FINANCE: Royal Cornwall Hospitals Trust is underperforming by £2.3m against the contract with its main commissioner, largely due to unpaid readmissions.

Minutes from a recent board meeting states that, although the largest element of in-month underperformance was related to elective case mix, “cumulatively non-elective underperformance driven by a combination of flat activity and unpaid readmissions is the largest element”.

Since the start of 2011-12 trusts have not been paid for patients readmitted within 30 days of discharge.

To date the trust has treated 1,245 unpaid readmissions, 95 spells above plan and worth £2.1m. Non-elective spells are 1,117 below plan, worth £1.4m.

The trust appointed a coding lead consultant to undertake a review of case mix to ensure coding is being maximised.

A report to September’s board said the trust was working with NHS Cornwall and Isles of Scilly on the contract “with a particular focus on developing and agreeing longer term activity plans to support the development of the foundation trust bid”.

At the end of month five the trust had a surplus of £1.6m against a profiled plan of £2.3m. Overall income is £2.7m behind plan.