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.


  1. It’s all down to the government, just give the NHS the cash ,The NHS isn’t there to make a profit, the NHS is there to say lives

  2. We have an ageing population ( with around 15 ,000 people over 100 years old for examplele). We also have widespread poverty leading to poor food poorly insulated houses etc.
    So we are bound to need increasing amounts of money for health care.
    Some people are living longer ( success!) but, apparently there is little improvement in the period of actually healthy lifestyle. Just more years of poor health. We are just going to have to pay up and stop talking about “deficits”.

  3. No-one is talking about the elephants in the room, namely the obesity epidemic. Why do we have one in three children over-weight? I suggest we start we making it a legal requirement to give them extra exercise, perhaps starting with a good run around the school playground every morning? Today’s fat kids are tomorrow’s health problem!

  4. The answer Ms Pink is ultra processed foods, which are heavily promoted by the food industry.They are cheaper than other foods, heavily promoted everywhere and designed to be tasty to eat.
    If you listen to Michael Mosley and others about the food industry,and read the Marmot report about how the NHS has been underfunded for years, you might add something to the debate, instead of showing your prejudice and ignorance.
    Yes, there is an obesity problem, but there is a reason for it, apart from your accusation of the undeserving poor.
    Actually, exercising as a punishment for being poor and fat shaming will do the opposite as most doctors will tell you.
    Go to the library and read a book about the problem instead of spouting the nonsense you have repeated so many times before.

    • Lunches during school holidays when I was a kid was either bread and dripping or sugar on toast, and we lived on a rough South London housing estate. Yet, I was always skinny – because I and my siblings were always outside playing, no matter what the weather.

  5. The sooner the NHS stops using private companies that line the pockets of shareholders the sooner the NHS finances will improve.

  6. They need to promote persons from within the NHS to management roles as opposed to taking on graduates to run a hospital which are clueless on operations of a hospital. Then scrap subbies and empty cleaners, cooks, medical staff directly, then get this government out which over every tenancy the tories have had have consistently under funded the NHS and tried to privatise it by stealth. It will be a long road but will get there.

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