£44m hospital cuts now biting

With 370 jobs to go over the next year, including nurses, moves to peg back hospital admissions look to be heralding a new era of cost cutting by the Oxford Radcliffe Hospitals NHS Trust that is expected to last for years.

And it seems that hospital staff are to pay a heavy price for ‘overperforming’ — taking in too many patients and treating them too quickly.

The seriousness of the financial position will be set out in the trust’s annual report to be published later this month, with the cost of servicing the huge loan for the new £109m cancer centre at the Churchill adding to the financial pressure.

With some consultancy sessions having to be reduced and cutbacks in agency staff planned, the spectre of longer waiting times for hospital treatment has been raised, with some patients complaining of having operations cancelled.

The trust’s finance director, Chris Hurst, said: “Because the number of people coming to the hospital has not been reduced, it has, in the short term, put a lot of pressure on staff. It is not something we are proud of.

“One option would be to increase capacity. But this leaves us with an affordability problem. What we are seeing are early symptoms of operational problems. More work is coming down the line than had been planned for with the primary health care trust.”

He said the trust currently sought to treat patients well within the 18-week waiting target, and that while the trust would still be likely to hit its Government targets, waiting times could increase.

The trust is presently faced with reducing costs by three per cent to meet Government savings demands. It has also been hit by a £5m increase in the cost of insurance for clinical negligence, while servicing the private finance initiative loans for the cancer hospital and the new children’s hospital is costing tens of millions a year — with little money coming to them as yet from selling services to other health trusts.

But it is feared the trust has become a victim of its own success, by bringing down waiting times below the Government’s 18-week target.

For this has helped fuel a big rise in patients being referred to hospital by GPs, leaving the hospitals to cope with more patients than had been planned for.

Rises in patient numbers referred from the county’s primary care trust left the ORH Trust with a £3.1m hole in its financial plan in the first two months of the year.

New initiatives will be launched in the coming weeks in a renewed bid to get GPs to “do a bit more” by treating patients themselves rather than immediately referring them to hospital.

The ORH Trust said it remained hopeful of avoiding compulsory redundancies. But a new briefing paper warned that “a significant proportion of the required cost reduction is likely to come from our wage bill”.

The paper says: “Avoiding redundancies is important. It can be costly and does not help the trust to sustain a high-quality workforce. We will use less overtime and fewer agency staff, and not all vacancies will be filled.

“The trust will need staff to be more flexible in their approach to work. We may require them to change the location they work in or the balance of the type of work they perform.”

Dr Peter Skolar, chairman of Oxfordshire’s health scrutiny committee, said that “zero waiting lists” had simply encouraged GPs to refer more patients.

He added: “It has been good for patients and good for GPs. For me the trust should actually be rewarded. Unfortunately that is not what happens in the NHS, where, if you overperform, you get less.”

Mark Ladbrooke, the county health representative of the trade union Unison, said: “Staff will find it breathtaking that jobs are going because they have been overperforming. They are being penalised for seeing patients too rapidly.

“We’ve heard that discussions are taking place about cutting operating theatre capacity at the John Radcliffe.

“We are already worried about the increased levels of stress and sickness among staff.”