Agenda item

This paper is an organisational update from the Royal National Hospital for Rheumatic Diseases NHS Foundation Trust (RNHRD) to the B&NES Wellbeing Policy and Development Scrutiny Panel.

The Chairman invited Kirsty Matthews (Chief Executive of the RNHRD) to introduce the report.

Kirsty Matthews took the Panel through the report and introduced Eugene Sullivan as the new Chair of the RNHRD and the Council of Governors.

The Chairman commented that the hospital was able, in very short time, to reduce their forecast deficit from £3.7m to £2.6m.  The Chairman said that this was extremely positive and asked if they could continue to reduce the deficit.

Kirsty Matthews replied that the hospital had been able to improve the financial position in a year.  The hospital was able, during this financial year, to pull additional clinical activity in of around £250k.  Part of the plan to reduce the deficit was improvement with pain services – moving all Pain Services to Specialised Commissioning.  There is also an increase of 4.5% of outpatients in Rheumatology Services.  Kirsty Matthews also said that, at the beginning of the year, some money had been put in reserves for some unknown factors, such as non-clinical staff and corporate services.  These reserves (around £350k) were released back out as there was no need to spend that money.  The hospital was able to work through some cost improvement programmes which contributed to improve end of year position.  The hospital had to work with a very cautious budget.

The Chairman asked why the endoscopy referrals are reducing dramatically.

Kirsty Matthews responded that the reduction in referrals was more to do with the fact that it is a single handed consultant service, which always creates a risk.  When the consultant was unavailable for a number of reasons then it was very difficult for the hospital to get the right level of cover for that post.  The impact on the hospital was that they could not operate at optimum capacity.  There are also greater ranges of providers in the community and GPs have a greater level of choices where they can send their patients.

The Chairman commented that the endoscopy could be at risk in the same way as Neuro-rehab services were.

Kirsty Matthews responded that the hospital wanted to flag to the Panel that endoscopy referrals are significantly reduced.  The Board of the hospital is aware what the minimum number of referrals is in order to continue provision of endoscopy.  The hospital is also looking quite closely with the commissioners on what is the best plan for services in 2014/15.

Councillor Organ said that despite the deficit of £2.6m, the public are delighted with the services provided by the hospital.

Councillor Bevan said that the issues such as fall in referrals for endoscopy and/or rise in referrals for Pain Services often change in time and asked how flexible the hospital would be to deal with these issues.

Kirsty Matthews responded that the hospital saw an enormous degree of change in Pain Services.  The team at Pain Services had adapted in looking at different types of programmes and made adjustments in how they run their programme to meet those needs.  Kirsty Matthews added that she is working quite closely with the clinical lead to adapt their staff to be as flexible as they can.  The hospital is able to manage that flexibility to meet the change in patients’ demands.

The Chairman noted that Kirsty Matthews will be standing down as Chief Executive of the RNHRD with effect from 31^st December 2013.  The Chairman said that it is sad news because of the very good working relationship.

The Chairman wished Kirsty Matthews every good fortune for the future.

The Chairman also welcomed Eugene Sullivan in his new position, as the Chairman of the RNHRD Board.

Eugene Sullivan thanked the Chairman for kind words and said that the hospital will miss Kirsty Matthews.  The hospital will interview candidates for the Chief Executive position next week.

Eugene Sullivan also said that the hospital will do their best to come out of financial difficulties though it will be difficult task considering that the RNHRD is small hospital.

It was RESOLVED to note the report.