ST ALBANS HOSPITAL IMPROVEMENTS DELAYED AMIDST TRUST CASH CRISIS
Money intended for new buildings and services at St Albans Hospital is being diverted to day-to-day operations as the West Herts Trust struggles to keep financially afloat.
There was tough questioning at the Trust's Board meeting this week as officials explained that work intended for this year on a new surgical hub, endoscopy and a diagnostic centre is being delayed until next year at the earliest. Funds which are supposed to go towards buildings and equipment are being used to meet 'revenue' - running - costs.
The cash crisis shows that the Trust is very unlikely to be able both to afford the £1.1 bn plus tower block hospital on the Vicarage Road site at Watford and still run its services to a decent standard. The towering infirmary would waste huge sums of money because of the difficult site and the interference with everyday operation of the existing Hospital.
The Trust faces a likely deficit of at least £22m this financial year as senior management pleas to cut spending fail to make a difference across the organisation. Patient demands on the main clinical departments have led to stubborn deficits in the year to date. The Surgery Division's costs are £4.8m higher than planned, Medicine Division's costs are £6.8m above budget, and Emergency Division's costs are £3.8m above budget.
With winter on the way, these figures could easily get worse.
Faced with deficits like this in other big hospital trusts in Herts and West Essex, the regional supervisory body, the ICS, is demanding even tighter controls over spending.
The result could be that the local West Herts Trust loses some of its independence.
We may be fed up with the Trust's performance and bias towards Watford General - but the risk is that an even more remote and unaccountable body could end up running our health services.
HOSPITAL ACCESS COULD BE KEY POLL BATTLEGROUND
Hospital issues - especially the difficulty of getting to Watford General Hospital - could become an important issue in the polls that are coming up, including the General Election.
That's clear from the results of a major public consultation on plans for the future of South West Hertfordshire.
With the results in several marginal Herts parliamentary seats looking too close to call, candidates will need to listen to complaints about the location of the Vicarage Road hospital. Access to GPs will also be a big issue.
The consultation on the South West Herts Joint Strategic Plan covered thousands of respondents and showed that:
- One of the biggest issues for residents was access to healthcare
- The 'principal concerns' on infrastructure 'related to Watford Hospital and the fact that this was hard to access.'
- People frequently mentioned Health and Transport under the 'biggest single issue' category.
- In the summary of responses - Hospital concerns about Watford featured highly.
A startling 'Word Cloud' showed which issues loomed largest for the people surveyed - and Hospital and Transport came up top.
COULD YOU SHAKE UP THE WEST HERTS TRUST BOARD?
There's a great opportunity for a professional to begin to make waves on the West Herts Trust Board.
At present, there's not a single non-executive director on the Trust Board with a main residence in Dacorum.
We desperately need more people who understand Dacorum's health needs, to make the grossly unbalanced West Herts Board fairer.
Can you help to correct that outrageous situation?
The NHS is running a recruitment campaign for a Non-Executive Director for West Herts Trust - they must have senior experience as a registered nurse, midwife or an allied professional.
Do you have that sort of experience - or do you know someone who does?
It would be great if someone from Dacorum could get on the Board. That would be a small but important step towards ensuring the Borough's health and hospital needs are properly represented in decision-making, for the first time for years.
It would also be good if there was someone on the Board with an independent mind - who could push for alternatives to the Trust's disastrous plans for Watford General.
This is the link to the application forms. You'll have to be quick - closing date is 1 November.
https://www.england.nhs.uk/non-executive-opportunities/2023/10/10/west-hertfordshire-teaching-hospitals-nhs-trust-non-executive-director/
GOOD LUCK!
TRUST IN DENIAL AS DOUBTS GROW OVER MONEY AND DESIGN FOR WATFORD'S TOWERING INFIRMARY
The West Hertfordshire Trust was in full denial mode last week as it insisted that all was well with its 260-foot tower block hospital for Watford.
But there's growing uncertainty that the Trust will get the money to build the hospital - or approval for its preferred design.
- On finance, a Trust Board meeting on 5 October was assured that there was 'full funding' for its triple-tower, 400-foot wide design. A Trust official claimed not to know that funding could be changed under future government finance reviews. Yet the Department of Health made clear in a press release in May that funding could be altered by government. In tough times for public spending, that financial uncertainty casts doubt on the Trust's £1.1 bn plus Watford plans - among the most expensive of all the 'new' hospitals.
- On design, Watford Borough councillors will be taking a very close look at the Trust's present plans and may seek big changes. The Council's policy is to keep new buildings in the hospital area to a decent height of about six storeys. That could mean lopping over one hundred feet off the height of the present enormous design, which runs to the equivalent of 20 plus storeys. The Council's development management committee warned last month that it will also be looking at the quality of the design after doubts were raised about the amount of shadow that would be created by the three tall towers - crammed together just 15 or so metres apart.
The Trust needs to get real and accept that its plans just won't work.
TRUST FAILS DACORUM AS HEMEL INVESTMENT IS KICKED INTO VERY LONG GRASS
The future of Hemel Hempstead Hospital looks more uncertain than ever, with West Herts Trust looking at 'options' for the site.
Ambitious plans for a major Community Diagnostic Centre (CDC) for the town have slipped well behind schedule, with the Trust refusing this week to explain why.
CDCs offer one-stop visits for checks, scans and tests, to achieve early diagnoses for patients, timely treatment and intervention.
In November 2022, the Trust made a big promise that Hemel would be the 'hub' of a West Herts CDC, with St Albans as a mere 'spoke'. A 'new build extension' to accommodate the Hemel CDC was planned for 2024.
But nothing has happened to bring this important facility any closer.
When asked the target date for submitting a business case for the Hemel CDC, a Trust official told this week's Board meeting that there was no date yet. So there is no chance of anything being built for many years. 'Options' for the site are being explored - which, according to many sources, is likely to include closure and replacement by a new facility in the town centre. There is no detail whatsoever on what that might mean,
Expect a glorified GP's surgery at most.
Financially, West Herts look to be abandoning Hemel Hospital and hoping for someone else to pick up the tab for services in Dacorum. Papers for this week's Board meeting say:
bids have been submitted for alternative funding for planned care services, where this is available. The future [?] for St Albans lend themselves readily to these individual service bids, whereas the focus at Hemel Hempstead is on developing care pathways ahead of significant investment to consolidate the site.
This sounds as if the Trust are optimistic about outside funding for St Albans but not for investment at Hemel, where the focus is simply on 'consolidation' of the site.
It is clearer than ever that the Trust, faced with a huge bill for Watford General's towering infirmary project, are intent on cutting back hard on investment anywhere else.
As ever, the big losers are the people of Dacorum, who are faced with long journeys for treatment in the shambles that is Watford General.
CAMPAIGN HITS PARLIAMENT WITH ATTACK ON BOTCHED NEW HOSPITAL PROGRAMME
The New Hospital Campaign has sent Parliament a scathing attack on the Government's hospital-building efforts, especially the plans for Watford General.
The Campaign has submitted to the House of Commons Public Accounts Committee a detailed report setting out the many failings of the Government's New Hospital Programme. The Programme aims to build 40 new (or refurbished) hospitals in England by 2030. The Campaign's report says that:
- The reasons for the choice of sites for new hospitals, including Watford, have never been explained. There was no proper evidence to say why one hospital is to be given a new building while others are to be left as they are;
- Plans for 'Hospital 2.0', a standard system of building, using factory-made components to cut costs and construction time, have been very slow to emerge. The West Herts Trust have been allowed to waste years on their absurd 260-foot high tower-block hospital, which will never fit Hospital 2.0;
- The Trust will struggle to find any company to build their big and expensive hospital because there is not enough capacity in the construction industry. The narrow, sloping site right up against a working hospital makes Watford an unattractive proposition for contractors.
The Committee is likely to publish a very negative report on the Government's programme, and the NHC criticism will certainly play into that.
The NHC report to Parliament is here
SIR MIKE BACKS CAMPAIGN CALL FOR REVIEW OF WATFORD PLANS
Hemel Hempstead MP Sir Mike Penning has backed New Hospital Campaign calls for a review by senior NHS officials of redevelopment plans for Watford General Hospital.
A scathing report by spending watchdog the National Audit Office has recently uncovered serious problems with the NHS's efforts to deliver 40 'new' hospitals, including the proposed collection of tower blocks at Watford, by 2030.
In a letter to the Hertfordshire and West Essex Integrated Care Board (ICB), which oversees the conduct of the West Herts Trust, Philip Aylett, NHC Co-ordinator, shows how the NAO report helps to undermine the Trust's case for Watford. Key issues include :
- Confusion over the amount of money needed to build the 260-foot Watford structure. The Trust have suggested it will take about £1.2 bn, but the NAO reveals that it could cost up to £2 bn;
- Concern that any new Watford building will be too small to serve the rapidly growing and ageing population of West Herts. The Trust is having to look again at its 'costs and scope' to make it fit within national guidelines;
- Lack of capacity in the construction industry. Few building companies will risk taking on massive projects like Watford General, where a severe and potentially contaminated slope alongside a busy existing emergency hospital makes the site very unattractive. That could mean higher costs and delay for the Trust's plans;
- Failure to consider alternatives that could offer better services for patients, and better value for money, which is a key factor for the spending watchdog.
Mr Aylett calls on the ICB to carry out 'a new review of possible sites for an emergency care and specialist hospital in West Hertfordshire.' That should include a new, independent and comprehensive review of potential clear, new accessible sites away from Vicarage Road.
Sir Mike has sent the NHC letter to Health Secretary Steve Barclay and West Herts Trust Chief Executive Matthew Coats, saying that he fully concurs with Mr Aylett's letter. Sir Mike continues:
'We have a great opportunity here to make sure that we have a hospital facility for the 21st and 22nd Century, and I urge all recipients of this letter to take the contents of it very seriously and treat it with the respect that it deserves'.
The NHC letter to the ICB is here.
CASH CRISIS FOR TRUST AS TREATING PATIENTS IN CORRIDORS PROVES EXPENSIVE
West Hertfordshire Teaching Hospitals Trust is facing a potential £33 million deficit this year as costs run out of control and the Government refuses to pay for high inflation. The best scenario for 2023-24 is a deficit of £11 million.
The Trust may have to borrow this autumn just to keep afloat - just as it prepares to borrow another billion to build the Watford General triple towers.
The Trust Board will hear at a meeting tomorrow (7 September) that:
- A and E pressures including opening 'surge beds' and 'caring for patients in Emergency Department corridors' have bust the budget by £1.5 m
- The drugs and clinical supplies budget has been overspent by £2.7m
- The budget for outsourcing - which is supposed to save money - is overspent by £500,000
- The Trust is burning through its cash reserves rapidly - it had £35 m 'in the bank' in March, £16.9m in May and just £11m in July. Borrowing could be needed by early next year
- Tight spending controls are being imposed to bring costs down
THE GOVERNMENT'S FAILURE TO FUND INFLATION AND THE IMPACT OF THE STRIKES HAVE MADE IT DIFFICULT FOR THE TRUST.
OTHER TRUSTS ARE PROBABLY SUFFERING TOO.
BUT QUESTIONS MUST BE ASKED ABOUT WHY THE WEST HERTS TRUST MANAGEMENT HAS ALLOWED THIS TO HAPPEN QUITE SO QUICKLY - AND WHY, FOR INSTANCE, HIGH SPENDING HAS NOT BROUGHT BETTER RESULTS IN A AND E, WHERE WEST HERTS LAGS THE REST OF THE NHS ON SOME MEASURES
WATFORD GENERAL 'SINKHOLE' HAS ITS FIRST BIRTHDAY - BUT NO-ONE'S CELEBRATING
The collapsed services duct unpopularly known as the Watford General sinkhole has just passed its first birthday. The Trust have been struggling to sort out the mess in the road by the main hospital entrance for a year now, and the digger is still digging.
To be fair it looks as if they are nearing the end of the fiasco and the road may be open before too long. That would be a big relief to patients and staff.
But the saga has shown up the frailty of the vital services tunnels, with cables and pipes, under the hospital. The Trust took months to work out what had happened and what repairs were needed. They still don't know what lies beneath the old buildings and how safe it would be be to build on top. All sorts of things, including asbestos and other pollutants, may be down there.
That matters because it looks likely that the Trust will have to use the site of the existing buildings in the future, for whatever new hospital emerges from the mess that is the acute redevelopment project.
This is just a terrible place to put a new hospital.
ARE WE SAFE IN THE HANDS OF THE NHS? RATE YOUR LOCAL SERVICES
Hertfordshire's top NHS body is asking the public to rate local health and social care services by how good - and how safe - they are.
People will also be able to say how well online services provided by GPs and others are working. The Integrated Care Board (ICB) for Herts and West Essex is running the online survey.
This is a chance to tell the NHS what we think of it, and the Dacorum Health Action Group (DHAG) is urging people to take the chance to get their voices heard.
DHAG Chair Philip Aylett says:
'It's not often that the NHS lays itself open to judgment like this, and I hope a lot of people will take the opportunity to make clear where services are safe and of good quality - and where they're failing. That means we can say what is good or bad at Watford General, St Albans and Hemel Hempstead Hospitals, but also give our views of GP and social care services.
'The NHS is going to rely more and more on online services in the future, so we need to tell it where they can be improved.
'This is a simple survey which doesn't take long to do. I hope lots of people will fill it in.'
The link to the NHS survey is below
https://www.smartsurvey.co.uk/s/4M3QZ1/
How confident do you feel, using a scale of 1-5, that the care you or a family member received was safe?