FINANCE: Chelsea and Westminster Hospital NHS Foundation Trust narrowly missed breaching its 3.5 per cent private income cap due to a technical change in how the sum is calculated

The trust’s finance report for its March 3 board meeting, released to HSJ under the Freedom of Information Act, shows the issue was highlighted as a “near miss”.

Monitor announced in February 2010 that the calculation for the private patient cap would change, to include “overseas non-reciprocal income”.

During 2010-11 foundation trusts had to vary their private income cap in line with the new definition.

Trusts had been able to do this since the beginning of the financial year, and those that had not put the changes in place by the end of 2010-11 would have been in breach.

Under the new rules, Chelsea and Westminster had a rate of 3.8 per cent of total income for 2010-11, against the 3.5 per cent cap established under the previous system.

The report warned: “A breach would generate significant concern by Monitor around our governance rating.”

Monitor was able to make the alteration with immediate effect following a request in writing from a trust director after the board meeting.

A trust spokesman said: “It is embarrassing, but we realised this late in the day. We should have done it at the beginning of 2010-11. We would have breached on a technicality, which would have been pretty stupid.”

The spokesman emphasised that the trust had not asked for a special exemption, and had made the necessary technical changes in time.