Hospitals need £14m in extra funding to avoid debt

The Mid Yorkshire NHS trust, which runs hospitals serving 550,000 people in Wakefield, Pontefract and Dewsbury, is targeting efficiencies of £30m by next March, but also needs an extra £14m in financial support to break even.

Auditors are warning they will have to come up with alternative plans if the additional funding cannot be found, as latest figures for the six months to September show the trust is already £4.4m overspent.

The support comes after the trust last year received £21m in extra funding from the Department of Health to help its transition into new hospitals in Wakefield and Pontefract.

Hospital chiefs yesterday confirmed plans to shut A&E at Pontefract overnight from 10pm-8am from November 1 due to staff shortages – despite accusations from MPs the move broke key pledges to local people.

The unit, which opened only nine months ago, could be downgraded further to a minor injuries and illness service following a major re-configuration of services.

In an audit report, accountants Grant Thornton warn the risk if the extra £14m is not received is a “cause for concern”, exacerbated further by the risks to the delivery of its savings plans.

Managers need to “urgently resolve” if the extra cash will be available – or draw up a “Plan B” to break even.

The report adds: “The trust’s financial position over the medium term remains extremely challenging as it seeks to remain in financial balance while facing significant cost pressures impacting across the NHS, the challenge of achieving foundation trust status, and at the same time ensuring quality of clinical performance.”

Mid Yorkshire’s finance director, Bob Chadwick, said the trust needed to save £60m in total over two years and plans had been set out to save half of that in 2011-12.

“Work continues to identify savings and a significant level have been identified. All savings are closely scrutinised to ensure there is no impact on patient safety or experience,” he added.

Managers yesterday agreed the overnight closure of casualty at Pontefract due to “significant risks” caused by a shortage of doctors to cover emergency care.

Chief executive Julia Squire said the overnight closure was the “only possible decision to take” until there were enough doctors to safely staff its three emergency units.

The “vast majority” of patients using the unit did so during the day when they would still be seen.

“The safety of our patients is our absolute priority,” she said.

“There is a national shortage of experienced emergency department doctors and clinical advice is that we have not managed to recruit enough to keep three emergency departments safe.”

The board also confirmed plans to consider a shake-up of care which could see a full A&E service end altogether in Pontefract, saving an estimated £3.5m a year, centralisation of inpatient care for children requiring more than 24 hours in hospital in Wakefield, and centralisation of planned orthopaedic surgery at Dewsbury.

Stroke rehabilitation and routine eye operations would be carried out in Pontefract and Dewsbury, which could also see its full maternity service closed.

Detailed work on the plans will now be carried out and there could be a public consultation next summer.