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NHSI places trust into financial special measures following ‘rapid deterioration’ of finances

NHS Improvement (NHSI) has decided to place Barking, Havering and Redbridge University Hospitals NHS Trust into financial special measures.

The move comes less than a year after the trust was taken out of special measures, as three years ago the CQC placed it in special measures when inspectors raised safety concerns.

The NHS body says that it has made the decision after the trust reported a “rapid and significant deterioration in its in year finances.”

When establishing whether a provider can be placed into special measure, NHSI looks at whether the provider has not agreed a control total and is planning a deficit for the year; if it has agreed a total and has significant variance against the control total plan, and is forecasting a significant deficit; and whether the provider has an exceptional financial governance failure, such as significant fraud or irregularity.

In order to be eligible for financial special measures, the trust must meet one of these criteria – NHSI has not specified in its announcement which criteria the trust met.

A financial improvement director has been appointed to provide the trust with additional help and oversight.

The trust will be required to draw up and deliver a plan to improve its finances, which NHSI will closely monitor.

In order to leave special measures the trust will need to demonstrate rapidly that it is returning to a robust financial recovery plan.

Ian Dalton, chief executive of NHSI, said that the organisation is concerned about “the speed and pace” of the trust’s financial decline, and so is “taking quick action to prevent the financial situation getting worse.”

He added: “Our action is designed to give the trust the immediate and direct intensive support to rapidly improve its finances, while continuing to provide the safe, high quality care its patients deserve.”

A joint statement from Joe Fielder, chair of the trust, and Matthew Hopkins, its chief executive, explained: “We reported last year that we were experiencing financial difficulties, which first came to light in the second half of the year when it became clear that our cash flow, and overall financial position, were not as healthy as had been reported.”

They added: “There are several reasons for the deterioration in our position, including an absence of thorough oversight, a loss of financial control, and increased demand on our services.

“All of this combined has meant that we were not able to secure a large sum of performance-related income.”

In addition, Fielder and Hopkins said that the trust has been unable to agree its contract with its commissioners, who are also under “severe financial pressure at the moment.”

They pointed out that the move is not a reflection of the care that the trust provides, stating that it has made “huge improvements across the board,” which they said have been acknowledged by NHS England, NHSI and the CQC.

Top image: Chris Radburn PA Archive

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John G   14/02/2018 at 15:45

I have a question: Will the appointed 'Financial Improvement Director' be paid for by deduction from existing failing management salaries, in particular the Trust Chairman and CEO? If not then why not?

Nona   14/02/2018 at 16:29

There are trusts in the Essex fast deteriorating and not delivering their control totals as well. These also have so called improvement directors yet their deficits have more than doubled in a year. Improvement directors or turnaround directors are over paid consultants who come in and have little or no impact; they come in bring a few of their friends along as PMs for a few months and get paid exorbitant fees for not very much. Financial governance is poor across many trusts and a longer term solution that would impact on culture is in dire need.

Julia A   16/02/2018 at 22:14

I agree with Nona. It's all a waste of money. There is no consultant that can make the nhs work. We are providing care on a shoestring. There hasn't been enough investment in prevention or long term solutions . The here and now is having to take priority.

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