Princess Alexandra Hospital Trust’s ambitious aim to “become one of the best local hospitals in the country” is revealed in a “transformation programme” report in its most recent board papers.

Challenges to this goal for the Harlow based trust include underperformance against A&E, 18 week and diagnostics targets; poor patient experience compared with national benchmarks; worrying staff survey results; and delivering only 63 per cent of planned cost improvement in 2010-11.

The trust faces a £17m “financial challenge” this year – 10 per cent of its turnover – and has asked for £5.2m of “transitional support” from NHS West Essex and NHS Hertfordshire. Reassuringly, the report says: “We have started to make progress.”

Strategies to make the savings include a length of stay and bed management plan that aims to find £4.7m. “Increased efficiencies” will mean “an overall reduction in the size of the workforce of about 250 posts and a need for approximately 60 fewer hospital beds”.

Princess Alexandra might take inspiration from Southend University Hospital. The foundation trust is now able to reap the benefits of moving to a locally agreed pay deal five years ago.

Historically Southend has used this freedom to attract staff, but its plan submitted to Monitor this month warned that “decisions made locally could impact on recruitment and retention if the actions that the trust takes appear to disadvantage staff to a greater extent than national pay settlements”. 

Southend is saving £412,000 this year by holding back the national pay rise for lower-paid staff.

Elsewhere all staff paid £21,000 or less received a pay increase of £250 this year.