PERFORMANCE: Pressures from extra activity in March and April has had severe effects on Medway Foundation Trust.

It failed to meet the four hour standard for A&E patients for 2012-13 and spent more than five weeks in a state of “business contunity” when it was forced to open escalation beds. Failing to meet the target could cost it £1m in CQUIN payments, the board heard.

In March a patient waited more than 21 hours to be admitted after coming to A&E with a dislocated shoulder.

The pressures meant that spending on temporary staff increased dramatically – the trust was overspent on staff by £1.2m in March alone, with temporary staff spending the highest for two years - and the trust’s deficit for the year was £1.8m, against a plan of £1m.

Temporary staffing costs for the year were more than double the plan at £16.6m.

The trust will now have to plan for cost improvements of £13.5m in 2013-14 – and will still make a deficit of £1.2m if it achieves these.

It plans to merge with Dartford and Gravesham Foundation Trust but the scheme has been on hold because Medway is one of the 14 trusts under investigation for high mortality rates.