East Kent Hospitals Trust: Trying to solve local NHS finances like “trying to boil an ocean”

Hospital trust

By Local Democracy Reporter Daniel Esson

East Kent NHS chiefs admit trying to fix an ailing hospital trust’s finances is like “trying to boil an ocean” as they face a further overspend of almost £50 million this year.

Top brass at East Kent Hospitals University Foundation Trust (EKHUFT) say their ballooning costs are “unacceptable” and they need to meet further “ambitious” saving targets next year.

The organisation is one of the biggest NHS bodies in the country, running hospitals in Ashford, Canterbury, Dover, Folkestone and Margate and serving a population of about 700,000.

In December the trust was running at a deficit of almost £70m – when the organisation had planned a deficit of only £72m by April 2024.

Papers for a meeting of the board of directors on February 2, revealed that by the end of January, the trust had a deficit of £84m.

At that meeting, acting chairman of the board of directors Stewart Baird said: “There’s a lot of things to fix in this trust we have to prioritise, it’s like boiling an ocean.”

He explained the trust’s priorities are improving waiting times, reducing waiting lists  – particularly for cancer treatment – and cutting costs.

Costs have “got to an unacceptable state,” he added.

New chief finance officer Tim Glenn (pictured) was brought into the trust from Royal Papworth Hospital Trust in Cambridge to help cure the organisation’s financial ills.

By December “we were losing about £10m per month,” Mr Glenn told the board and revealed there would be a new “forecast deficit” of £117.4m.

The original plan was budgeting for a loss of £72m in the 2023/24 financial year.

“I deliberately choose the word acknowledge that deficit rather than accept.

“We acknowledge but it is not an acceptance and it is not acceptable nationally or at the trust.”

As a result of the overspend, the trust needs to make a minimum of £49m of savings next year.

Board papers for the meeting point out though “there are already some early signs of improvement” in reducing the use of agency staff, which reduces the total spend on pay.

Detailed plans on how to make those savings are expected in March, but Mr Glenn added at the meeting: “We’ve got 17 schemes of work we’ve set up and the executives around this table have all got involved with those schemes and are working up plans around them to enable us to deliver savings next year.”

However, in board papers it is noted that failure to deliver savings already planned are a “key driver” of the organisation’s growing black hole.

“I believe we can do it, I think we’ve made a very good start during January, but there’s a lot more work to do over the next couple of months,” Mr Glenn said.

In a statement issued after the meeting, he added: “The trust has set a necessarily ambitious £49m efficiency improvement target to ensure we deliver for patients next year and has made changes to ensure its cost improvement programmes are better supported and managed.

“We are working with clinicians and managers to develop savings programmes that will improve our patients’ experience as well as reduce our costs, by addressing inefficiencies in our systems and improving care and outcomes for patients.”

When coffers are empty, NHS trusts have their spending re-forecasted through a process called the National Protocol working with NHS England, and new cash is made available.

In 2012, the South London NHS Healthcare Trust, which ran three hospitals, was scrapped in the face of financial woes.

It was placed in administration after accumulating debts of almost £150m, and it was divvied up between other NHS bodies and private companies.

It is rare for NHS trusts to fall into such a situation, but when facing especially severe financial woes they can be placed into administration, special measures, or scrapped and their functions taken up by other NHS bodies instead.