No-star trust chair quits as workload pressures mount

Jenni Bowley stepped down as chair of Middlesex's Barnet and Chase Farm Hospitals trust, having been in post since it was formed in 1999. The trust has had a history of financial problems and failed to meet performance targets on 13-week outpatient waits, the number of cancelled operations, the two-week target for breast cancer appointments and achieving a satisfactory financial position.

It has also been involved in a large rebuilding programme on both hospital sites, the first stage of which was funded as a private finance initiative project.

Trust chief executive Liz Heyer told HSJ that Ms Bowley's decision had been made in discussion with her and that, though there were serious workload issues arising from the trust's problems, the decision had been a personal one.

'The trust is under a lot of pressure, and I think she thought she had taken the trust through its first stage. Some of our operational problems have put a lot of pressure on the chair.'

Ms Heyer said good progress was being made on meeting all the targets. 'I think the good news is we can demonstrate that the performance has improved, most markedly in terms of our financial position. Nursing and midwifery budgets have broken even in the last few months. We are by no means out of the woods, but it is improving, ' she said.

Ms Heyer added that the trust is predicting an overspend of up to£700,000. This compares with a£3m overspend last year.

'The area where we are having some problems is outpatients, and we are not alone in that. We do have the highest outpatient new referrals in any trust in London. I think it is particularly because our services are very good, ' she said.

The PFI project has meant that some of the budget has been ringfenced for payments to private companies, and a significant management commitment to the contract has been needed. 'What it does mean is that the part of the budget that we are able to manage is less than some other trusts. It creates less flexibility, ' Ms Heyer pointed out. 'It does take time and effort. When management resources are restricted, it doesn't help. If you have PFI, it does take management effort.'

Ms Heyer said that although services were viewed locally as very good, the no-star rating had been bad for staff morale.

Barnet community health council chief officer Kay Laurie said: 'Our perception is that things are getting better.

'The patients are pleased with the quality of care, but the staff have suffered a terrible knock.

They are working on a building site and they are working under difficult circumstances.

'They are to be commended on the efforts they are making.

We know that they have been running at 97-98 per cent occupancy.

We sense that the system runs pretty lean.'

London Health Link chair Elizabeth Manero said: 'It doesn't do local communities any good if people are driven out because insufficient support is given to them.'