Health chiefs get grilling

AROUND 250 people attended last night's meeting in the Spa Grand Hall to hear the boss of Scarborough Health Trust explain the latest position about medical services in the town. Members of the public joined consultants, nursing staff, GPs, councillors and other campaigners fighting to maintain an acceptable level of health services in the area – to voice their concerns publicly.

The meeting had been organised by North Yorkshire County Council's scrutiny of health committee.

Chairman John Blackie was scathing in his criticism of Janet Soo Chung, the chief executive of North Yorkshire and York Primary Care Trust, PCT and Claire Wood, the boss of East Yorkshire PCT for refusing to attend last night's meeting.

He said: "It shows that they are afraid to face local people and instead choose to run away from them."

Ian Renwick, a consultant radiologist at Scarborough Hospital said Dr Soo-Chung should "consider her position" after refusing to come and address the meeting.

Ian McInnes, chief executive of Scarborough and North East Yorkshire Healthcare NHS Trust, told the meeting that the local health trust was on the road to "financial recovery" following the decision by the Strategic Health Authority to "suspend" the trusts historic debt of £20.7 million.

He said: "And I hope that we never find ourselves in this position again."

Leo McGrory, chairman of the local patient and public forum said that unless the issue of year on year underfunding was resolved the trust "might well find itself back in that position."

Mr McGrory also told Mr McInnes that consultation with members of staff had to improve, he said: "The recent months have been very stressful for staff and I would urge a meaningful dialogue with them as you look to make the savings you say are still necessary."

Mr McGrory also appealed to members of the public to take a greater interest in how the health trust was run in the future.
At the end of the meeting Cllr Blackie said he would write to the two PCT bosses saying how "surprised and appalled" at their lack of attendance and that he would also write to the boss of the Strategic Health Authority asking for clarification of the status of the trust's historic debt.

Breakthrough on our Financial Plans

A major step forward has been made on the next stage of our financial strategy.

A new approach to the Trust s historic debt has been agreed following negotiation between Chief Exec Iain McInnes and the Strategic Health Authority. This has enabled us to develop a strategy that will take us back into financial balance and secure the future of safe, high quality NHS care for local people.

Chief Exec, Iain McInnes, said: Over the summer we have worked hard to secure the long-term future of high quality NHS care for people in this area. We had identified two fundamental problems to address: firstly, a historic debt of £20.7m. This was money spent by the Hospital Trust that we did not have. And secondly, we need to live within our financial means year upon year.

Following negotiations with the Strategic Health Authority, they have agreed that the Trust s historic debt does not have to be addressed as part of this financial strategy. Providing we deliver on the obligations set out below we will not be required to make repayments which in anyway adversely impact on clinical services now or in the future.

The Strategic Health Authority have agreed to this arrangement provided that the Trust returns to year-in-year balance, delivers on all our contractual arrangements and makes efficiency savings of 2.5%. These are the same conditions that every other NHS Trust are being asked to observe. To return to in-year balance we needed to identify a £10.5m saving this year. I am delighted to tell you that the Trust has already identified plans to save £8m over the summer. These plans include reducing unnecessary overnight stays, using natural staff turnover, cutting down the number of temporary staff we use and better financial management. These plans will be discussed at the Trust Board meeting on 11 September. We are now engaged in identifying the final £2m of savings this year and assessing the scope for further efficiencies.

These plans offer the best possible solution to a long-term problem that must be addressed. We have looked to minimise the impact on staff and have looked to mitigate any changes to frontline staff. Although we can t rule out making compulsory redundancies, every effort will be made to ensure that they are not necessary. Thanks to our agreement and the efficiency savings we have identified any role changes will not be of the scale previously reported in the media, for example the £2m which remains to be found this year would equate to approximately 50 posts. We are optimistic that, if required, these posts could be found from non-clinical roles in the Trust.

I have called for an immediate review of all nonclinical roles within the Trust but we will continue to work with the unions and our staff through this difficult time and I thank everyone associated with their trust for the help in doing this so far. Yorkshire and the Humber Strategic Health Authority Chief executive, Margaret Edwards, said: We are committed to providing the highest quality of patient care and have a duty to ensure taxpayers in Yorkshire and Humber receive the best possible value for their investment in the NHS.

Provided that the Trust deliver on their agreed obligations we will not be requiring them to make repayments which adversely impact on clinical services now or in the future.

Following my discussions with their Chief Executive, I am confident they are moving in the right direction and that is why we have reached this agreement with the Trust.

Dr Janet Soo-Chung, Chief Executive of North Yorkshire and York PCT commented: All NHS organisations in North Yorkshire are working hard to establish a stable financial platform on which to develop NHS services that meet the changing needs of our population.

North Yorkshire and York PCT have been fully engaged in the planning process and are supportive of the schemes being tabled. As a commissioner of services our responsibility is to ensure that our population can access high quality healthcare that is tailored to their need. As part of this approach we are continuing to work with our providers to develop more community based healthcare services to allow people to be treated closer to their homes, which is often better for patients, their families and carers. It also allows our colleagues in acute hospitals to focus on developing their services for those patients who require that higher level of specialist care. This will ensure the people of North Yorkshire can benefit from future developments in what is a fast changing healthcare system.

TRUST BOARD DISCUSSIONS

Our Trust Board discussed the next stages in its Financial Strategy at its public meeting on Tuesday (11/09/07). Last week it was revealed that a major step forward has been made on the next stage of our financial strategy, after a new approach to the historic debt was agreed with the SHA. This confirmed that our historic debt does not have to be addressed as part of this financial strategy provided that we return to year-in-year balance; deliver on all contractual arrangements; and make efficiency savings of 2.5%. As long as these criteria are met, the Trust will not be required to make repayments which in any way adversely impact on clinical services now or in the future.

Chief Exec Iain McInnes, said: These plans offer the best possible solution to a long-term problem. We will look to minimise the impact on staff and patients, and although we can't entirely rule out making compulsory redundancies, every effort will be made to ensure that these are minimised or avoided.

On Bridlington Hospital , he added: The future of Bridlington Hospital has been the subject of an extended Public Consultation during which we have taken into account many views. As a result of this, we plan to increase day case surgery at Bridlington; we continue to seek a sustainable way forward to re-establish the 24 hour Minor Injury Service; and we will introduce an Emergency Medicine consultant-led assessment service very soon. All of these are very positive developments for the future of NHS health services in the Bridlington area.

"We are particularly grateful that National Emergency Care Tsar Professor Sir George Alberti has visited on more than one occasion to offer his clinical opinion and share his expertise. The developing thinking, on grounds of patient safety and clinical support available, is that the current level of acute medicine, including cardiac care, is really no longer appropriate. A detailed recommendation will be put to the board later in the year.

In the conclusion to his report, National Emergency Care Clinical Tsar Professor Sir George Alberti says: It is obvious that changes in acute medical services at Bridlington are vital on the grounds of safety and quality. The current physicians have done an excellent job but the position is not sustainable.

Concluded Iain: Patient safety and care are our top priority and have been non-negotiable throughout this process. All our decisions have been, and will continue to be, thoroughly considered and approved by the clinical staff on the independent clinical advisory group.