• NUH chief executive Tracy Taylor says trust finances are “very serious cause for concern”
  • Trust confirms “vacancy pause” except for safety critical posts
  • A&E performance dipped to 57.2 per cent over winter

One of the country’s largest teaching trusts has predicted a deficit of more than £40m by the end of the financial year and has declared 15 black alerts since December.

In Nottingham University Hospitals Trust’s most recent board report, chief executive Tracy Taylor said: “After month 11, our finances remain a very serious cause for concern and, as such, are receiving attention from the trust’s management board”.

Ms Taylor added “very tight controls remain in place”, including a “vacancy pause” with some limited exceptions such as “key frontline and safety critical posts”.

She said the trust would complete a full establishment review by the end of the year.

Rupert Egginton, NUH’s chief financial officer, told HSJ: “At month 11, we have a £40.8m deficit and are £17m away from our challenging 2018-19 financial plan despite actions taken.”

Mr Egginton said the trust has been unable to deliver its forecast levels of non-emergency care because of “ongoing pressures” on its emergency pathway, despite opening more than 100 additional beds over the winter.

The trust confirmed it declared 15 black alerts – now known as Opel 4 alerts – between 1 December 2018 and 3 April 2019. Its accident and emergency performance against the four-hour target dipped to as low as 57.2 per cent on one day during the same period.

“We have a well-developed recovery plan in place to return the best possible results for the year,” Mr Egginton said.

He said additional actions included controlling the trust’s pay spend, stopping all but essential non-pay and discretionary spend and driving further improvements to clinical efficiency and productivity.

He added: “We are on track to deliver the year-end position that we have submitted to our regulator, which is a £43.8m deficit; £18.9m adverse to our original plan.”

NUH also faced substantial pressure last winter and declared black alerts on multiple occasions, including alerts covering the entire Greater Nottinghamshire area.

HSJ reported last year that, according to the region’s sustainability and transformation partnership, the trust was due to dispose of 200 beds over two years, but Ms Taylor said that was not going to happen.