellent services from Trusts in Kent and settling accounts accordingly.
Monday, November 10, 2008
where are the community hospitals do we not count?????????
Saturday, October 25, 2008
I am a senior consultants at one of the Trusts in capital letters. Our financial problems are the legacy of poor financial management foe several years. Chief executives come and go. They have poor insight into the delivery of clinical services. There is no doubt in my mind that patient care has deteriorated over the years as a result of poor financial management. Clinicians are not involved with many of the decision making processes. Clinicians in management should be appointed by their peers and not managers. Many of the decisions taken are short lived and are knee jerk reactions. There is no long term strategy. Closure of services has been a disaster and I would not recommend merging services. It is a recipe for disaster. Our finances can improve by getting rid of 60% of managers.
Thursday, October 23, 2008
I work in one of the Trusts in capital letters. We have had interim management for 2 years. We have no chance of recovering until the merry-go-round of senior managers stops and we get a CE for longer than 6 months so he/she can actually see some changes through.
Wednesday, October 22, 2008
I work for one of the trusts listed. I disagree entirely with the rating. It is historical and does reflect current state of affairs.The problem in our case is poor support from the local PCT which is refusing to pay for work already done in our hospital. Yes there are improvements that can be made but mergers / closure of services is a BAD IDEA.
Wednesday, October 22, 2008
My Trust has failed for more than 10 years to implement the most basic Clinically based Resource management.Consultant staff other than the favoured(very) few are not involved in decision making other than as a gesture so no progress has been made.Even a new hospital has been a disaster because the managers at top level did not consult or accept the advice of those with massively more experience than they had ,presented Staff with a new design and told us to fit in to it.Since the design is not fit for purpose it is ,of course,a Financial disaster as well as a clinical one.
Managers then get sacked with a massive compensaton package for FAILURE while the rest of us have to struggle to maintain some sort of service.
This Board-sponsored culture is SICK-- Managers must not be allowed both to fail dangerously AND be compensated.If doctors fail they are suspended for re-training and may be Struck off by the GMC so why are failing Managers not sent for re-training before the public are exposed to Risk again.Perhaps a more level playing field would give all staff a bit more confidence.
Managerial Appointment committees should always have a working Clinician on the panel from the Trust and their References must include a fully informed one from a senior clinical colleague.
Gordon Edward MacLellan, Wednesday, October 22, 2008
As a senior doctor i find it interesting that most of the "failing" trusts are in east london. Moreover the local PCTs to these trusts seem to have the biggest surpluses. Many of the staff have in these "poor" trusts given their lives to medicine and are very dedicated (every bit as much as those in successful trusts) and it is soul destroying to see these peoples reaction when they are told the trust they work in is failing. The management are often as good as in other trusts. The situation is much more complex than is first seen. I think these types of "hit lists" cause more damage than help
Tuesday, October 21, 2008
Why is it that there are so many hospitals in East London which have a deficit? Are they being properly resourced? Do the local PCTs have a financial surplus?
Tuesday, October 21, 2008
Your article suggests there is a link between poor Audit Commission results and poor quality patient services. The rating at Winchester and Eastleigh Healthcare NHS Trust has risen from fair to good. Our rating of weak for financial management refers to a planning work that should have been done in 2007/08. As far as our financial position is concerned, the Trust has broken even and delivered a surplus for the last two years.
Tuesday, October 21, 2008
Queen Mary's has been making great efforts to make it one of the top 20, not bottom. I am very surprised and disappointed at the result. I am not certain of which factors make up the score or how they are calculation. What I am certain of is, if industry and committment of staff was a factor, we would be hard to beat! The publishing of these results has a detremental affect on morale. What more do we have to do!! I hope the proposals and plans to merge, rationalise and improve patient care across Trusts will persuade the Department of Health to "write of" historic debt which can only continue to have a detremental affect of patient services.
Rowland Gardner, Tuesday, October 21, 2008
I think you need to differentiate the table headings with hospitals in one and primary care trusts in the other, as their roles are very different in terms of finances, with the PCTs being commissioners and the hospitals as providers, as it would be interesting to see what PCTs are financing which hospitals. Also now the PCTs are just going to be commissioning and corporate services, with their clinical and other provider services forming alliances with provider services in other areas and the provider services may not have the same financial situation as the commissioning/corporate arm of the PCT, as is the case in Hounslow.
myra savin Hounslow PCT Provider Services, Tuesday, October 21, 2008
One of the reasons we achieved one star was the lack of data collected to supppot our achievements, this was partly due to the outdated computer programmes and thier inability to colate the data requested by DOH.
Tuesday, October 21, 2008
I work for one of the poorest performing Trusts and am not at all surprised at the rating. It is toatally unsurprising that we are in so much financial trouble as the budget is far too small. But, financial management in the Trust is also very poor , except when it comes to employing Modern Matrons, Practice Development Matrons, Service Managers etc etc, all at Band 8 and above. Money has been found to employee these staff, but no money available to employ band 5 & 6's, get real!!!. Patient care is obviously affected by this top heavy policy, as none of the band 8's actually get near a patient and patients are telling us this is a problem, with the very poor results of patient satisfaction surveys.In some ways it would be a good thing to merge with the 2 other local Trusts, at least then there would only be one Board to pay instead of 3.
Tuesday, October 21, 2008
I work for Winchester & Eastleigh Healthcare Trust. I'm a sister on an acute medical ward. I think our new Chief Exec (been in post for about 18 months)is really trying to get us out of debt and his staff are behind him. He has tried to stop using Thornbury Nursing Agency, however, this must be difficult as alot of our bank nurses have left to work for this agency! Vicious Circle. They need to match the agency rate for the individual if they are to encourage nurses to stay on the nurse bank (example: £12ph hospital, £22 agency, weekend: £17ph hospital, £30 agency....the hospital obviously have to pay the agency more than that, up to £99ph!
Tuesday, October 21, 2008
Too many managers and too many meeting with out any outcome. Need to give more time and help to clinician to turn around clinical issues.Measures need to be taken in order to improve emploees moral.
Dr Imdad Ali, Tuesday, October 21, 2008
I am not suprised. For a relatively small trust - Newham persists in creating needless internal politics. This prohibits progressive change. There seem to be layers of management/ offices that seem to be expanding , whilst wards close. Everything is short term, and I mean planning ahead only months in advance.
The hospital is only triggered into action by the imminent visit by the Health Care Commission.
There is serious lack of attention to patient privacy/ dignity.
This starts right from A&E, majors cubicles that leave room for a trolley and one slim person. Patients are less than four feet apart. Patients are shipped to a make shift assessment unit ( mixed) and then to another ward, and perhaps another move to the specialist wards.
Elderly patients are moved from one of the hospital to the other.
The place is only working at all because of it's dedicated staff.
It lacks leadership - on the shop floor!
Monday, October 20, 2008
My perspective is infection control. I work at a Trust with allegedly one of the worst financial records (Whipps Cross). I feel that it is wrong to state that patients are being put at risk in my hospital. For the third year running, we have had the best MRSA bacteraemia rate among London acute hospitals, and we have one of the best (sadly not the very best, but it is my ambition to get us to the top spot) C.diff rates. In the most recent National Survey of Health Care Associated Infection, we had rates below the national average. So we must be doing some things right. I have been happy for both my mother and father to be treated in my hospital as I have confidence that we take patient safety seriously for all (not just infection control). I'd rather they were treated here than some other institutions.
Albert J Mifsud, Monday, October 20, 2008
yes I do work for a listed hospital (where there are many people working hard to keep things going, despite
I am not supprised by the rating. I totally agree with the rating.
There are wards way under establishment, and with winter pressures these will get worse. There is little or no capacity for staff to complete work outside of basic patient care (even this is under threat constantly).
It manages it's resources on a day-by-day method. When resources are made available they are short of whats required (i.e. getting good capable staff)
Mergers would allow for the consolidation of exec management teams. Financial problems are not coming from those working hard in wards and theatres, but from a lack of serious business management competencies at a Director/CEO level.
Monday, October 20, 2008
Queen Mary's Sidcup NHS Trust has worked extremely hard to pull back its Financial position over the last 2 years. However, crucial depts are being outsourced in an effort to save money to under pin PFI trusts in the area. This will not work as local knowledge is paramount in identifying areas of concern particularly in Payroll processing. The savings identified by being outsourced could have been acheived by combining all four local trusts into one department.
Mrs. Marion Beazer, Monday, October 20, 2008
A weak Trust is defined as one that has a budget deficit. It doesn't matter how well you have tried to manage it - a deficit means "nul points". There are two reasons why a Trust may be in deficit (1) it is financially mismanaged (Bromley is one such, with an independent report saying so) or (2) it budget is too small or possibly both. A historical comparison of SE London hospitals indicates that the budget for Queen Mary's Sidcup is disproportionatly small and has been for years. So to say we are among the worst performing conceals a lot.
It doesn't matter how brilliant your managers are if you aren't given enough money to meet your clinical obligations. We have made major efforts to cut costs, to no avail, largely because for some reason patients keep coming through the doors and forcing us to keep beds open that had been earmarked for cost-saving closure.
Mergers may save money around the margins, but the effects of PFI interest payments into which many Trusts are locked are seriously damaging.
Andrew Bamji, Monday, October 20, 2008
I work at one of the failing trusts and considering the large staff cutbacks and constant service improvement, am surprised to see that we are in the list of worst trusts. Even more frightening is the prospect of being merged with two other failing trusts, Bromley and Queen Elizabeth, who we are lead to believe are in a much worse position than us, thus creating a huge poorly performing group - can someone explain why that seemed like a great idea to the powers that be?
Monday, October 20, 2008
I work at Hinchingbrooke hospital . The Trust finally managed to achieve a small surplus on its income/expenditure account last year and will do so this financial year . It has consistently managed to put patients first and ther is no question of patients being put at risk . It is an innovative Trust helping lead on 18 weeks with members speaking at national meetings and being on the National Orthopaedic coaching team for 18 weeks in the SE corner . It is one of the leading Trusts for same day admissions .It has been accepted as a partner with Peterborough for colorectal screening . Hinchingbrooke is one of the smallest Acute Trusts and only came into being in 1983 . It was set up as a very lean organisation with no possibility for economies of scale . Its finances were thus precarious from the outset. The accumulated historical debt was allowed to build up by both the SHA and the DOH who must take some responsibility for not insisting that financial balance was achieved as soon as it started to accumulate . The staff at Hinchingbrooke hospital are very proud of the clinical care given to its patients and are concerned at the numerous inappropriate remarks that it is a failing trust . This creates uncertainties for patients . How can a Trust with an income of £69 million ever hope to pay off a debt of £40 million ? We are aware that management will need to change but what other organisation , private or NHS , would be willing to take on such a substantial debt . If the debt is to be " written off " for a new organisation then surely this should also apply to the present management team who have got the profit/loss account back on tack .
tim vaughan-lane, Tuesday, October 14, 2008
I am amazed to see my trust as one that has performed well.
We are constantly being told that we are overspent.
Recently all temporary staff have been finished, many are newly qualified staff nurses.
Bank shifts appear drastically cut down.
All this leaves remaining nursing staff covering the shortfall and compromising quality care and patient safety.
So if they are performing well financially it is at a cost to staff and patients.
Tuesday, October 14, 2008
NO however i do know that the hospital i work at is about 10 million in debt and it makes me laugh that suddenly at the end of the financial year that debt magically is written off!
Also how can the trust i work at have a recruitment ban for all job below band 8 - BUT be recruiting band 8's in abundance - clearly again this Trust is top heavy with its management.
Can't merge this Trust that is the problem the last merger caused the problem.
I also think the chief executive is no more than a figure head who says the right words at the right time, but does not really have a clue what is going on at ground level, and does not make decisions, delecated other people to do that for him.
christine Moysey, Tuesday, October 14, 2008
I don't work for one of those trust's but I can understand how so many hospitals get into trouble the NHS as a whole waste a farst amount of money on the companys they order stock from instead of paying £30 pounds for a chair they pay £60 thats just an example but its like that for every thing from paper clips to instroments they pay more. We have a lots of reps coming round and because we have been with a company for a long time we stay with them even if things are more exspensive this is barmey. Our department has a bugget which we order things for patient care but we have to stop ordering so much because of the limit on the bugget which affects patient care. It is poor management that needs to be shaken and better communication between staff at all levels. I think closures is wrong because management have made a booboo. Mergeing is a good idea but communication is the key.
