Royal Brompton & Harefield Board Meeting in public March 2016
The Chairman was unwell so the meeting was chaired by Neil Lerner.
CQC inspection June: The Care Quality Commission requires some 300 documents prior to its inspection. This is not just a visit, it will be more of a forensic analysis going back some years.
Budget: The draft plan submitted to Monitor showed an £8.9 million deficit. This received an uncompromising response stating that a new control total of £3.7 million deficit was required, so more work is being done. Meanwhile NHS England is grabbing an estimated £3 million profit that the trust makes from supply of high-end devices. Final plan is required by 11 April, which is not achievable.
Property sale is a necessity to ensure positive cash flow. Block contract with NHS England ceases 31st March and there is no new agreement for the period ahead. A cash sum will be due next month regardless. 151 Sydney Street might be sold to RBHT charity to raise further funds. Currently NHS margins are now wafer thin. Some 80% of staff costs are for clinical staff, with little scope for more cuts.
If the Board cannot come up with a rational solution with Monitor, then RBHT will be subject to an external challenge by NHS Improvement. Bob Bell, the Chief Executive intimated that he would welcome anyone wanting to come in to end this "charade". Monitor appears to understand the basis of the financial figures but comes back with its own inexplicable figures.
Private facilities: Wimpole Street opens in May, with its first patients expected around June. Wigmore Street and Kuwait both represent income risk due to lack of beds. Most profit comes from converting out-patients to in-patients. No finalised contract yet with Kuwait, but the Chief Executive was confident that this will be agreed.
Planning ahead: A new Board brainstorming session is to be held to discuss planning strategy for 2017 onwards. Input suggestions should also come from clinicians and middle managers. Innovations may impact further on cost pressures. Income generation is the priority as they are already running "lean and mean".
Targets: The Trust appears to fail on its 62-day lung treatment target yet is way ahead in successful outcomes for over 60-day and 90-day survival rates.
New infection risk: The Trust is working with Public Health England to work out where and how this infection, candida auris, is arriving in hospitals. There are currently no national protocols in place.
Staff abuse from management: This is a cause for concern, a serious issue, which CQC is expected to address.
Finance: The deficit is less than forecast, but year to date is virtually on plan. The target for the whole year deficit is £10 million.
Bad debt write-offs were approved.