99 Job Cuts & 2 Ward Closures @ Scarborough Hospital in Cards?
Scarborough Evening News Reports..... NINETY-NINE jobs could be cut at Scarborough Hospital as it meets demands to balance the books, the Evening News can reveal today. Leaked documents and correspondence in our possession show the full dramatic extent of the cash crisis - and pressures on the health trust to get out of the red by £7 million.
The key options would see the loss of 99 jobs, including medical and clerical staff through cuts, reductions or non-replacement, and the closure of two wards.
An internal briefing document for consultants dated August 31 says: "This is our last chance to remain in control of our own destiny. If we don't do it for ourselves, others will do it for us."
The financial ultimatum hangs over the hospital following pressure from the Audit Commission. A letter distributed among consultants, dated August 17, adds: "If, as a trust, we are not able to deliver the financial savings required within the next two to three months there is little doubt that external agents will be brought in to remedy this."
The possible savings include:reduction of 99 posts through staff turnover and non-replacement; closing two hospital wards, not named; reducing the number of midwives; cutting back on the use of "locum" doctors brought in for weekend cover, sometimes from abroad; cuts in agency nurses; reducing the amount of hours of consultants and junior doctors.
Accountants PriceWaterhouseCoopers were brought in to review the finances.
The trust employs 63 midwives on an average salary of £27,000. It says this figure is above the national average and needs to be looked at. The midwives deliver 1,700 babies a year.
Richard Grunwell, chairman of the hospital trust board said: "The report needs to be viewed in context and the proposals are suggestions about the kind of options we need to be considering."
The accountants' report also proposes closing Bridlington for emergency admissions and transferring related activity to Scarborough, and shutting operating theatres at Whitby and Malton hospitals.
Former hospital boss Alison Guy and finance chief Bernard Flynn were relieved of their duties on July 11 after the Trust was told not enough was being done to sort out the cash crisis.
* What do you think? Do you work at the hospital? How is morale following the announcement?
Contact Mick Pilling E-mail: [email protected]
The consultant briefing from the Trust Consultant Briefing - 31 August 1 General knowledge that over past several years Trust financial performance has underperformed versus both plan and expectations.
* Profit improvement initiatives designed, but not driven and completed
* Challenge of changing work practices and continuing under delivery
* General frustration, disillusionment plus revolving doors at senior management level.
3 Based on recent financial performance and new DoH/Treasury financial mandates we are now designated as formal turnaround status with delivery of an exacting plan to PCT and SHA by 11 September
8 As absolute minimum, return to break-even by year-end
* Represents a saving challenge of £11.5M for FY07 in-year balance (assumes SLA at PBR)
* Depending on results of SLA negotiations with PCT, gap gap increases to £15.8M-£20M
* When FY05 and FY06 deficits are factored in, performance gap widens to £24M-£32.5M
* Hopefully, recovery of £12.5M historical deficit can be rolled over to FY08.
4 So far, possible in-year savings of £6.2M have been identified with PWC and the in-house SNEY team
* Need to challenge robustness of assumptions which may increase/decrease numbers - but minimum gap of further £5.3M to find
* We have 2 weeks to identify and validate new opportunities
5 Therefore a major challenge remains before us which requires radical thinking and total teamwork/commitment
* Financial target of break-even at minimum is mandated and non-negotiable
* If we don't achieve it ourselves, others will do it for us
* This is our last chance to remain in control of our own destiny through a combination of
- Radical thinking
- Personal and professional sense of ownership and the will to manage implementation of radical solutions
- Leadership and the inspiration of our colleagues
* United we stand, divided we fail.
6 What's new and/or different to change the outcome this time
* PWC is appointed as turnaround advisor to SHA, PCT and SNEY
* Cross patch turnaround Directors all known to PWC, so joined at hip and thigh
* New Restructuring of SHA and PCT encourages mutual co-operation and open-mindedness with no shackles to the past
* Appointment of new SNEY CEO and DoF with strong skills and turnaround experience
* Provision of organisation structure with associated financial metrics
* Successful turnaround the critical next stop to achieving Foundation status
* Failure is unacceptable
7 You and your colleagues are absolutely critical to the Trust's successful recovery and we wish to place you at the heart of this joint new enterprise
* Where do you see the real opportunities
* How do we mobilise the consultant cohorts to drive enhanced productivity and profitability
* Are you up to the challenge.
8 Requirements for joining the turnaround team are as follows
* Missionary zeal and determination
* Out of the box thinking and vision
* Challenging received wisdom/practice
* Disciplined thinking, planning, analysis and execution
* Leadership and powers of persuasion
* Commitment of around 50% of time to the project and arrangement of cover/backfill
Letter to trust staff The letter below has been sent out to the Trust staff as a financial update from KG Brame, Divisional Clinical Director for Surgery
Most of you will no doubt be aware that we are now officially in "turnaround". A Turnaround Director has now been appointed from outside the Trust to ensure that financial balance is achieved in the current year and that strategies are developed to ensure financial stability in the future. This situation has arisen from the Audit Commission's review of the Trust's finances over the previous two financial years which have resulted in them issuing a Public Interest Report criticising the Trust's financial governance arrangements.
Despite the cost improvement programmes put in place over the previous financial year (05/06), the draft accounts showed a deficit for the year of £7.3 million which on revision by the auditors has risen to £8.9 million. This deficit will have to be repaid and built into future financial recovery programmes. The draft budget for this financial year based on a projected income of approximately £89 million contains an unidentified savings programme of approximately £5.4 million. Unfortunately our main commissioners, Scarborough Whitby and Ryedale PCT (SWR PCT), are still in negotiations with the Trust regarding the Service Level Agreement and commissioning levels for this financial year. We were expecting, as in the previous two years, to receive an income of approximately £59 million from SWR PCT but owing to their financial deficit they are attempting to reduce commissioning levels with the Trust by £8 million to £51 million. This will clearly have a further adverse effect on the Trust's finances and produce a potential deficit of up to £13.8 million.
Failure to achieve financial balance is not an option. As a result of this various workstreams are being introduced to deliver the necessary savings required through a comprehensive turnaround plan. This is likely to involve significant service reconfiguration and reorganisation in order to achieve any form of future financial stability and this will have to be achieved with the co-operation of our local PCT's and SHA. The timescale for realising the necessary savings is extremely tight as we are already nearly half way through the present financial year and the Turnaround Director will be expected to report tangible improvements in our budget situation by mid-September. If, as a Trust, we are not able to deliver the financial savings required within the next two to three months, there is little doubt that external agents will be brought in to remedy this.
This is going to be an extremely difficult time for all of us working in the Trust and it is extremely frustrating when, despite years of under-funding, we have still managed to perform well against all the clinical targets set and already have one of the lowest cost bases of any acute trust in the country. On a positive note, however, we should benefit from the continued introduction of payments by results and practice based commissioning over the next three years providing our present commissioning levels are maintained.
The present acting Chief Executive, Mike Potts, and Finance Director, Bryan Machin, are due to leave the Trust by the end of August and at present we are unaware as to what arrangements will be made following their departure. I will keep you informed of further developments as they arise.
KG Brame
Divisional Clinical Director for Surgery