This month the board will have to consider a range of options to
bridge the gap. As we went to press, there were no firm indications of what
these might include.
The news followed what finance director David Dumigan called
"slow and painful progress" to reach agreement on the Local Delivery
Plan.
All that seems certain is that BSUH will have a budget of £300
million.
This falls short of the current cost of running the trust, which
includes covering last year’s £7.7 million overspend, by £34.5 million.
In an internal staff memo, trust chief executive Peter Coles
said the trust had plans to save some of the money but these still left a gap of
£18.5 million.
"This is the first time the trust has faced a funding gap
of this size," he added. "We have to tackle it, even if it means
taking difficult and unpopular decisions."
Subsequently, financial director David Dumigan has told the Bulletin
he was anticipating receiving financial support of up to £10 million from the
strategic health authority. But this was subject to delivering the remaining
savings, he said.
In his memorandum, Peter Coles cites a number of reasons for the
shortfall. These include the consultant contract, European working time
directives for junior doctors, the new payment by results system and the
commissioning of fewer services by the primary care trusts such as reduced
outpatient, emergency and specialist services.
There is also a reduction in orthopaedics activity commissioned
from the trust.
David Dumigan assured the board at last month’s meeting there
would be no "knee jerk reaction" to the situation. But he made it
clear that in the first instance vacant posts currently covered by bank and
agency staff would be removed from the establishment.
In his memo, which is also published on the trust Intranet,
Peter Coles says further redundancies would be "a last resort."
He promised that proposals for making other savings would be
discussed with staff.
Several of the trust’s non-
xecutive
directors at the June meeting urged the executive directors responsible to press
the strategic health authority to acknowledge that the immediate burden of
proposed changes from hospital to community care should not be borne entirely by
the hospitals but should be shared with its primary care trust partners.
As we went to press, David Dumigan told the Bulletin that
he had discussed some risk sharing arrangements with the PCTs.
As a result, the trust will not have to bear the full cost if
more elective inpatients and emergencies are treated than planned.
However, this will not apply to outpatient appointments where
the trust is expected to be able to control the number of follow-up
appointments.
The Royal Sussex County Hospital, Brighton
