Foundation trusts under “sustained and exceptional pressure”, says Monitor, plus the rest of the day’s news and comment

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4.25pm Paul Briddock, director of policy at the Healthcare Financial Management Association said: “The latest Monitor Quarter 4 performance report for Foundation Trusts demonstrates further distressing news on how the sector is performing.

  “As the new Government settles in, the demand on healthcare services continues to increase against a backdrop of ambitious efficiency targets and quality initiatives. The financial pressures are mounting as we continue to see foundation trusts report a shortfall of £349 million, with 51% of all FT’s and 70% of acute FT’s now being in deficit. Overall the sector reports an catastrophic deficit of £822 million.

“Foundation Trusts are working flat out to maintain a high level of service for the public, but the sustained operational pressures and financial constraints are making the books incredibly hard to balance in the current climate. The injection of cash pledged by the new Government will be welcomed and go some way to help the situation. But the question is how far these additional funds will take us when the deficit in the sector is so pronounced and how quickly we will see it invested. 

“The real challenge facing all those working in the sector will be how to reform and change the way the NHS delivers services and to approach the future by shaking up the way we’ve always worked in the past.”

4.00pm Commenting on Monitor’s report into the performance of the foundation trust sector, Rob Webster, chief executive of the NHS Confederation, said: “This report provides a clear indication of the pressures faced by the NHS today, with the foundation trust sector posting a year-end deficit for the first time.

“The financial issues within providers are well-documented and these figures further highlight the impact from an FT perspective.

“Sustainability in the NHS is a challenge that must be met by the whole system and we will need to see strong leadership over the next five years to meet it.

“Following the debate around the NHS during the general election, we welcome the Prime Minister’s commitment made earlier this week to find at least £8 billion extra investment in the NHS by 2019/20. We look forward to working with the Government as it develops its spending plans for health and care.

“A clear signal from the Government that it will increase funding each and every year of this Parliament will allow the NHS to focus on the tough efficiency savings required and achieve the vision set out in the Five Year Forward View. 

“The figures published today demonstrate that the NHS has a fragile settlement and that this will remain over the coming years. We will need to count on transformation funding delivered up-front and action to prevent social care from being cut, in order to prevent NHS organisations from being knocked off course. 

“Local leaders continue to work with their teams to deliver great care in the NHS each and every day. We now need to change the way care is delivered in many parts of the NHS, with new models of care, backed by strong support from national bodies and politicians over this full Parliament. This looks within our grasp if we align behind the Five Year Forward View, secure sufficient funding and back the NHS to deliver.”

3.23pm Which means that…

3.21pm HSJ’s regulation news supremo Will Hazell tweets:

3.19pm Commenting on the sector’s performance Dr David Bennett, chief executive at Monitor, said: “The last financial year was exceptionally challenging for the FT sector, and it is clear the current one is following the same pattern.  The sector can no longer afford to operate on a business as usual basis, and we all need to redouble our efforts to deliver substantial efficiency gains in order to ensure patients get the services they need.

“This will no doubt involve some significant changes to the way people work at some institutions, but as the regulator we believe there is scope for more to be done at a number of levels without compromising patient care.  Monitor is therefore stepping up its efforts to provide practical help and support to FTs that are struggling both financially and operationally.

“Foundation trusts are providing more treatment, to more patients with more complex care needs.  Therefore, it is right that, in these difficult circumstances, agency staff are used to ensure patients always get quality care,

“However, trusts should act to reduce their over-reliance on agency staff in the longer-term by improving their planning and building up their reserve staffing resources, so they can protect their finances”

3.18pm A report to Monitor’s board on the performance of the foundation trust sector - year ended 31 March 2015 found:

  • Overall, the sector reported a deficit of £349m compared to £10m planned;
  • 77 FTs (51 per cent) ended 2014/15 in deficit of whom 70 per cent were acute trusts; 
  • Trusts spent £1.8bn on contract and agency staff which is more than double the amount they had planned (£766m);
  • Trusts made £1.17bn worth of cost savings compared to £1.23bn in 2013/14;
  • The FT sector as a whole has missed the A&E waiting time target of seeing 95 per cent patients within four hours since autumn 2013/14; 
  • The size of the waiting list for routine operations reached 1.76m, an 8.3 per cent increase on 2013/14;
  • Between January and March 2015, 55,400 people waited on a trolley for more than four hours between the decision to admit them to A&E and their arrival on a ward due to reduced bed availability;
  • FT ambulance services meet the national waiting time for responding to the most critical and life threating incidents between January and March 2015;
  • Monitor intervened or agreed regulatory action at 32 trusts (21 per cent of the sector) because of operational or financial concerns

3.00pm The Department of Health today released the following statement:“We will not allow public health policy to be held to ransom by the tobacco industry.

“Smoking is the biggest preventable cause of death in England – killing 80,000 people every year. We would not have gone ahead with standardised packaging unless we had considered it to be defensible in the courts.”

2.22pm Responding to the critical CQC report out today on Barts Health Trust, Labour London Assembly Member for City and East John Biggs AM said: “There are obviously serious issues with Barts Trust that need urgent action from Government. Whilst the staff at the hospitals are doing an excellent job in tough circumstances, the CQC report identifies worrying concerns about understaffing and the number of cancelled operations at the Royal London and Newham University Hospital.

“Residents in East London need to have confidence that the Government and NHS will take urgent action to increase staffing levels and bring these hospitals up to standard.”

1.41pm A pledge by the home secretary to invest £15m in new health based places of safety to detain people experiencing mental health crisis will be funded from existing budgets, HSJ can reveal.

The money, to prevent people sectioned under the Mental Health Act from being detained in a police cell, will also only be available for 2016-17.

After then, clinical commissioning groups will be required to continue further funding of services to reduce the number of people being detained by police. Last year more than 4,000 people were detained in a police cell under the act.

1.38pm National officials have identified a stalling of improvement in the prevention of premature deaths by the English health service, with one potential cause being the NHS’s “economic challenges”.

An NHS England internal paper seen by HSJ says this prominent outcomes measure had “been improving steadily until 2010, but in 2012, 2013 and 2014 the improvement has been much more gradual”. It describes the effect as “plateauing”.

10.50am The Independent reports that the average pay of an NHS nurse has fallen over the last year, while the salaries of senior managers have risen by nearly two per cent.

According to the Health and Social Care Information Centre, average basic pay for nurses, midwives and health visitors dropped 0.2 per cent between February 2014 and February 2015, to £30,713.

In the same period, the average salary of NHS senior managers rose from £77,315 to £78,606.

Dr Peter Carter, chief executive and general secretary of the largest nurses’ union, the Royal College of Nursing (RCN), who this week warned the Government that any attacks on NHS staff’s out-of-hours pay would be a “red line” for industrial action, said that steep rises in executive pay could “poison the well” in terms of staff morale.

10.50am Looking to this morning’s newspapers, The Daily Telegraph reports that thousands of men suffering from advanced prostate cancer have been offered new hope of a cure after scientists discovered the genetic cause behind 90 per cent of tumours.

Nine out of 10 cases of late-stage prostate cancer can now be linked to changes in the DNA of sufferers. In some cases, there are already drugs to tackle those genetic defects, which are currently used to treat other cancers.

9.50am A newly published report on the performance of the NHS Trust sector from the NHS Trust Development Authority states: “In March 2015 there were 273 patients waiting longer than 52 weeks at NHS trusts, an increase of six from February 2015. 14 NHS trusts reported having over 52 week waiters in the month. North Bristol NHS Trust reported 239 of these long wait patients.”

9.46am Patrick Leahy, head of public affairs at the Royal College of Suregons tweets:

9.35am Just a quarter of the Care Quality Commission’s inspection reports have been published on time, new figures show.

According to information in the CQC’s May board papers, 26 per cent of reports under the regulator’s new inspection regime in 2014-15 were published within 50 days.

A switch to a “more robust data source” revealed that performance was worse than previously thought, with the CQC revising the figure down from 33 per cent.

7.00am Good morning….

The largest trust in the country has been rated inadequate by the Care Quality Commission, and has appointed an interim chief executive.

Barts Health Trust had already been placed in special measures following an inspection of its Whipps Cross Hospital in March.

The CQC has now published a report for the trust after inspecting its two other acute sites, The Royal London Hospital and Newham University Hospital.

The trust was found to be “inadequate” for whether services were safe, effective, responsive and well led, and “requires improvement” for caring. This is one of the worst assessments the CQC has given a trust.