Trust faces deficit of nearly a tenth of turnover

Queen Victoria Hospital Foundation Trust – a specialist trust based in West Sussex – had a control total of £0.6m surplus for 2018-19 before sustainability and transformation funding and money from land sales. But it has recently reforecast a £5.9m deficit and said “lines of credit” would be made available to enable it to pay bills.

Papers for the trust’s March board meeting revealed its current plans would not improve its financial position sufficiently to break even in 2020-2021. “This will need further initiatives beyond those currently under discussion,” a report from the finance and performance committee said. “There is currently no visibility of what those plans might be.”

A small team from NHS Improvement were reviewing what actions could be taken to improve the financial situation, the report added.

HSJ understands the trust, which has a turnover of just under £70m in 2017-18, has been given a control total for 2019-20 which is roughly in line with this year’s control total. However, the trust has not yet accepted this, as the board feels it is unlikely to return to surplus that quickly.

The trust does not, however, expect to be put into financial special measures, despite it rating financial sustainability a “catastrophic” 25 in its risk register.

The board was told the next financial year could be even more challenging. It expects increases in both pay and non-pay costs, which are unlikely to be matched by income, while its cost improvement programme is £1.9m short of its just over £3m target for this year. 

QVH has had costs associated with clearing a backlog of long waiters, which emerged in the middle of last year, and a higher than expected spend on agency staff, which have worsened its financial problems recently. The trust has been looking into its theatre productivity and is now planning to investigate its productivity within its outpatients work. 

The trust provides a mix of specialist services, such as reconstructive surgery, alongside a minor injuries unit. It is rated “good” by the Care Quality Commission, and rated “outstanding” for caring.

QVH is planning to work closer with neighbouring Brighton and Sussex University Hospitals Trust on the provision of paediatric burns care, plastic surgery, dermatology, and head and neck care. The two trusts are also examining back office synergies.