PERFOMANCE: Monitor has told East Kent Hospitals Foundation Trust to improve waiting times in its accident and emergency departments.

Meanwhile, the trust has warned that it is struggling to deliver acute clinical services across its sites because of a staff shortage.

East Kent Hospitals University NHS Foundation Trust

The trust has overspent on staffing by an estimated £6m so far this year

The trust is attempting to fill gaps in its staffing rotas with locums, which has caused an estimated £6m overspend in the year to date, its August board papers said. This has contributed to the trust’s ballooning deficit, which was predicted to be £17m at the beginning of the financial year and has now grown to £37m.

The regulator has told the trust to improve waiting times and its finances.

A paper presented to the trust’s board said the staffing overspend was “directly contributing to the current financial deficit the trust is in and will impact [on] how we deliver the service”.

The trust requires 10 A&E consultants and 20 middle grade A&E doctors across its two departments. It currently has six consultants and eight middle grade doctors.

The paper said: “Over the past two years issues have started to emerge which potentially threaten the delivery of a safe, quality sustainable service.”

The trust aims to fill the gaps on the rota but said this was not always possible. The paper said: “A&E for example, is only filled 90-95 per cent of the time, with the registrar and junior doctor element of the rota being particularly hard to fill at an average of 68 per cent.”

It added: “The running of three hospital emergency medical multi-tier rotas and two A&E rotas is clearly a substantial issue for the [urgent care and long term conditions] division and does not appear to be sustainable in its current format.”

The urgent care division is facing an “immediate crisis”, it said.

Junior doctors at the trust have had their training broadened to include community settings “thereby reducing the numbers available for hospital specialities”.

HSJ previously reported that the trust plans to consult on moving its emergency services on to one site.

Paul Streat, regional director at Monitor, said: “Since last year the trust has refreshed its leadership team and has made progress engaging the staff in the day to day running of the trust.

“The trust now needs to harness this improved staff culture to focus efforts on speeding up how quickly patients are seen in A&E. We also need the new management to make sure the trust returns to a good financial position for its patients.”

Trust finance director Nick Gerrard said: “A national shortage of doctors and nurses makes it difficult to recruit permanent staff in some areas, which means that to provide safe services to patients on our multiple sites we have to employ very expensive agency staff.

“We recognise we have to take action and we are working with our staff to look at ways we can provide services more efficiently, to look at how we can become more productive – for example by speeding up our recruitment processes – and at ways we can reduce our expenditure. We will also be benchmarking our services to see how we compare with other similar trusts and if there are any lessons we can learn.”