Cuts are on the way as health chiefs look to save £19m

PUBLISHED: 12:07 27 July 2006 | UPDATED: 10:34 06 May 2010

The Lister

The Lister

HOSPITAL chiefs have been forced to announce more controversial cuts in order to make savings of £19m this financial year. East and North Hertfordshire NHS Trust, which runs Lister Hospital and the QEII, has given more details about the planned job cuts a

HOSPITAL chiefs have been forced to announce more controversial cuts in order to make savings of £19m this financial year.

East and North Hertfordshire NHS Trust, which runs Lister Hospital and the QEII, has given more details about the planned job cuts and wards closures which were announced last month.

These cuts will still leave a gap of £5m so the Trust will stop London weighting payments, cut consultants' pay and find new ways of working with other NHS Trusts to share services.

But the Trust has warned that even these measures will not be enough and that more cuts will be needed.

Chief executive Nick Carver said the Trust had been under financial pressure from the first day it was formed but the situation had got worse recently due to a decision by primary care trusts not to refer as many patients to the hospital leading to the hospital receiving less income.

He promised to keep redundancies "to an absolute minimum" saying: "This is a difficult time for everyone, from nursing, medical and other healthcare staff caring for patients in all clinical areas, through to those who are responsible for keeping our hospitals running smoothly all day, every day.

"While reducing the number of posts and beds across the Trust will be unsettling, if we don't make these difficult decisions now then the Trust's future financial challenge will be even greater."

Here we take a look at the different money saving schemes expected to be approved by the Trust's board:

Job cuts

There are two ways the Trust is looking to cut jobs - through planned schemes, such as the new medical transcription service and the merger of the

Trust's health records department and then posts that will no longer be required as new initiatives are introduced, including the reduction in the number of beds.

It is the Trust's aim that while clinical posts will be included in this process, no frontline healthcare staff - including doctors or nurses - will face being made redundant.

The Trust expects 300 whole time posts to go between now and March 31, 2007. By 2009 the Trust will employ 700 less staff including staff lost through working at the surgicentre and by not allowing as many junior doctors to train at the Trust's hospitals.

The Trust's director of human resources, Danny Mortimer, said: "When it comes to making changes to the number of posts that the Trust employs, we have a very successful track record of making the best use of opportunities to redeploy staff into new jobs within our hospitals. Last year we closed two wards and all affected staff were found jobs that suited them, either within the Trust or the NHS locally.

"The Trust is confident that the actual number of staff that will be made redundant will be kept to a minimum. In achieving this outcome, the aim is that no frontline healthcare staff are lost."

Ward closures

The Trust's plan is to reduce its total number of inpatient beds by 48 by November 2006 - currently the Trust has around 900 beds.

The majority of beds will be lost from Lister Hospital with 42 beds going - 28 surgical beds and 14 stroke beds.

The following changes are expected:

*l By the end of July, the six inpatient beds on the QEII's Essendon ward will close.

* A new 23-hour surgical 14-bed ward to be opened at the Lister in August, which will improve the rate at which patients are admitted and discharged on the day of their planned surgery.

* In September, a new elective admissions unit (EAU) will be created on the vacated part of Essendon ward.

* The QEII's current clinical assessment and decision-making unit (CADMU) will be relocated in September to the area occupied currently by the surgical assessment unit, which is close by A&E.

* In September, the Trust will create its first full-sized dedicated stroke unit at the QEII, and close the service at the "size limited" service at the Lister.

* In October, the Trust will close the 28 beds on ward 7A at the Lister, which to date has been used for urology patients.

* Also in October, Lemsford ward at the QEII will become a medical ward with trauma patients being cared for in the hospital's existing dedicated surgical wards.

The Trust's director of operations, Julie Lowe, said: "While beds will be lost, this is possible through a combination of more innovative clinical practice - for example the new 23-hour surgery ward at the Lister - and creating important new services such as the new surgical assessment and full stroke units at the QEII."

London weighting

From September, the Trust proposes to cease to pay the additional London weighting payment - worth £846 to £1,466 per year - to new staff. Staff based at the Lister do not receive the payment and the position for those new staff joining the specialist teams at the Mount Vernon Cancer Centre will be unchanged. Based on historical recruitment patterns, this change is expected to reduce the Trust's wages bill by around £250,000 in the first 12 months - the total cost of the London weighting payment across the QEII and Hertford County Hospitals is £2.5m.

Mr Carver said: "The payment of London weighting on two of three of our principal sites was always an anomaly. We believe that we can withdraw the payment from new employees without affecting our ability to recruit new staff."

Consultants' pay to be cut

The Trust is also planning to introduce changes for 165 of the Trust's 190 consultants who are on the new national contracts introduced across the NHS.

It will mean that 80 per cent of the Trust's consultants will find their pay reduced by a minimum of £4,000 per year.

Talking about these employment changes, the Trust's chief executive, Nick

Carver, said: "When it comes to paying our consultants for the work that they do when not caring directly for patients, we have to live within our means.

"Our consultants will continue to be paid for carrying out such work, but at a time when jobs and posts are being removed the Trust cannot be as generous as it has been in the past."

Shared services

Other changes being pursued include a new combined pathology service that will support the work of the Trust, as well as Bedford Hospital NHS Trust and the West Hertfordshire Hospitals NHS Trust.

Blood samples would continue to be taken locally at each hospital, which would also retain the ability to carry out urgent tests itself. All routine pathology requests would be handled by the new combined service, which may or may not have private sector involvement.

Similar plans are also being developed for a new sterile services facility, which would provide a service to a group of hospitals in areas of north London, Hertfordshire, Bedfordshire and parts of Essex.

The Trust's chief executive, Nick Carver, said: "Although yet to be quantified, the potential savings offered through these pathology and sterile services initiatives is considerable.

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