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1. Finance.
The overspend at the end of November was £1,394k worse than last month which is £852k worse than the expected position under the recovery plan. There has been an increasing underspend on non-acute and corporate services - the increased overspend overall is due to acute services especially those commissioned outside Hertfordshire ( Bucks. hospitals, Luton and Dunstable, Royal Free, RNOH, UCLH ).
For 2010/11 savings of £12.8M have been earmarked but no detailed plans have yet been drawn up as to how these can be implemented.
Non-executive directors expressed a lot of concern about these figures. Also concern was expressed about little or no growth in mental health provision despite a commitment for growth here.
Questions were asked about how much detailed planning can be done / would be sensible to do when no decision has yet been taken about the merger of the Herts. PCTs.
2. Performance.
28 targets are being achieved; 4 are under-achieving and 3 are failing. This last group is Chlamydia screening, Four week smoking quitters and Cancer waiting times. Report claimed that measures taken should ensure that the first 2 meet their target by the end of the year but this is not anticipated for the cancer waiting times.
Progress towards meeting targets for ambulance service and A&E are under great pressure due to the winter weather.
3. Quality.
C. Diff. and MRSA cases continue to be well below SHA targets. 60% of C. Diff. cases arise in the community not in the hospitals.
The trust is now compliant on ‘same sex accommodation’.
4. Commissioning.
Successful application to become ‘world class commissioners’ for speech, language and communication needs for 0-5 year olds.
5. Strategic Refresh Plan.
The strategic document underpinning health care in Hertfordshire is ‘Delivering Quality Healthcare for Hertfordshire’ (2007). Although many of the changes proposed in this report have been successfully implemented there was recognition that providing more care closer to home had not been achieved. This was being impeded by increased acute care being provided in hospital - this also means that other services do not receive full funding. £4M allocated next year to pilot schemes to achieve a shift in activity. Discussion of challenges to full implementation including reduced budgets in future years and reluctance to change on the part of clinitians.
6. Mount Vernon Cancer Centre.
Report presented giving an update on the March 2009 Development Plan. Following the decision to retain the cancer centre on the Mount Vernon site, development of parts of the site need to be progressed - substandard ward accommodation and pharmacy provision. Since people living in north Herts. and south Beds. have to travel more than 45 miles, a feasibility study is being conducted into having a satellite radiotherapy service.
David H.
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