Bad luck and poor policy hits hospital

Huntingdon s hospital and its staff are currently in a state of unrest. Wards are closing, people are being made redundant and rumours are rife. What exactly is happening at Hinchingbrooke Hospital? Ian MacKellar finds out. HINCHINGBROOKE Hospital, in Hu

Huntingdon's hospital and its staff are currently in a state of unrest. Wards are closing, people are being made redundant and rumours are rife. What exactly is happening at Hinchingbrooke Hospital? Ian MacKellar finds out.

HINCHINGBROOKE Hospital, in Huntingdon, is expected to close three medical wards in the next year - in a drive to improve patient care.

In spite of ward closures - the number of beds was reduced by 17 per cent in 2005/06 - the hospital is treating more patients than ever before, according to chief executive Douglas Pattisson.

Medical advances, particularly in surgical techniques and anaesthesia, mean more than 80 per cent of patients undergoing elective (non-emergency) surgery are now seen as day patients in the hospital's £25million treatment centre, which opened in September.

That hugely expanded the capacity for "day surgery", which involves patients occupying a bed for 23 hours or less. It also sparked the closure of Poplar Ward, which had been used for pre- and post-operative care.

There was also the recent closure of Rowan Ward - the hospital's women's ward - and the transfer of most gynaecological patients to the new centre. With the imminent closure of Holly, the children's ward, three central wards will have become free by next spring.

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Holly Ward will be replaced by a new paediatric centre, currently under construction.

The hospital's next plan will be to move the three remote general medical wards - Larch, Oak and Cedar - to the central part of the hospital, close to X-ray, pathology and other medical services, so there will be no loss of medical beds.

"We are looking to bring those patients closer to the front [of the hospital] and to the services they need, so that we can work more efficiently. It's a matter of making the best use of our facilities while at the same time looking after our patients.

"There are financial benefits, but that's not where we started from," said Mr Pattisson.

In the face of huge overspends across the NHS nationally, the trust is being made to claw back a £6.5million deficit by the end of March 2007, as well as having a statutory duty to break even year-on-year.

Management consultants KPMG started work on Monday to help identify savings.

Hinchingbrooke's deficit was a combination of bad luck and discriminatory policies by the Department of Health.

The bad luck was that the multi-million pound sale of staff accommodation at the site to a housing association was not completed before March 31, the end of the hospital's financial year. While it can be argued that the sale, once completed, is a capital windfall that will not reduce operating costs, it is equally true that Hinchingbrooke's core business is healthcare, not key-worker housing.

The DoH policy that discriminates against Hinchingbrooke lies in transitional arrangements for "payment by results", which aims to pay hospitals the same money for the same procedures - in four years' time.

Until then, while foundation trusts such as Addenbroooke's Hospital, in Cambridge, and Papworth get the full whack, efficient hospitals - and Hinchingbrooke is one of the most efficient in the country - are paid less for the same work than inefficient hospitals.

That it will iron itself out over time is little consolation for up to 200 Hinchingbrooke workers who may now face compulsory redundancy between the autumn and next March.

In the short-term, with the deficit hanging over the trust, it is aiming to save £5.1million in pay costs - it has already identified or achieved cuts of £3.6million through not replacing people who have left or renewing contracts - and a further £1.9million in non-pay costs, mostly procurement.

The jobs will go in two phases, the first 100 expected quite soon after consultation with employees and trade unions to identify where losing the posts would hurt patients least. A 30-day consultation period with employees whose jobs might go will start early next month.

How many more than those 100 are actually required will depend on how effective round one is in delivering savings.

The trust will also review jobs at four levels, including management, specialist nurses, administration and clerical, and junior medical staff.

"We are trying to maintain the integrity of the hospital and look after the very loyal people who work here," Mr Pattisson said.

"It's going to be a very difficult time for our staff, and it's very disappointing for us."

At the same time, the hospital is reviewing whether it could reduce full cover in certain specialities at times of day when there is little demand for them, such as orthopaedics at 4am, without compromising patient care. The board expects a further report next month.

But that does not mean - Mr Pattisson stresses - withdrawal from 24/7 emergency cover.

The trust says its ultimate aim is for all care to be removed from the original 20-year-old hospital into state-of-the-art new facilities. In addition to treatment and paediatric centres and following the £6million refurbishment of the A&E department - now re-named the emergency care centre and officially opened last Friday - the trust has applied for planning consent for a new renal unit and extra car parking.

The parts of the building occupied by the soon-to-be-closed remote wards could be a future home for other NHS activities or could be sold for conversion to housing, perhaps for key workers, such as nurses, teachers or paramedics.

It would have the added benefit of injecting capital into the trust for new, modern facilities and saving huge sums on running costs.

* Are you concerned about the changes and redundancies at Hinchingbrooke or are you looking forward to new state-of-the-art facilities? Let us know your views by e-mailing or writing to The Hunts Post, 30 High Street, Huntingdon, PE29 3TB.

* The Patient and Public Involvement in Health Forums for Huntingdonshire PCT and Hinchingbrooke Hospital are planning to conduct monitoring visits to review the out-of-hours GP service, pharmacy services throughout the district, physiotherapy services including physio-direct and dental services.

Chairman Dr Angela Owen-Smith wants to hear the experiences of members of the public, patients and carers in advance.