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Risky business

Barking, Havering and Redbridge University Hospitals Trust has published the full investigation report into its financial governance failings – revealing the shocking extent to which its cash was allowed to run dangerously low in 2017-18.

A review by Grant Thornton found patient safety was put at risk by a “significant breakdown in financial governance”, after the trust routinely delayed payments to suppliers to cope with cash shortfalls.

The delays eventually led multiple companies to cancel deliveries and threaten legal action to obtain payment, including one firm that refused to supply equipment that was vital to perform caesarean procedures.

The issues were repeatedly reported to the trust’s senior finance team from November 2016 onwards, and also raised at the aptly named “OMG meeting”, but were not added to the risk register until October 2017.

It seems the “operational management group” didn’t fully grasp the urgency of the situation.

But one also has to wonder; would the trust have been allowed to exit quality special measures in February 2017 if the cash issues had been properly escalated?

International rescue required

Trust chief executives have warned they are struggling to fill rotas in their hospitals because visas for international specialist doctors are being rejected due to a government cap.

Tier two visas are given to workers who have a skilled job offer and are not from the European Economic Area. Government statistics show 2,193 certificates of sponsorship were granted in April and 1,975 were made available for allocation in May.

At Nottingham University Hospitals Trust, the cap has been an issue for the trust since December. She said 18 doctors have been appointed from outside the EU but had their certificates of sponsorship refused. In March, all the trust’s applications were turned down.

Royal Wolverhampton Trust chief executive David Loughton said he has 24 doctors waiting for their visas to be approved, including three consultant radiologists who he is struggling to get visas for, which will have an impact on the 62 day cancer treatment target.

Meanwhile, the number of nurses and midwives from EU countries registering to work in the UK has dropped by 87 per cent since last March.

The Nursing and Midwifery Council reported that between April 2017 and March 2018, 805 EU nurses and midwives joined the register – 5,577 less than the year before.

Janet Davies, chief executive of the Royal College of Nursing, said efforts to boost the number of nurses are being dragged down by a “botched Brexit”.