'We've sold all the silver': NHS Improvement publishes incendiary report into Queen's Hospital trust's finances
PUBLISHED: 12:00 07 August 2018 | UPDATED: 13:01 07 August 2018
A financial investigation by the NHS into Havering's hospital trust has blamed a "lack of clear leadership" for the organisation having to take a £20.7million emergency bail out last year.
NHS Improvement commissioned consultancy firm Deloitte to carry out a review of board governance at Barking, Havering and Redbridge University Hospitals Trust (BHRUT) – the trust which runs both Queen’s Hospital in Romford and King George Hospital in Goodmayes – after the trust required an emergency loan to avoid bankruptcy.
In October, the trust was placed in financial special measures after it accepted a £15.7m emergency loan from the NHS to help with a sudden cash flow problem which meant it was struggling to pay suppliers.
In fact in August 2017, BHRUT was only able to pay 8pc of its monthly invoices.
That initial loan was followed a month later by a further £5m bail out to try and strengthen the trust’s position while a recovery plan was enacted.
Published on Monday, August 6, the Deloitte review concludes that “an absence of proactive chief executive leadership” and “a lack of urgency in the subsequent financial recovery” are to blame for the trust’s poor financial situation – which saw the hospital trust burn through its reserves attempting to avoid having to declare large monthly deficits.
A copy of one email from interim chief executive Chris Bown – dated August 17, 2017 – reveals the trust was in very real danger of running out of money by October last year.
It reads: “We have ‘sold all the silver’ and can no longer compensate for the underlying deficit which has been running at approximately £1m per month.”
Mr Brown assumed the interim chief executive role while actual chief executive Matthew Hopkins took extended sick leave from March 13 to September 1 to have a kidney transplant.
Mr Hopkins joined BHRUT in April 2014, and is widely credited as the architect of the trust’s emergence from healthcare special measures last year.
On July 27 the trust announced Mr Hopkins was stepping down “to seek new opportunities”, and Mr Bown was once again installed as an interim chief executive.
The Deloitte report’s conclusions, written before Mr Hopkins resigned, called for an urgent change of leadership at the trust, despite crediting him with improving the quality of healthcare.
The report concluded: “The response of the board post October 2017 has lacked grip, pace and clear leadership.
“Whilst the CEO enjoys high levels of internal visibility and is credited with playing an important role in leading the trust out of quality special measures, we have concerns over whether the CEO has the skill set to lead the trust out of financial special measures.”
Ian Dalton, NHS Improvement chief executive, believes the trust was in sore need of new leadership.
He said: “I am encouraged this has begun to happen already with the arrival of Chris Bown as interim chief executive.
“The trust’s board must now deal with the important task of stabilising finances, ensuring it is fully and actively engaged in making progress, and most importantly, maintaining and continuing to improve the quality of care for patients.
“I am confident that with the right focus the trust can exit special measures for finance while continuing to make quality improvements.
“We will continue to work closely with the trust to support them on this.”
In a joint statement, BHRUT chairman Joe Fielder and Mr Bown vowed to improve the trust’s financial sustainability.
They said: “We have already made significant improvements in our financial processes, controls and governance.
“Many of these changes were recommended in an independent report by Grant Thornton that was published in April. We commissioned them to investigate why we had experienced a severe cash shortfall.
“We have brought in external expertise to help us put in place a financial improvement plan which has been signed off by our board and by NHS Improvement.
“Our staff understand the problems we face and are responding well to the challenge.
“We remain focused on providing the best possible care to our patients while also tackling our financial deficit to ensure our trust becomes sustainable.
“Chris, as our new interim chief executive, will now work with our board and ensure that we complete all the work required by the Deloitte report after we have considered its recommendations fully.”