The man brought in to lead a Cumbrian trust through a takeover process has said it would have kept its independence if managers had tackled financial problems two years earlier.
Neil Goodwin, interim chief executive of North Cumbria University Hospitals Trust, was also doubtful that acquisition or internal efficiency savings could fully resolve the problems facing the trust and the Cumbrian health economy.
As HSJ went to press the North Cumbria board was due to decide whether one or both of the two trusts bidding to take it over would be invited into the second stage of the acquisition process.
Speaking beforehand, Mr Goodwin, who joined the trust in June to see it through the takeover, told HSJ: “If the trust had got its financial act together two years ago and begun to address these financial inefficiencies it could have been a standalone foundation trust.”
He said he felt the trust’s clinical staff “would be more in control of their own destinies than they are now”, had they “had as effective or as good senior management as they should have been entitled to” over the past five years.
North Cumbria’s formal agreement with the Department of Health setting out how it intends to achieve foundation status through takeover estimates the trust would need to find savings or extra income of £77m between now and 2013-14. The trust had a turnover of £223m in 2010-11.
The trust is one of the six in England whose private finance initiative costs had been “acknowledged as an issue” by the DH, said Mr Goodwin.
He said North Cumbria had negotiated a contract £10m higher than NHS Cumbria’s original offer, and received £17m in “transitional support” from NHS North West, but would still need to make £15m efficiency savings.
The trust estimates its nursing costs are between £3.5m and £6m higher than those of comparable organisations, and plans a “root and branch” review of its nursing establishment over the next two months, he added.
But he warned efficiency savings within the trust would not resolve the deeper structural problem facing the Cumbrian health economy with its widely dispersed and rural population.
He explained it was an hour’s drive from the trust’s West Cumberland Hospital in Whitehaven to the Cumberland Infirmary in Carlisle, meaning there “has to be an acute presence on the West Coast”. He was “not convinced the trust can provide services within [NHS] tariff [prices] for two sites 40 miles apart”.
The trust is now participating in a “system wide leadership board” with commissioners to maximise efficiency.