Surge in QA patients blamed for £3m overspend

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THE trust that runs Portsmouth’s Queen Alexandra hospital is under new financial pressure after seeing an unprecedented surge in patients.

According to August board reports, Portsmouth Hospitals NHS Trust is £6.9m in debt – £3.1m more than it had thought it would be in at this stage in the financial year.

It had been forecast to be in £3.8m in debt, but this has almost doubled because of an influx of patients coming to the emergency department.

In the last financial year of 2011/12, there were 43,137 patients who went into A&E.

The figure for the current financial year, which started in April, shows 44,869 have already visited the emergency department.

As previously reported in The News, the trust has been taking on more agency staff to meet the demand, which has caused a much higher spend on pay than expected.

The trust negotiates how much money it needs by predicting how many patients are likely to be treated at QA. That prediction goes to primary care trusts, which commission services.

Steve Gooch, deputy director of finance for PHT, said: ‘We have a contract with commissioners and we will negotiate and try to predict what levels of activity we will have.

‘But we have seen more activity in the emergency department than we had planned.

‘This puts more financial strain on the trust as it said it has to open more wards, buy in more drugs and pay for more staff – all things that add to the pay bill.’

The trust said it also faces pressure as it gets less money from commissioners to provide services than it needs.

‘Our prices are set by the Department of Health, which is one of the reasons why we’re in a deficit,’ added Mr Gooch.

‘We get paid on a per-patient basis and the pressure the trust faces is every year the prices are cut.

‘We have a contract and prices are set nationally – tariffs which are being reduced every year.

‘If we do the same number of patients, our prices have gone down, but the costs to provide the service are going up.

‘We have to put on more staff, the price of drugs goes up, and it goes on like that.

‘So if we had £5,000 last year, then this year we have £4,950, even though we are doing the same amount of work we are getting paid less for it.’

The trust has introduced a raft of measures designed to claw back the deficit – and the trust insists it will have a £4.3m surplus by the end of the financial year next March.

It is looking to hire more full-time staff and reduce using more expensive agency staff, will take steps to ensure it is getting the best deal on clinical supplies and is working with community healthcare providers to make sure patients are going to the right places to ease the burden on A&E.

Penny Mordaunt, MP for Portsmouth North, said she was not convinced enough is being done to sort the situation out.

She said: ‘Although I recognise the health budgets are protected, PHT faces major challenges to become more efficient.

‘Every other institution operates on the same tariff system.

‘It doesn’t add up and I will be meeting up with trust members.

‘I’m sceptical that everything is being done to get the financial management under better control.

‘There isn’t continuous progress exhibited. The trust should be constantly looking at best deals and how administrative costs can be reduced and how new money can be brought in.’

The amount of debt could affect the trust’s bid to get foundation trust status, which if achieved would give the trust more control over budgets and services provided.

Monitor is an independent regulator of trusts applying to become foundation trusts.

One of the criteria Monitor looks for is proof that a trust is financially stable. It looks for a minimum score of three on its scale – but PHT currently has an average score of just 1.35. Mike Hancock, MP for Portsmouth South, said: ‘It is disappointing on both accounts – that the trust is in debt, and that this could impact on its bid to become a foundation trust.

‘But if the trust is paying staff, then it doesn’t have much choice.

‘I would rather see staff in the hospital than keep the debt down by losing staff.

‘The trust needs to make a special case to Monitor about its plight.’