Agenda item

Representatives of Stockport NHS Foundation Trust have been invited to the meeting to answer questions from members of the Executive about their Financial Improvement Programme.

The Leader of the Council welcomed to the meeting Ann Barnes (Chief Executive) and James Sumner (Deputy Chief Executive) of the Stockport NHS Foundation Trust who had agreed to attend to answer questions from the Executive about the Trust’s Financial Improvement Programme to address their financial deficit, and the impact recent announcements were likely to have on Stepping Hill Hospital.

The Executive asked a number of questions and received responses. The issues covered included:-

The background to the financial deficit at the Trust and the reasons for the measures proposed

Most NHS Foundation Trusts were operating with a deficit, and the local causes were due to reductions in tariffs paid for activity and the challenge of stemming rising demand at the hospital. Although a number of innovative schemes had been developed to improve care, these had not been successful at preventing the rise in attendances and admissions that was reflective of a national trend.

As 71% of the Trust’s costs were associated with staffing, this area would need to be considered in order to achieve the saving needed, but the aim was to approach reductions on a voluntary basis. It was not known at this stage where redundancies might occur until a panel of senior Trust Managers and clinicians had assessed every application, including its potential impact on patient care.

Press reports that the number of potential redundancies was 410 were inaccurate as the Trust was planning for no more than 350, with the expectation of less should other cost reduction activity achieve the savings needed.

Potential impact of the bed closures and speed of implementation after announcement

The closure of the bed capacity was not unusual in the summer months as there was less demand for elective operations and less need for orthopaedic beds due to seasonal decline in fractures. The Trust had consolidated a number of unused elective beds which allowed for a ward closure, which would have closed in October in any case. Every decision to close beds is subject to a clinical assessment against a set of nationally prescribed criteria. NHS Improvement (the NHS Regulator) had assessed the Trust’s proposals and found them to be robust.

Extent to which closures were seasonal, reversible or part of the Financial Improvement Plan

Clarification was provided that what had taken place was a reduction as had been done in the past, not the stopping of a service, in advance of the service moving to the new surgical centre. Analysis had indicated that the bed closures had made no impact on A&E waiting times. A benefit that had been overlooked in the press was that the closure of a ward allowed staff to be redeployed onto other wards.

Whether communications with patients and staff had been appropriate

Contextually, the voluntary redundancies and bed closures amounted to 20% of savings challenge for the Trust, with the remaining 80% from improvements in other area. The NHS regulator required the Trust to resolve its funding gap this year, including the use of temporary funding, which would allow the Trust to better participate in the Stockport Together programme.

The measures being discussed were not service changes, and should be imperceptible to patients. The Trust had designed a consultation and communication plan based on previous feedback from staff, and had initially met with 200 line managers to explain the situation, and tasked them with communicating directly with their staff, but once the initial briefings had taken place it was difficult to control the sharing of information. Stakeholders were also informed promptly after this initial round.

The Stockport Together programme had highlighted the funding deficit in health and social care, and the financial challenges facing the Trust and the Financial Improvement Programme had also been the subject of public discussion at Scrutiny etc.

What the worst case scenario would be should the Trust not be able to contain costs and reduce demand

The future of the Trust in this scenario was not the real concern but the impact on care. In light of the hard work being undertaken it was anticipated that the savings would be achieved.

Clarification on the tariff deflators and activity to reduce admissions/ demand

Year on year the amount the Trust could charge the NHS for activity was reducing, but the costs to the hospital associated with this activity would increase. The situation faced by the Trust was no appreciably different to other Trusts.

The Trust’s performance in relation to admissions was an outlier, but there was also a lack of alternatives to admission. Stockport Together sought to address this through providing alternative and more appropriate care.

The impact of Healthier Together on the Trust’s finances

As no significant implementation of the Healthier Together decision had taken place there was currently no impact. Once the implementation began it was expected that there would be a marginally beneficial impact on finances due to the increased concentration of higher tariffed treatment.

RESOLVED – That Ann Barnes and James Sumner be thanked for their attendance.