Agenda item

The Health Partnerships Overview and Scrutiny Committee has asked for a report from North West London Hospitals NHS Trust on its budget position for 2011/12. This follows concerns about the level of savings that the trust will be required to make during the financial year. Members should consider the presentation by the Chief Executive of the hospital trust and consider how the cost pressures will affect services provided by the trust. In particular, members should ask questions around the savings plan that will be implemented to make £18.55m of savings, and how these will be delivered. 

Fiona Wise began by advising that the budget and plan was yet to be formally agreed by the Department for Health.  An underlying deficit remained and the report explained why the budget gap had widened in 2010/11 compared to 2009/10, with the deficit now at £11.6m.  This was partly attributable to the loss of non-recurring funding, including Urgent Care Centre funding.  Fiona Wise drew Members’ attention to the savings proposed to reduce the deficit as set out in the report.

During discussion, Councillor Hunter asked if service delivery could be maintained in the face of the savings that were proposed.  Councillor Daly sought further details of what kind of efficiency savings would be made and commented that reducing in-patient time may increase the risk of patient admissions.  Councillor Cheese also felt that this was a risk and that such a measure may be rendered a false economy.  Councillor RS Patel enquired whether consideration had been given to merging the Trust with Ealing NHS in order to help achieve savings.  Councillor Colwill suggested that Government funding for frontline health services had been offered and he enquired why it was not being used for this purpose.

The Chair enquired how certain was the Trust that it could achieve £9.7m savings through the Annual Plan and she asked for an update on this item at the 29 November meeting.

In response, Fiona Wise stated that it was not intended to make all the savings required in one year as a balance needed to be maintained between maintaining service delivery and achieving savings.  Efficiency savings measures included shortening the length of hospital stay for patients, re-organising staff rotas and reducing management overheads.  Every effort was being made to minimise redundancies.  Fiona Wise acknowledged that reducing patients’ length of stay could increase the risk of re-submissions, however consideration needed to be given as to what the optimum length of stay is for each patient and many patients in any case wanted to return home at the earliest opportunity.  She cited developments in best medical practice with regard to this issue, such as patients who had knee operations whose recommended length of stay in hospital had been reduced from ten to four days.  The STARS scheme also addressed the issue of reducing the number of beds to increase efficiency and effectiveness whilst also reducing costs.  Strict rules were in place with regard to administrating medication, ensuring patients were appropriately supervised and carrying out patient checks.  In addition, comfort rounds were conducted every two hours to ensure patients’ needs were being met.  Fiona Wise was confident that the £9.7m Annual Plan savings could be achieved providing the conditions set down were adhered to.

Rob Larkman added that consideration of more radical ways of working was needed to both increase efficiency and achieve the required savings.  In addition, the ever changing population of the area needed to be taken into account. 

Alison Elliott (Director of Adult Social Care) advised that in relation to the Government funding referred to by Councillor Colwill, the pot of money was not ring fenced and that £3.24m had been allocated to Adult Social Care from Health to help address the council’s priorities.  The council was working with NHS Brent and Harrow to introduce preventative measures to reduce the number of patients requiring hospital treatment.  Adult Social Care and NHS Brent faced huge challenges and Alison Elliott stated that the committee would be informed of how the discussions between the two organisations were progressing.

Members noted that informal discussions were taking place with regard to the possibility of considering a merger with Ealing NHS and update on this would be presented at a future meeting.