Chief Executive talks of challenging year ahead
11/01/2005
Cotswold and Vale Primary Care Trust is carrying a substantial year-on-year financial shortfall, says Chief Executive, Richard James.
The PCT started its life almost three years ago with a shortfall of around £5.5 million. This has been reduced by a range of measures to the current problem of £3.5 million. In this year, we are still trying to find approximately £2.8 million to enable us to break even. Any shortfall in this amount will simply increase the problem for next year, as any deficit has to be carried over.
The NHS now works under a new financial regime, in that every treatment offered to a patient has a specific price attached. For instance, an average outpatient appointment costs £150 and the average medical admission £3,000.
Therefore, to reduce our costs, we have to reduce our call on our NHS services, for instance referrals to the district general hospitals or reducing our prescription costs.
Our buildings also cost substantial amounts to run in terms of overheads such as heating, lighting, mortgage repayments, etc, so we want to ensure as much work as possible goes through them to keep these overhead costs as low as possible by improved productivity.
We have already taken a number of short-term cost saving measures that are painful but necessary to minimise the current financial deficit.
. We have put a stop to recruitment - except in emergencies.
. We have stopped all bank and agency staffing - except in emergency.
. We have put a stop to all training, except statutory and professional registration training.
. We have stopped non-essential attendance at conferences.
. We have stopped all purchases other than for clinical needs.
In addition, we took the decision to temporarily close eight beds in Moreton and eight in Bourton. The beds at Moreton Hospital re-opened yesterday (saving over £13,000) and those at Moore Cottage Hospital, Bourton-on-the-Water will re-open at the end of March 2005 (saving almost £18,000).
We believe this deficit can be tackled effectively, but it is going to require all of us, both in the clinical community and management, to work very differently and use our NHS as efficiently as possible. The NHS is not a "free good" and we have to understand that every call upon the service brings with it not only patient benefits and well-being but also a cost.
It is our intention to work with our local stakeholders, clinicians, local councillors, Leagues of Friends and our public to provide our NHS services more efficiently and more locally but within the resources available. There is an overriding objective of getting our use of NHS and financial resources in balance.
So why is your local NHS and indeed the NHS in many parts of the country finding it difficult to balance its books when so much new money has been invested? There are four main reasons for this:
. the cost of new consultant and GP contracts substantially above the funding allocated;
. changes in the standards of service offered by the NHS, rightly investing in reducing infection rates and improve training and education for our clinical staff;
. the substantial investment required to reduce waiting lists;
. investing in improved technology and treatments, for instance diagnostic tests and new drugs such as those used for cholesterol lowering.
Many of these new costs have improved the care of patients but have not in all cases increased the productivity. The NHS Plan is very ambitious. Getting the ambitions of politicians, clinicians and the public into line with the financial resources is undoubtedly proving to be a major challenge.
