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.
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 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.
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?
MONEY PUZZLE AS DACORUM COUNCIL HEARS CASE FOR BEEFING UP HEMEL HOSPITAL
Dacorum Health Action Group (DHAG) Chair Philip Aylett made the case for investment in Hemel Hempstead Hospital to a full meeting of Dacorum Council this week.
He called on the Council to press West Herts Trust to keep a wide range of hospital services in Dacorum, Hertfordshire's largest borough, slamming as 'misleading' claims by the Trust that their current plans would give Hemel Hospital a 'distinct role' for the future in hosting planned medical appointments. Trust documents analysed by DHAG show that Watford will retain its role as the area's main centre for planned medical appointments.
And there is a mystery about money for new hospital developments, with the Trust position confused.
Council Leader Ron Tindall reported that he was in discussion with the Trust about health services for Dacorum, but revealed that there was no news about finance for any development. Mr Tindall said of his talks with Trust Chief Executive Matthew Coats and Chair Phil Townsend:
We couldn’t actually come to a great deal because the government are still keeping their cards very close to their chest and we’ve still got no details about the money, which is unfortunate because nothing else can be decided without that.
Dr Aylett commented: 'It was good to get a sympathetic hearing and to see that there is interest from our elected representatives in Dacorum in ensuring good hospital services here. There seems to be a cross-party recognition that we need to have convenient hospital care close to home. Action is needed - there is no guarantee in the plans of the unelected and untransparent Trust that Hemel Hospital would have a clear future role, despite their misleading claims to the contrary.
'Whatever happens in the Borough there seems to be agreement across the Council that a new emergency care and specialist hospital on a clear new site would still be the best way forward for Dacorum residents.
'But we are a long way from decisions, and confusion reigns about funding. The Trust say they are unable to tell the Council what money will be available for redevelopment, but less than two months ago they welcomed a Government announcement of 'full funding' for their preferred option at Watford. No funding figures were made public.
'Does that mean that, while Watford funding is agreed, Hemel and St Albans Hospitals will still have to fight for financial support? Or was the 'full funding' announcement just mostly hot air, as we have suspected all along?
'In recent months the Trust has gone into its shell, with almost no public engagement about its plans. The funding picture for Dacorum and West Herts generally is totally unclear and the mystery needs clearing up.'
WATFORD HOSPITAL WARDS RATED WORST IN NHS FOR FOOD SAFETY
Wards at Watford General Hospital have been officially rated the worst in the whole of the NHS for food safety.
The Food Standards Agency (FSA) has given the Vicarage Road facility a hygiene rating of one out of a possible five, meaning that ‘major improvement’ is necessary.
The Hospital is the only hospital of many hundreds in the NHS in England, Scotland, Wales and Northern Ireland to get the 'single star' rating. It has not improved its rating since 2019.
A damning report by Watford Borough Council health inspectors on behalf of the FSA uncovered a litany of hygiene failures. A kitchen in a children’s ward had a dirty floor and bare plaster on the walls. Patients with allergies have been put at ‘serious risk’ by poor safety practices, with stroke patients among those exposed to the danger.
Read the Food safety media release . Read the Watford General Food Safety Report
WEST HERTS TRUST BOTTOM OF THE LEAGUE FOR PLANNED TREATMENT
West Herts Hospitals Trust has been lagging behind the rest of the English NHS when it comes to elective - planned - treatment.
A recent Health Service Journal article pointed out that the Trust is way behind its target to do more elective work. The targets have been set by the NHS to push trusts into recovering from the backlog of work caused by Covid.
But West Herts is far off the national pace. In early 2022-23 it only managed to do 77 per cent of the pre-pandemic level of elective work, and has been told to increase this to 103 per cent.
This poor performance puts it well behind other local trusts, such as Bedfordshire including Luton and Dunstable, which is achieving 95 per cent of the pre-pandemic figure, and East and North Herts (including Lister) which is recovering well to achieve 110 percent.
And the many years of construction work planned by the Trust on the site of Watford General (and St Albans City) will probably deter people from choosing W Herts. The result will be financial pain for our Trust as patients vote with their feet to avoid our building site hospitals.
Photo: Clay Banks on Unsplash
£39 MILLION HOSPITAL PARKING ‘SOLUTION’ WON’T WORK
A parking crisis is looming for West Hertfordshire Hospitals Trust. Demand for car spaces from new developments at Watford General and St Albans City Hospitals looks like exceeding planned supply. A year-old £39.3 million multi-storey car park, the Trust's claimed 'parking solution', is not likely to be big enough. Many patients, other visitors and staff could be forced to park well away from the hospitals.
The New Hospital Campaign is urging a ‘radical rethink’ of the Trust's Watford proposals - planning for an emergency care and specialist hospital on a clear new site rather than trying to squeeze so much onto the cramped Watford General site.
NHC Co-ordinator Philip Aylett said:
‘The Watford General site is simply unsuitable for the planned expansion. The case for redevelopment there relied on the claim that construction work would not interfere with the operation of the Hospital. This is patently untrue – disruption will be endemic at Watford General.'
At St Albans City Hospital, plans for a new elective surgery hub to reduce backlogs, serving the whole of Hertfordshire and West Essex, are stumbling over lack of car park space.
The Trust are desperately searching for spaces to meet the increased demand generated by the new hub. One possibility is for 20-30 cars to park on the Batchwood estate - a mile away across a busy road. Mr Aylett criticised the Trust's St Albans parking proposals as 'absurd'.
The full media release is here
