PERFORMANCE: One of the worst performing areas on the four hour accident and emergency target has seen its “system resilience” money withheld temporarily after failing to devise a “believable” improvement plan.

North Bristol Trust and South Gloucestershire Clinical Commissioning Group had submitted an operational resilience and capacity plan, envisaging the trust would achieve performance of 92 per cent against the A&E four hour standard by April.

The national target is for 95 per cent of patients to be admitted or treated and discharged within four hours.

A paper presented to South Gloucestershire CCG’s governing body last week said North Bristol had been “reluctant to commit to delivery of greater than 92 per cent” and more work was required to “establish a date by which 95 per cent performance will be realistic”.

It said that as a result the release of £1.35m in system resilience money had been put “on hold” by NHS England “pending the receipt of a ‘believable’ improvement trajectory for the four hour standard”.


Pressure on beds and high levels of non-elective activity have had an impact on the Bristol trust’s finances

Between July and September, North Bristol Trust had the third worst performance in the country against the requirement to treat and discharge or admit 95 per cent of A&E patients within four hours.

Just 83.7 per cent of patients were seen within four hours, the eighth consecutive quarter the trust has missed the target.

A spokesman for the trust said they were working on calculating when the 95 per cent could be achieved.

The trust has recently moved the bulk of its services from two hospitals into a new £430m private finance initiative hospital.

It hoped this would help improve both patient flow and A&E performance as patients would no longer need to be transferred between the two sites.

The paper said the biggest reason for avoidable breaches of the target was due to the availability of suitable beds to admit patients.

Pressure on beds and high levels of non-elective activity have also had an impact on the trust’s finances.

Its latest board papers reveal the £560m turnover trust had a deficit of £20.1m at the end of August, £6.7m worse than planned, largely driven by the failure to carry out enough elective activity.

The paper said the trust anticipated needing external cash support from the NHS Trust Development Authority by the end of November.

A spokesman for the trust said £33m of cash support had been agreed with the TDA in the trust’s financial plan for 2014-15.

A spokeswoman for NHS England said every system resilience group now had a “yes recommendation” for the release of funding.