TRUST BOARD DECISIONS PLUS Q&As
At yesterdays meeting of the Trust Board, the Board gave approval to two significant agenda items: the Financial Strategy for 2007-2010, and the Maternity Services paper, which proposes that we develop a home-from-home midwife-led unit in Scarborough for women from across the Trust area. The financial strategy describes the scale of the financial challenge we have to address and sets out the task before us. The financial situation has been known for some time the financial strategy consolidates the tasks ahead and approach to resolve these difficulties. Rather than make rash, hasty cuts we are involving our clinicians in developing detailed plans for change and we are reviewing the numbers of staff across the whole of the Trust to achieve savings in a managed way that protects patient safety. We need to reduce our expenditure by £28 million over the next three years or find some new income. We anticipate being able to achieve this by improving the efficiency of the hospital and reshaping the workforce to reflect future demand. This financial strategy will help Scarborough and North East Yorkshire Healthcare NHS Trust become a leaner, stronger, more efficient trust. It is a major change programme that will result in a stronger local service for our patients. The strategy has raised many questions amongst staff, some of which are answered below. If you have any other questions, there will be the opportunity to ask these at future staff meetings, which will be held every two weeks until further notice; or send them to any of our directors, or, if you prefer to remain anonymous, send them either by internal post addressed to Questions, Trust HQ , or go to www.scarborough.nhs.uk and use the form under contact us/feedback, leaving the name/ contact details blank. Implementation plans for the Financial Strategy are currently being formulated, and more detailed proposals will be submitted to the next public meeting of the Trust Board, which will be held on 11th September.

FINANCIAL STRATEGY: SOME QUESTIONS ANSWERED
Is this just about saving money? No. Our number one priority is safe clinical care. But we can t disregard our obligation to spend public money your money and my money responsibly and efficiently.

Wouldn't it be better all round if the Trust was merged with another one? A Trust with financial problems would not be merged, it would be acquired that is, taken over . Local healthcare is best is locally anaged by a strong team: that is our intention.

Being taken over by another trust would mean services centralised away from Scarborough and Bridlington. By strengthening this Trust, we can retain the broad range of core NHS services that local people most need, provided close to their homes. We need to adapt to the current healthcare requirements: we must become a smaller, more responsive, more efficient, more accountable organisation. And the process of adaptation must become part of our culture once we have our finances under control. Standing still is not an option.

How many staff are going to be made redundant? For the Trust to be the right size for current and future needs, we should be working more efficiently and with 600 fewer positions across the Trust. We will still employ over 1500 staff. Before we consider redundancies we will looked at all the alternatives including natural turnover of staff as well as reducing overtime and the use of temporary staff. Natural turnover of staff can account for over 200 positions per year. We'll be holding talks with other NHS organisations to see if other opportunities exist for staff who wish to leave. Once these avenues have been followed we will look at early retirements, only then will we start to look at voluntary redundancies, with compulsory redundancies a very last resort. How can the Trust function with fewer staff? The number of staff we need is determined by the number of patients who come through our doors. For trusts providing secondary care, such as us, that number is decreasing. At one end of the scale, more patients are seen in a primary care setting. At the other end of the scale, more work is taking place in specialist centres. When people are admitted here most are here for a shorter time than previously, because of improved drugs, or less invasive procedures, or because they move into the community with support.

All these factors result in the same outcome: we need fewer beds than in the past, because the work we re- doing is not the same as in the past. In addition to these changes a review will examine the future requirements for non clinical staff.

Will nurses and doctors go, too? We need a structure that is configured to reflect the number of patients we will see; the conditions we treat and the procedures we will perform. Staffing levels cannot stay constant when patient numbers are falling. We will reduce posts in non-clinical areas first but fewer patients in fewer beds will require fewer clinical staff to care for them.

Why doesn t the Trust get rid of managers? Managers will not be immune to the job cuts. Spending on management is a very small percentage of Trust income less than 6%, and some of these managers also have clinical responsibilities. Putting good management in place, however, is part of the solution.

Why aren t the managers responsible for the financial problems being held accountable? The previous Chair, Chief Executive and Director of Finance carried the ultimate responsibility for management, governance and performance standards: all have now left the Trust. We now have a substantially new Trust Board to lead the organisation forwards. We have the basis of a new, strong team and it s time to look forward, not back.

Will all these cutbacks mean longer waits? This Trust has done well on treating patients quickly, but needs to be more efficient in its spending of public money. With careful management we can make sure we use our resources more efficiently and meet targets.

Will Bridlington Hospital close? No. Bridlington Hospital provides a range of important services. Bridlington and Scarborough are a single Trust, and we have to get the overall provision right.

Aren't both hospitals sometimes full? Changing for the future means ensuring we offer the best possible modern care for patients. If we keep patients in for too long by bringing them in too early, admitting them when they need not be admitted, or keeping them too long we re not only using too many bed-days, we re not doing our best by the patient. Patient care is always our priority and an efficient Trust is good news for patients.