NHS Finance

07.08.18

CEO at cash-poor trust ‘did not grasp’ severity of financial crisis, damning review says

A destructive review into the management and finances of an Essex NHS trust condemned the “clear lack of financial grip” of the provider’s management of cash.

An external Deloitte review into Barking, Havering, and Redbridge University Hospitals NHS Trust was commissioned by NHS Improvement after the trust was placed into financial special measures following the “rapid deterioration” of its books in February. Prior to the decision, the north London trust had been taken out of special measures in March last year after three years stuck in the recovery programme.

The review of the trust— which controls both Queen’s Hospital in Romford and King George Hospital in Goodmayes— highlighted a range of factors including low levels of transparency in financial reporting, poor escalation of risks to the Operational Management Group (OMG), weaknesses in board oversight, and an absence of proactive chief executive leadership.

CEO Matthew Hopkins— who stepped down from the role on 26 July— was particularly criticised by the scathing report: upon returning from sick leave in September 2017, despite being “specifically alerted” to the looming financial crisis of the trust, Hopkins “did not appear to grasp the severity of the situation” and did not take a proactive leadership approach to managing the ongoing issue, the review said.

It added: “The fact that the CEO did not grasp and respond to the severity of the situation, coupled with the lack of pace in subsequently driving the Trust Financial Recovery Plan and low levels of contribution to the finance agenda in observed meetings, raises concerns regarding the CEO’s ability to lead financial turnaround at the trust.

“As such, whilst recognising the excellent qualities the CEO has brought to the trust, we believe that a different skill set is required to lead the organisation out of financial special measures.”

Deloitte also pointed out a “level of silo working” across executive director portfolios, highlighting a lack of a collective ED response to the to the urgent financial situation outlined by the interim CEO in August 2017.

Additionally, the review blasted the response of the entire trust board, which argued: “The board post October 2017 has lacked grip, pace and clear leadership. We also have concerns over the depth and breadth of the NED [non-executive director] group, based on performance over the last several months, to drive this change and believe that the group needs strengthened through a combination of bringing fresh perspective and developing existing NEDs.”

There was a “clear lack of financial grip” at the operational level of the trust, the consultancy company noted, as it called for a greater focus on supporting and developing senior leaders to promote ownership and accountability for delivery of services.

Joe Fielder, chair of the trust, and Chris Bown, interim chief executive, said: “We have already made significant improvements in our financial processes, controls and governance. Many of these changes were recommended in an independent report by Grant Thornton that was published in April. We commissioned them to investigate why we had experienced a severe cash shortfall.

“We have brought in external expertise to help us put in place a financial improvement plan which has been signed off by our Board and by NHS Improvement. Our staff understand the problems we face and are responding well to the challenge.

“We remain focused on providing the best possible care to our patients while also tackling our financial deficit to ensure our Trust becomes sustainable."

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