• Worcestershire Acute Hospital Trust one of four trusts to refuse control total
  • Run by former Barking, Havering and Redbridge CEO Matthew Hopkins and chaired by former NHS England CEO Sir David Nicholson
  • Targeting £73m deficit

One of the country’s most troubled hospital trusts, which is chaired by former NHS England chief executive Sir David Nicholson, has rejected regulators’ request for it to rein in its large deficit.

Board papers show that Worcestershire Acute Hospitals Trust is one of just four trusts that have not yet agreed to a control total with NHS Improvement.

In January, the regulator asked the trust to commit to a £64.4m deficit for 2019-20. In response, the trust said in June that it could only commit to a deficit of no more than £82.2m.

Responding to questions from HSJ on Monday, the trust said it has since decided it could save a further £8.5m and was now planning for a £73m deficit, still £9m short of the control total - or financial target - proposed for it by NHS Improvement.

In a paper that went to the board in June, the trust said: “Whilst we recognise that it is disappointing that we have not been able to submit a plan closer to the control total, we believe that the submission reflects a credible plan based on the existing plan information and assumptions available to us at this time. Clearly, we are some way off the target we are trying to achieve.”

The paper suggested the gap between the two figures was “due to the cost pressure from investment in essential additional ward capacity initially requiring additional premium staffing resource”. The trust is opening nearly 100 additional beds this year.

Last year, Worcestershire Acute agreed to a £41.5m deficit control total with the centre, but fell £32m short, reporting a £73.7m deficit excluding sustainability funding. This was the third largest trust shortfall against the budget in the country.

Since the trust agreed to its last control total, it has replaced both its chair and chief executive, with Sir David and former Barking, Havering and Redbridge chief executive Mr Hopkins respectively.

Responding to questions from HSJ, Mr Hopkins said the extra beds, which were needed to improve quality and safety, meant an additional £22.5m savings had to be found this year.

He said: “Our plan for 2019-20 is to stabilise our finances and prevent any further worsening of our 2018-19 performance, which was a £73.7m deficit.

“However, even delivering this ambitious target still leaves us some £9m short of our control total. We are in discussions with our health and care system partners about how they can help to close the gap – and in doing so potentially unlock additional centrally held funding of as much as £26.9m.”

The Care Quality Commission has rated the trust “inadequate” for several years, with particular concerns about accident and emergency performance. It is currently in quality special measures.

Last year, 29 trusts refused to agree to a control total with NHSI. At a combined NHSE/I board meeting last Thursday, outgoing NHSI chief executive Ian Dalton said this was down to just four trusts for 2019-20. The other trusts are: London North West University Healthcare Trust, East Kent Hospitals University FT, and Queen Victoria Hospital FT.

An NHSE/I spokesman said: “Just four providers haven’t agreed their control total, compared to 29 last year. Regional teams will continue to work with the four trusts to help improve their forecast financial positions.”