Weekly updates and essential insight into the NHS in the South West, by Will Hazell

Crunching the numbers

In recent weeks my colleague Lawrence Dunhill has been crunching the financial figures for NHS providers nationally.

The numbers provide some interesting perspective on the financial shape of trusts in the South West, and how they compare to the national picture.

Looking at the outturn financial performance figures for 2015-16, the South West provider which finished the year with the largest deficit as a proportion of turnover was Yeovil District Hospital Foundation Trust.

The trust had an £18m deficit – 15 per cent of its revenue. As HSJ reported in March, the prominent vanguard site received a £23m loan from the Department of Health.

Is Yeovil’s deficit the burning platform which will drive it to transform services, or will any good work the trust is trying to do simply be overwhelmed by the size of its financial problems?

It’s probably too early to say, but I imagine the numbers are beginning to make those pinning their hopes to Yeovil’s new model of care a bit nervous.

After Yeovil, the South West trust with the next largest deficit is North Bristol Trust, which ended the year with a shortfall of 12 per cent of its turnover.

North Bristol also experienced a bigger deterioration in its finances in the final months of the year than any other provider in the country.

The trust’s £55.6m deficit was £17.9m worse than its forecast at the end of the third quarter. Predictably, North Bristol said that spending on agency staff was a major factor, along with “issues around patient flow and timely discharge” which had impacted its ability to schedule operations and meet targets.

Hopefully the progress North Bristol has made in improving its care quality will not be reversed by the trust’s attempts to get on top of its finances.

At the other end of the financial scale, three acute trusts in the South West finished 2015-16 with surpluses – Royal United Hospitals Bath, Gloucestershire Hospitals and University Hospitals Bristol Foundation Trusts. The latter, North Bristol’s neighbour, had the biggest surplus, at £3.5m. 

Of course these days no trust is an island, not even the few which are still in surplus. With health economies having to draw up shared sustainability and transformation plans (including “whole system control totals” in some cases), a big deficit in the trust next door is definitely not “somebody else’s problem”.

Torbay rated ‘requires improvement’

On Tuesday Torbay and South Devon Foundation Trust was rated requires improvement by the Care Quality Commission.

The trust is one of the first “integrated care organisations” in the country, and came into being when South Devon Healthcare Foundation Trust merged with Torbay and Southern Devon Health and Care Trust last October (a move which has made it considerably easier to remember the correct configuration of provider names in Devon).

Torbay and South Devon’s staff should be applauded for being rated outstanding for caring, but its inadequate rating for accident and emergency should be a serious concern for the trust’s leadership.

CQC chief inspector of hospitals Sir Mike Richards said the merger had been “well managed” and most staff felt “upbeat about the new organisation and ethos”.

Integrating acute, community and adult social care is often justified on the basis that it can unblock hospitals by providing care in settings which help people retain their independence and remain healthy in the community.

Hopefully the longer Torbay and South Devon has to truly join up its services (and not just its organisational structures) the greater the benefits will be in terms of improved patient flow through Torbay Hospital.

Deep South

Deep South is HSJ’s email briefing on the NHS in the South West of England.

It takes an in-depth weekly look at a region which is one of the NHS’s most innovative, but also one of its most turbulent. The patch includes the cities of Bristol and Bath, through Wessex and Dorset, and all the way down the peninsular to Lizard Point.

Please get in touch with any suggestions about what you’d like to see covered and any story tips: will.hazell@emap.com