Friday, 31 May 2013

RLI ward closures planned; NHS Trust budget cut by 13%

The University Hospitals of Morecambe Bay NHS Foundation Trust (UHMB) has circulated a consultation document to staff outlining proposals to save the Trust £30 million from its annual turnover of £250 million. (You can see a scanned PDF copy of the consultation document here.)

Changes proposed include a reduction of 200 front line clinical and nursing staff and 40 clinical admin support staff. Redeployment proposals include downgrading ('reprofiling') of staff and a broad range of downward changes to pay and conditions. Skilled maintenance workers such as qualified plumbers and electricians are to lose any retention premium, which would drop their pay to apprentice-grade levels and the market is to be tested for external contractors.

In the new proposals the number of beds available at the RLI, now totalling 491, would be reduced by 40.  Wards 5 & 6 (30 beds) are to be closed. We understand that the Day Surgery operating theatre is also to be closed, despite having one of the best records for patient outcomes, infection-control and patient satisfaction across the entire Trust. In 2012 the Trust announced as an 'important improvement' for the RLI that 'From 30 October, day surgery patients will be seen in single sex wards with ward 5 as the female day surgery unit and ward 6 as the male day surgery unit.' Less than a year on, the Day Surgery unit is targetted for closure.

In addition, 10 beds are to be cut from Ward 16 (Gynaecology) at the RLI on the assumption that more of these cases could be treated as Day Cases if staff work longer shifts.

Day Surgery cases overall are to be increased, with staff shifts suggested as 7.30am·to 9pm Monday to Saturday / Sunday. General Surgery Theatre hours have similar shift increases proposed over a seven-day week.  In addition, Wards 5 & 6 are currently routinely and daily used to accommodate and monitor  'overspill' patients from General Surgery. If these wards are to be closed, then it is not immediately clear from the proposals how the current caseload will be safely accommodated, let alone an increase in surgical cases.

Many other services offered in both Kendal and Lancaster are under review, with a view to centralising them in a single base. Other services may be merged to share staff and facilities.
The cost reduction programme is timed to take place as the Health Trust also faces the challenge of adapting to the  fundamental change in the way medical services are commissioned by the new GP-led Clinical Commissioning Groups.

It's not bad news for everyone. Frontline nursing and clinical staff who face pay cuts and downgraded redeployment to different sites across North Lancashire and Cumbria may find comfort in The Westmorland Gazette report this March that the employment contract of former Trust Chief Executive Tony Halsall has survived both cuts and failure to deliver an acceptable service. He is still being paid his £150,000 a year salary from UHMB - despite stepping down in February last year. His severance package is said to total £225,000, plus perks such as an NHS lease car. Mr Halsall and several other trust board executives were made to walk the plank after the Trust was taken under special administrative measures by government watchdog Monitor, following a scandalous series of major organisational failures and avoidable deaths. (see previous report).

Staff were given 45 days to respond to the UHMB cost reduction consultation, which ends in June. We are yet to be informed when the public is to be consulted on the considerable changes planned to our services. There is no reference at all to any specific proposed change on the http://www.bettercaretogether-morecambebay.nhs.uk/ consultation website, although UHMB cost reduction plans appear to be at an advanced stage of development. However we are confident that the Trust will soon be announcing the publication of a comprehensive online statement of the proposals and organising a series of well-advertised-in-advance and well-briefed local and accessible public consultation events. It stands to reason that our NHS Hospitals Trust will be open to reconsidering some of the proposals if the public finds them to be unsustainable. It's all about choices.

We have asked the UHMB NHS Foundation Trust for clarification on the above issues, and will update you as and when. 

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