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Finance
In April the Trust was £82k behind plan for the month and £185k behind its efficiency savings target. Births returned to a level close to last year’s average, but no higher, which was disappointing. 2009/10 national pay awards were reflected in staff costs with an overall impact of a 1.7% increase. Year-on-year inpatient activity rose by 4% and outpatient activity by 23%, yet NHS Clinical Income only rose by 0.8% as a consequence of the caps on what the Trust can charge for its services. On a like-for-like basis comparable to 2009/10 the Trust’s NHS Clinical Revenue would have risen by 2.7%.
The Trust is clearly facing a daunting financial challenge, reflected in prolonged discussion at its recent Board Meeting, without significant progress. A year end deficit of up to £5.3m could be risked if current trends continue.
Infections
The MRSA standard has changed. This year the Trust is only held responsible for bacteraemias diagnosed 48 hours after admission, but its target is a maximum of four cases in the year. One case was reported in April, so this will be a challenging target. The spread of Norovirus infection was recently controlled by early isolation of patients and strict infection control measures; the four cases in Drayton Ward / ITU spread no further.
Cancelled Operations
The Trust partly failed the cancellation target in 2009/10 due to bed availability, the number of over-run and complicated surgery cases, problems with instrument availability and theatre infrastructure and consultants’ sick or compassionate leave.
These problems are all being addressed, but in April 2010 twenty of 1,650 patients had operations cancelled on their day of admission, a performance of 1.2% against the target of <=0.8%. Each consultant’s list is being analysed to see if there are recurring themes to rectify. The availability of instruments has been addressed by capital investment.
Winter Planning Review 2009/10
Staff co-operation and achievement during harsh winter pressures were acknowledged at the May Board Meeting and praised. Rotas were adjusted, shifts extended, new ward rounds introduced at 5pm to allow discharge of suitable patients and transport was provided to enable staff to work during heavy snowfall. Some staff stayed in hospital overnight in order to be in place next day. Up to 50 extra beds were opened during peak demands and extra trauma lists were run in the evenings and at weekends. An emergency multi-agency taskforce assisted with discharge of patients. However, there were still heavy pressures, particularly in A&E and the Emergency Admissions Unit.
Based on the above experience, a written Winter Pressure Plan is being prepared in advance for next winter, which will be synchronised with all relevant agencies.
Winner in national MS Care Award
Alderbourne Ward staff deserves all the congratulations it has received on winning this prestigious award.
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