PERFORMANCE: A struggling acute trust plans to close beds because it is ‘becoming unviable clinically’ and is ‘unable to consistently and safely staff’ the number of beds currently open, its leadership team has said.

The chair of the Princess Alexandra Hospital Trust, Douglas Smallwood, told the board’s October meeting that it is recognised by the “board, funders and regulators” that the trust is “not viable financially and is becoming unviable clinically”. He added that many of the causes of this unsustainability “are beyond our control”.

The trust does not expect to see, treat, admit or discharge even 90 per cent of patients within the accident and emergency four hour target. It has not agreed to meet the 95 per cent target because it could “potentially” compromise patient and staff safety due to a shortage of substantive staff, chief executive Phil Morley told the board meeting.

Mr Morley said the trust is currently in the bottom 10 organisations nationally against the four hour target and winter plans “do not give the assurance that we will achieve even 90 per cent let alone the required 95 per cent required”.

The trust only saw 81.5 per cent of patients within four hours during August, according to the latest data available.

Mr Morley added: “We have not agreed to sign up to delivering the requirement because we feel patient safety and staff safety are potentially being compromised with the volume of work being delivered and the physical number of beds open at PAH without substantive staff. It is likely we will be nationally escalated.”

Phil Morley

The trust has not agreed to meet the target as ‘patient and staff safety are potentially compromised’, Phil Morley said

The trust will close four beds on each ward “progressively” because it is unable to “consistently and safely” staff the number of beds being used. Mr Morley also noted the “increasing cost” of agency staff to “maintain a viable workforce”.

At the end of September the trust had a deficit of £20.1m, £4.6m worse than planned. It has a forecast deficit of £28.6m for the year.

It has contingency plans in place “if and when” it needs to escalate over winter and open more beds.

It may have to shut minor units and redeploy emergency department staff into the major A&E.

Mr Morley said at that “juncture”, the trust would issue a “help and assist” request to the wider Essex area to alert the system that only emergency “blue light” attendances will be accepted.

Essex is currently in NHS England’s “success regime”. NHS England has called an Essex-wide meeting on 3 November to discuss winter escalation.

The trust was recently inspected by the Care Quality Commission and a report is expected to be published shortly.