Royal Brompton & Harefield NHS FT, Board Meeting 28th September 2016
2. Performance against targets: Trajectories for measuring performance have now been agreed with NHS England and NHS Improvement. For the 18 week incomplete pathway target, the trajectory will take the Trust back to compliance with the national target (93%).
For the 18 week referral to treatment time pathway the Trust did not meet the trajectory for Month 4 but was back on track for Month 5. The trajectory is a cumulative measure so the sustainability and transformation funding target has been met for both months, as was the 62 day cancer target.
3. Infections: There have been no reported cases of MRSA in 2016/17, but five cases of clostridium difficile have been attributed to the Trust.
4. Cancelled operations: Patients whose operations are cancelled for non-clinical reasons on or after the day of admission should be offered another binding date within 28 days, to be funded at the time and hospital of the patient’s choice. There were 28 cancelled operations and procedures in the Trust in August 2016, 14 at Royal Brompton and 14 at Harefield Hospital.
5. Finance: The Trust planned a deficit of £2m for August 2016 but achieved a deficit of £1.9m, slightly better than planned. NHS England activity was £0.5m better than expected, but CCG and other NHS commissioned activity was £1.4m worse than planned. Private patient income at £3m was £0.5mless than planned. The Harefield Heart division had year to date raised £6.9m, £0.5m above planned. The Lung division contribution year to date stands at £10.3m, 8% behind plan.
6. Annual appraisals and revalidation of doctors: The Trust is responsible for the revalidation of 377 doctors, internally audited by KPMG in April 2016. In June 2016, NHS England performed a Higher Level Responsible Officer Quality Review Visit, leading to a favourable review but with some suggestions for further improvement, which have been acted upon.
7. Consultant in Respiratory Medicine with Expertise in Severe Asthma: A new appointment, the consultant will join two full-time physicians providing specialist severe asthma management commissioned by NHS England for over 600 new referrals a year. There are also around 3000 outpatient evaluations and 10,000 inpatient / daycase spells per year.
8. 77 Wimpole Street, London: This private patient facility opened on 18th July 2016 and in its first week received 58 patients, which was encouraging.
9. Although selling this property on the open market was considered, its configuration and services are inextricably linked with those of the adjacent 250 Kings Road, a property owned by the Trust’s linked charity. Another area of uncertainty is the possible construction of a Crossrail 2 station under 151 Sydney Street.
A series of negotiations have culminated in a draft Agreement to transfer the property to the Charity for £24m which is supported by market valuations. There is also an option agreement granted to the Charity to purchase an adjacent parcel of land for £2m.
The Trust is under considerable financial pressure following withdrawal in April 2015 of Project Diamond funding for complex clinical procedures. In 2014/15 this represented income of £13.3m. As a result, and linked to downward pressure on NHS tariffs, the Trust has been obliged to budget substantial financial deficits for the first time in 2015/16 and also for 2016/17, which are likely to continue for the foreseeable future. A disposal of 151 Sydney Street - which is held for income generation or capital appreciation and is non-operational, as it is leased to third party and office retail tenants (other than part of one floor which is used by the Trust) - would provide the cash to fund the Trust’s capital expenditure for a further 18 months. The sale would have various financial pros and cons, which have been taken into account.