Trust had no choice but to seek savings

Trust had no choice but to seek savings

5 November 2014

DOWN District’s most senior health chief has admitted the £5m saving the South Eastern Trust must deliver before the end of March could have consequences for patients.

Department of Health finances don’t match what’s needed to deliver services during the current financial year, resulting in a series of health cuts across the Province.

Nine beds are to close at the Downe Hospital, while the hospital’s dedicated coronary care ward is to be closed and subsumed into a large medical ward. Elective surgery will also be drastically scaled back.

There is more worrying news for the elderly with a reduction in domiciliary care packages which includes home help provision, respite and day care and a raft of other community care services. Trust officials are planning to replace only two out of every three domicilary care packages which could mean longer stays in hospital for the elderly, but expect to invest additional money in the service moving forward.

There will be no reduction in permanent staff but the use of agency staff will be cut along with overtime. Staff travelling expenses will be reduced with the Trust implementing the cuts by the start of next month.

While the raft of cuts have been labelled as “temporary,” Trust chief executive, Mr. Hugh McCaughey, said there are no guarantees they will not become permanent. He said it will simply not be possible to maintain current levels of service provision in the absence of all the required funding.

The Trust has warned its plans will affect both the quality and access to some of its services provided in the hospital and community settings and will endeavour to mitigate the impact the changes it will have. But the Trust says it cannot prevent impact on certain aspects of service quality and while the organisation does not believe its proposals will leave services unsafe, “there is an increased risk which has to be managed.”

Mr. McCaughey said the series of “contingency measures” at the Downe and elsewhere across the Trust have been introduced at a time of unprecedented financial challenges across the public sector, with the Department of Health requiring each health trust to achieve a break even position by the end of next March.

He said the cost-cutting measures planned for the Downe will be kept under close review and scrutiny and said that if it’s decided the proposals should become permanent, they will be subject to consultation.

Confirming Health Minister Jim Wells has approved the series of cuts proposed for the Downe, Mr. McCaughey said cardiology services at the Downpatrick hospital will continue.

“We are not stopping the cardiology service,” he declared. “What we are doing is consolidating services in two wards instead of three. People that have heart complaints have gone into the Downe in the past and those who are suitable for getting into the hospital will continue to do so.”

The chief executive said while politicians have been happy to throw brickbats at the Trust over its decision to reduce services to save money in line with a government directive, some of them are members of parties which voted through a level of funding which means savings have to be found.

“None of the parties or politicians want reductions in their area, but the reality is we are left having to find the money the political system has said we need to find,” he declared.

Mr. McCaughey said the South Eastern Trust has been trying to find savings which have the least impact on services, explaining there has been a slight reduction in the number of patients using the Downe this year.

“What what we are doing is consolidating services and when you consolidate three wards to two, clearly you make savings and this is also a more efficient way of doing things. We have had to take a number of beds out of the Downe and can I say this will not have an impact, no I can’t. At peak times we will struggle if we have 40 beds instead of 49,” he continued. “At peak times I can’t say there won’t be some consequence, but that’s the nature of what we are facing.

“We have been asked to find additional savings and I have made very clear that you cannot do that without it having some impact. We have taken beds out of each of the Trust’s geographical sectors and I know it’s been said we haven’t taken beds out of the Ulster, but we have taken beds out of its catchment area.”

Mr. McCaughey said the Trust looked at the best place to take beds out in terms of demand, efficiency and length of stay, explaining while there has been a reduction in patients going to the Downe, the numbers attending the Ulster Hospital have risen. He said if you are looking at trying to minimise the impact, taking beds out of the Ulster “would clearly have a bigger consequence.”

The Trust chief believes a hospital should not be defined by the number of beds it has and revealed he is aware that what the organisation is planning to do at the Downe is unpalatable locally.

Mr. McCaughey continued: “I am very conscious the issue we always have in a way with the Downe is the thin end of the wage and is the hospital undermined? I do believe the Downe has a strong and vibrant future around providing local services, including general medicine and care of the elderly.”

The chief executive said he fully understands the Trust’s proposals have generated concern and anxiety in the community, but urged people to look at the situation the South Eastern Trust has been placed in.

He added: “There are cuts across the broader public sector, with every department feeling the pinch at the moment. There is rising demand within health and social care every year and ring-fencing what we have is not enough. One of the big challenges is how do we do better at managing future demand.

“I know politicians will be critical and look at the impact on their particular area but these are big public sector, societal issues. If you take £5m out of the South Eastern Trust you can’t expect it not to hit our area.”