Hospital boss: 'Crisis is our fault'

THE jobs of senior doctors and surgeons at a cash-strapped Suffolk hospital could be at risk as it battles to save more than £16million, it has been revealed.

Andrew Reed, chief executive of Ipswich Hospital, said protection could not be offered to medical consultants and every role was being looked at in the recovery plan.

Around 350 jobs are expected to be lost as the debt-ridden trust goes through its second year of belt tightening - but redundancies will be avoided as much as possible to dodge the expensive payouts that go with them.

But Mr Reed, who has been in the top job since last July, admitted the financial crisis that has rocked the acute hospital was entirely its own fault.

In an exclusive interview with the EADT, he said: “It's all down to us. We take full responsibility for the problems and take responsibility for solving the problems. This organisation is in a bad place if we start pointing fingers.”

His admission came as the trust prepares to publish its detailed financial recovery plan for this year, which has seen every line of every budget meticulously analysed.

Mr Reed yesterday said consultants' jobs were being looked at as part of the rigorous money-saving review.

“We cannot guarantee protection to anybody and I do not think it is right that we do that. If we work on the basis that we have got a lot of money to save and 70% of our costs are staff costs, I do not think that any consultant would take the view that they should be protected when others around them are not.

“We are looking not at particular staff but particular areas and how we do in them and that may mean that we do not need as many staff in that area. The same applies to consultants.”

The project has concentrated on different work areas - from procurement to back office functions and from estates and property to clinical services.

It has seen a steering group of staff of all levels, including consultant medical professionals whose priorities are care rather than budget, look at possible solutions to the financial crisis, as well as 1,000 suggestions submitted by frontline workers.

The turnaround plan, Taking Control - which will detail the trust's financial baseline, the action it is proposing and how it will implement it - will be finished in draft form on September 1 and will go to a public board meeting on September 28.

The board will also receive a “public interest” report from the trust's external auditors, following an earlier report commissioned by the trust on the reasons behind its financial failings.

It comes after its forecast deficit of £5m worsened to £11.9m and then to £16.7m.

When the debt stood at £11.9m the number of posts the trust expected to cut was 105. Since then the debt has risen, leading to fears over more jobs, with hospital sources warning losses could reach 350.

Immediate measures since the last round of efficiency savings, which saw the trust claw back £5m last year, were put in place.

These included curbing stationery orders and expenses as well as stopping all hospitality in a bid to save money and avert the need for staff cuts.

Mr Reed said: “When an organisation gets itself in a big financial hole as we have done the only thing you can do quickly is to take tight central control.

“We have to take immediate, necessary action to stem the flow of expenditure; nobody likes it.

“What we want to do is stabilise the finances of the organisation so we can then hand control back to the departments so they can take their own decisions, by and large, but they will have to perform and earn the right to do that.”

Morale has inevitably been affected by the cutbacks, Mr Reed said, but he paid tribute to the professionalism and loyalty of his staff.

“It's a bit fragile and no doubt people are anxious about what we may have to do to recover the finances. However, we have been holding a lot of staff briefings that are open invitations for people to come along to, which have been well attended.

“When you need to worry about this situation is when people are quiet and not forthcoming. The critical issue is that people have been talking, whether it is negative, outrage or positive. They are coming up with positive suggestions.

“There will be anxiety until we have got to the point of having the plan together and publishing it and saying what we intend to do and what we are not.”

Looking back on the last year, Mr Reed confessed it had been “tough”.

But he was confident the current upheaval would ensure the trust's survival into the future not only as a top performing hospital but also as a viable business

When asked if he had a message to the people of Suffolk and the community the hospital serves, he said: “I think firstly, although they will be concerned that the hospital's finances are a problem at the moment, our clinical care and our standards are as high as ever. That means the standard of treatment they get is excellent and the length of time they wait has never been shorter.

“We are managing the clinical side of the hospital very well and will continue to manage it very well.

“We are going to have to take some difficult decisions in the next few weeks and months and will have to balance the need to provide excellent clinical care and accountability to the taxpayer when we spend the money.

“There is upheaval in the hospital in terms of the way we provide services over the next few months and years. But our core aim is to provide excellent patient care. If we fail to do that we might as well pack up and go home.”

Mr Reed said the recovery plan was not just about cutbacks and managing finances “much more aggressively” but was also tied into radically changing the way the trust works.

For example, Mr Reed said if it improves infection control it will save money as people will stay in hospital for less time.

“It's not so much about getting staff to work hard it's about focussing their efforts in the most productive way so we and they get the most value out of their time,” he said.

Mr Reed said it was a “big challenge” to ensure financial stability for the coming years and admitted cost pressures would differ from year to year.

The idea was to constantly check and review its practices so the trust keeps up with the constantly changing NHS, he said.

He could not see the current shift to more care in the community, which will see beds cut at Aldeburgh and the closure of the Bartlet Hospital in Felixstowe, putting pressure on the acute hospital, saying it would improve care for its patients.

With discussions surrounding the number of acute hospitals in the country in the future, Mr Reed was asked whether he could see Suffolk with only one such facility.

He said: “The complicated answer is what is an acute hospital? If you look at acute hospitals of 40 to 50 years ago it is massively different to what it is now. We have now got all sorts of things happening in the community and in nursing homes.

“I am sure every sizeable community, including that of Bury St Edmunds, will have good access to emergency health care and specialist health care but how that is provided will change, as it will everywhere.”