The Norfolk and Norwich University Hospital trust will be allowed to miss NHS targets, having been placed in special financial measures NHS Improvement has announced. Fines will be abolished for waiting time target failures in Accident and Emergency, cancer and routine operations. Hospitals will be given individual targets for improving standards, enabling them to qualify for NHS funding without achieving official NHS targets.
Currently, hospitals can be fined for not meeting NHS waiting time targets of four hours for A&E, 62 days for cancer treatment and 18 weeks for routine operations. Instead of having to meet these national targets, NNUH will now only have to improve on current performance standards to receive NHS funding and investment.
More than 50 hospital trusts in England have been placed into special measures a decision that Jim Mackey, the Chief Executive of NHS Improvement, says “will help restore financial discipline and ensure ongoing financial sustainability in the NHS.”
The new system will start immediately at NNUH, along with the North Bristol, Maidstone and Tunbridge Wells, Croydon Health Services, and Barts Health trust. Hospitals under these trusts will now be subject to a review and to discussions on strategies on how to financially recover. More than a dozen other trusts have been threatened with an immediate implementation of special measures.
Despite being named the most efficient acute teaching hospital in England in May, Chief Executive Mark Davies recognises the hospital’s problems. He commented that he was “determined to improve the financial position while ensuring the best possible quality of care for patients is maintained.” “Our staff are doing an amazing job but they are under significant daily pressure which is not sustainable.”
Davies said that the demand NNUH is experiencing is “rising relentlessly” with more patients being treated who need “more complex care.”
He also stressed that this problem was not unique to Norwich; “the vast majority” of similar hospitals are in a deficit and, according to Mr Davies, many other trusts are “facing the same issue.”
95 per cent of acute hospital trusts are in deficit, with only seven out of 138 hospitals in England in surplus profits according to 2015-16 accounts covering the April – December period.
The lobby group Patients Association has condemned the changes. Katherine Murphy, Chief Executive of the charity said that it signified a “slippery slope” backwards to “old days of never-ending waiting times and uncertainty.”
In May it was announced that the Norfolk and Norwich University Hospital would be appointing a financial turnaround director to work with NHS Improvement to decide a courses of both short and long term action to help make savings.
At the time, Davies the Chief Executive of N&N said he was glad to see that the “trust successfully applied to be part of a voluntary national programme run by NHS Improvement,” and said the hospital was “keen to benefit from the expert support that this will provide.”
The announcement by NHS Improvement and NHS England comes after a recent report from the Health Select Committee which claimed plans to tackle the huge financial pressures faced by the NHS are not on track to meet their targets.
The Health Select Committee said that in the context of large increases in demand and costs they were “not confident that the efficiency challenge is achievable.”
“We are concerned about the failure to plan for the consequences if the current plan for savings is not achieved.”
They concluded, “Years of squeezing more and more out of an overstretched workforce has left the NHS in a perilous position. Long term, sustained investment is the only way to ensure our health and care system can cope with the challenges ahead.”
A second year UEA medical student commented on the decision: “I don’t know if this will really affect us, as medical students are essentially unpaid labour for the hospital”. Another medical student, who also wished to remain anonymous, said they were “concerned about the ongoing financial pressures placed on the NHS and the NNUH”. They stated that “special measures make hospitals more vulnerable to implementing the junior doctors contract, which is designed to save money by overworking doctors and putting patients at risk”.
Clive Lewis, Labour MP for Norwich South said that Tories should not blame local NHS managers. He continued, “this is a direct result of a profound crisis in our NHS, made in Downing Street. There are many, many NHS Trusts across the country deeply in the red – including our local mental health trust.
“The reason is simple – national NHS funding is failing to keep pace with soaring demand. And to make things worse, the Tories’ decision to take the axe to funding for Adult Social Care and Out of Hours Services and doing nothing to prevent General Practice hemorrhaging experienced GPs is leaving ill and vulnerable people with no-where else to go but the local hospital.”
He blamed bankers, saying “[they]are getting an extra £3.5bn per year after the Tories axed tax on their bonuses, at the last budget Osborne’s Capital Gains Tax cut gave £3,000 each to the richest 0.3% and £35 billion is lost yearly as companies and individuals are allowed to avoid tax to just not pay up.
“No doubt we’ll be hearing local Tory MPs trying to pass the buck for their NHS failures onto ‘failing local management’. I say to them it is in your hands to properly fund our local health service instead of lining the back pockets of the already wealthy.”
Chloe Smith, MP for Norwich North, called the plan “sensible” and praised efforts to support hospitals facing financial challenges: “This plan is meant to restore financial discipline and ensure ongoing financial sustainability across the whole NHS. Norwich patients should look to the N&N to improve management and patient care and work with the rest of the NHS system to make best use of resources.”
BMA MSC Representative Victoria Lawlor said that because the role of medical students is primarily an observational one, it wouldn’t have a “major effect” on medical students during their placement. However, she added, “it is an indication of the increasing demand in an already-underresourced NHS in the area.”
UEA Med Soc committee said, “For medical students the N&N continues to provide a very good opportunity to learn.”