Chief Executive’s Message – Friday 14 October

October 14, 2022

It has been some time since I covered the Trust finances in my weekly message. This week it feels important to do so. This year is the first time for many years that our Trust is forecasting a deficit position at the end of the financial year. When we planned our budgets for the year, we knew that safely managing patient care whilst continuing to live with COVID-19 and reduce our planned care backlogs would be a real challenge and we would be very likely to need additional support from the two integrated care systems that we straddle. As we have tracked our spend over the first six months of the year, our planned budgets are being significantly exceeded and we need to get back on track.

This situation is not unique to our Trust. It is well publicised that public sector finances are under significant strain and the budget plans coming out of the government are clear that public services cannot expect additional funding. We should expect that any investments will need to be met by individual organisations or local systems without additional central funding. Investment is made even more difficult if we are not meeting our budgets as planned. It is also possible that Trusts and systems will be asked to fund pay awards in the future, something that we have not been asked to do before. This puts us and our partner organisations in an increasingly challenging position as we look ahead to the expected increase in the number of patients who need planned and urgent / emergency care, and at the changes we need to put in place to deliver services in a different way as we prepare for MMUH.

We have put in place a detailed financial recovery plan, in collaboration with the group leads, so that we can recover our cost position and meet our planned budgets once more. Thank you to everyone who has worked hard to put this together. Our plans were shared and approved at our public Trust Board earlier this month.

We know we have experienced a really tough time over the last two and a half years. During the first few waves of the pandemic, money was no object and we were fortunate that the funds we needed to sort out expanded clinical areas, changes to our estate, infection control measures including PPE were largely met in full. Those days are now very much over and stringent financial accountability must be delivered. All of us are accountable for how we spend taxpayers’ money and it is everyone’s responsibility, with a particular onus on every manager, to ensure you know and understand your budget and you carefully plan to deliver within it. Where there are patient safety issues that cause you concern then you must escalate these within your service and directorates so that we can look at disinvesting in other areas to ensure that safety is maintained. For noting, that will be the only way we can make changes – by either investing to save (schemes whereby putting in some funding and working in a different way can save resources) or by stopping spending in one area to fund another.

This is indeed a bleak picture. Of course, more funding would be welcome and many would argue absolutely necessary. However, we must not and cannot expect that new funding will be delivered. Instead, we all need to look carefully at what we spend, think about how we can be more resource efficient, identify areas of waste and get on and make those changes that will put more money back into our NHS and ultimately to give our patients better care.

Thank you for your continued support. Please share any suggestions with your teams and let’s pull together to ensure that we retain our dedication to spending public money wisely (we are all taxpayers after all) alongside our priority to provide safe patient care.