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After two years, University Hospitals of Leicester has finally published its overdue 2019-20 accounts.

This has not been an easy road for the trust. The financial saga started back in 2020 when it became apparent that there was a £50m hole in its 2018-19 financial position, meaning it was unable to sign off the next year’s accounts. And it has been trying to untangle the mess ever since.

Lorraine Hooper, the new CFO, told HSJ there had been “a number of inter-related issues” which led to the accounting problems, “but principally [it] was the need for us to deliver against a control total”.

She also described a finance team that was understaffed and unable to whistleblow or raise concerns.

Published along with the accounts is a report from its auditors Grant Thornton which shed more light on what went on in the past, including an admission the trust may only return to the position of having “unqualified accounts” in two to three years’ time.

With 2020-21 accounts still being worked up and an NHSE review to be published, UHL has a bit further to go before it can put this episode in the past.

Major disappointment

When Sheffield Teaching Hospitals’ maternity services were rated “inadequate” by the CQC last year, the trust CEO said she was “exceptionally disappointed” and was working to make rapid improvements.

Yesterday Kirsten Major said she was “devastated” that the whole trust had been downgraded from “good” to requires improvement, including a two-grade fall to “inadequate” on safety.

Inspectors said the leadership team “didn’t always have oversight and weren’t always managing the risks effectively”, voiced concern that issues they had identified in the last year had not been addressed and warned that the problems they uncovered were not due to “immediate pressures… as a result of the covid pandemic”.  

Ms Major said the trust was already acting on the CQC’s recommendations, pointing to investment in staffing and simplified reporting processes.

But she also contended that the trust had fewer staff during the inspection due to high levels of covid-related absences and said the “immediate crisis” caused by covid had disrupted care quality.

Whatever the truth about the cause of problems at Sheffield, yesterday’s report will lead to questions about the CQC’s approach to inspecting services that are still very much dealing with the virus.

Also on today

In our comment section, James Titcombe and Nadine Montgomery say the NHS is still not learning from past mistakes in maternity, and in The Download, Nicholas Carding looks at the trust trying to become the largest user of virtual outpatient appointments in the NHS.