King's College hospital trust makes biggest overspend in NHS history

[editor]

Ruddy Nora

A leading London hospital trust is expected to record an annual deficit of between £180m and £191m – the biggest overspend in NHS history, the Guardian can reveal.

King’s College hospital trust believes it overshot its projected £146m deficit for 2018-19 by a further £34m-£45m after experiencing a series of setbacks, documents seen by the Guardian show.

The trust is struggling with the most serious financial problems in the NHS as a result of a private finance initiative (PFI) contract, high use of agency staff to cover its chronic lack of nurses, and being fined for missing the four-hour A&E target. The 2013 takeover by King’s of the Princess Royal university hospital (PRUH) in Orpington, Kent, has also increased its costs while it is paid less than other nearby hospitals for providing certain types of care.
It has found it impossible to balance its books for several years as the government’s policy since 2010 of limiting the NHS to annual budget rises of just 1% a year, at a time when demand for care has been rising, has pushed many hospitals into the red.

Drastic budget overruns led to the trust being placed in “financial special measures” in December 2017 and the departure of most of its leadership team, including the then chair, Lord Kerslake, the former head of the civil service.

King’s posted a deficit of almost £132m in 2017-18 – which until now was the largest ever seen – and £48.6m the year before. But last year’s record overspend of £180m-£191m represents a major worsening in its already precarious finances.

Papers circulated to the trust’s senior managers say: “King’s started the 2018-19 financial year with a deficit control total of £146m.” However, they then detail how that projected deficit has risen by at least £34m as a result of delays to its new critical care unit (£4m), failure to hit its savings target (£8m), and loss of expected income because of “poor operational performance” – its inability to meet targets for A&E care and planned operations.

The papers say: “We have experienced further one-offs not foreseen in the original budget of £17m, taking the expected in-year deficit to £180m. We have submitted business cases which, if not approved by [the NHS regulator] NHS Improvement, would increase the in-year deficit to £191m.”

King's College hospital trust makes biggest overspend in NHS history

 

[ska invita]

i know a doctor who works at Kings and she is running around like a headless chicken trying to deal with the case loads....
she was told the other day 'send home x number of people to clear beds' - before they were ready for discharge...obviously she didnt, but thats indicative of whats going on there
one things for sure, its not for staff not pulling their weight

 

[wiskey]

I have never really understood the logic of financially penalising NHS trusts who miss targets, they used to do it when I worked for the LAS and it baffled me then.

 

[ska invita]

I have never really understood the logic of financially penalising NHS trusts who miss targets, they used to do it when I worked for the LAS and it baffled me then.

Its not logic its market idiocy

 

[CH1]

I wonder how much Lord Kerslake was concentrating on his King College Hospital Trust job when he was simultaneously making Peabody Trust more "market oriented".

Incidentally although Kerslake resigned from Kings the day before the original bad results were published, he still retains his chairmanship of Peabody.

The article alludes to problems at the Princess Royal Hospital at Orpington. Surely this was merged into Kings BECAUSE it had problems, and Kings was supposed to sort it out?

There is no particular geographic affinity between Camberwell and Orpington. Actually Orpington is not even in London.

Additionally Kings is an example of NHS planners out of control. Remember the Kings 2000 project? They're still at it in 2019. The Neurology Research Unit (ie the Maurice Wohl Clinical Neuroscience Institute on Cutcombe Road opposite the Corner Surgery) opened 3-4 years ago.

Then more recently the The Institute of Hepatology, London (111 Coldharbour Lane) was opened.

It's great to have these prestige buildings and research teams nearby, but it does seem to me that there is less chance of appintments these days, not more, not withstanding this investment in "OUR" NHS as the politicians put it (on all sides of the house).

To sum up - IMHO like everything else the prestige projects of Kings are booming, routine services are failing and merging in failing hospitals from Kent into Kings can only add financial risk. As borne out by these terrible financial figures for Kings.

 

[editor]

I have to say I had bloody wonderful service at Kings recently. Fantastic staff and I was afforded the highest level of care.

 

[kalidarkone]

It's a scam for sure. I don't know one trust that has met their target in terms of waiting times. How will the arbitrary target ever be met when staff numbers are decreasing due to stress,Brexit, retirement and a significant drop in the number of nursing and midwifery students? Penalising trusts and not investing in public healthcare -it's a mass rip off!

 

[CH1]

I have to say I had bloody wonderful service at Kings recently. Fantastic staff and I was afforded the highest level of care.

Ironically the Phlebotomy Department (Blood Tests) is currently at peak efficiency. You can be in and out in ten minutes. Years ago you might waste half a morning waiting. But if you notice it is actually outsourced to a company called Viapath - look at the staff uniforms.

According to their accounts Viapath Analytics LLP made a profit of £2.8m on revenue of £71.2m. It provides pathology testing services for Kings, Guys St Thomas's, Princess Royal University Hospital Trust and SLAM.

Interestingly it appears that SERCO controls 33% of Viapath.

I had very good treatment from Kings a couple of years ago when I got shingles.
The problem was it took about 10 days to get my GP practice to refer me.

The problem is that GPs were given control over the NHS under Cameron and Blair, and this "market system" in the NHS produces unpredictable results.
If Viapath is making £2.8 million of profit, who is it making that from - the CCG (GPs) perhaps?

And whom pays the CCG? Its all smoke and mirrors - and an accountant and lawyer's holiday.

 

[CH1]

Anybody have any idea of what "Kings Health Partners" is or does?
Why does it have to be a separate company.?

The MD of Kings Health Partners used to work for SLAM Jill Lockett

Her report into the death of Sean Rigg seemed pretty gross to me on reading it just now.
It's on Lambeth Council's website.

https://moderngov.lambeth.gov.uk/documents/s50147/02b%20Sean%20Rigg%20Inquest.pdf

Apart from the obvious mistake (a SLAM funded outsourced private hostel becomes in her prose "hospital") the report has a gloss on it which is reminiscent of Boris at his most oleaginous, notwithstanding it is dated 2012

 

[kalidarkone]

About Us | King’s Health Partners | London

Our aim is to create a centre where world-class research, education and clinical practice are brought together for the benefit of patients.

www.kingshealthpartners.org

 

[Agent Sparrow]

There once was the idea to merge them all, or at least the three NHS trusts, into one huge super trust. A consultant psychiatrist I know summed up why it probably didn’t happen quite well, with “well if they merged there would only be one chief executive, and now there are three”

The huge KCH deficit probably didn’t help either.

So I think Kings Health Partners is basically the collective compromise.