More foundation trusts in deficit

Blackpool Citizen: Performance against a key target for urgent cancer referrals has fallen to its lowest level in two years, figures for NHS foundation trusts show Performance against a key target for urgent cancer referrals has fallen to its lowest level in two years, figures for NHS foundation trusts show

The number of NHS foundation trusts breaching an urgent cancer target has more than quadrupled in a year, while more trusts are struggling with finances, a report has found.

The study from Monitor, which regulates England's 147 foundation trusts, said 39 trusts are now in deficit, almost double the 21 in the same period last year and more than the 24 expected.

The combined financial hole of these trusts is £180 million - higher than the £168 million anticipated, with 60% of the deficit concentrated in five organisations. A further 17 trusts have "very small" deficits.

The research also showed that performance against a key target for urgent cancer referrals has fallen to its lowest level in two years.

The Government target is for 85% of patients with suspected cancer to start treatment within 62 days of being urgently referred by their GP.

Quarterly figures for October to December 2013 show 18 trusts breached this target, up from 12 the previous quarter and compared with just four in the same period the previous year.

Monitor said reasons given for breaches vary between trusts, but an increase in the number of referrals by GPs "is a possible common factor". Late referrals and consultant cover were also mentioned as troubling issues.

Trusts did perform well, however, against a target to see the most urgent cases within two weeks.

Overall, foundation trusts achieved three other waiting times targets, but more trusts breached all three during the quarter compared with the previous one.

One key target for inpatient treatment showed that 90.7% of patients in November started treatment within 18 weeks of referral by their GP. This was down from 92.1% in the previous November, although the overall target was met.

Some 17 trusts failed the target during the quarter, with general surgery and trauma and orthopaedics generating the longest waits.

Overall waiting lists have also "risen significantly", the report said, with 1.6 million patients waiting for treatment in December. This is 14% higher than December 2012.

Of 80 trusts where waiting lists have grown, 75% said a "significant increase" in referrals was the main reason for a growth in their waiting list. A fifth blamed a reduced capacity to cope with the numbers or other issues such as data quality.

Regarding A&E, the report said the sector has "so far managed to cope with winter pressures". Some 28 foundation trusts failed the four-hour A&E waiting time target during the quarter.

The report said: " 34% of acute foundation trusts failed the A&E waiting time target (during the quarter). This is a slight improvement compared with 39% in the same quarter in 12/13, but a large deterioration compared to 16% in 11/12."

And while the foundation trust sector as a whole remains in surplus financially, "the size of the surplus has more than halved since this time last year, reflecting the tough financial climate and foundation trusts' response".

Two- thirds of England's NHS hospitals are now foundation trusts.

Of the 147, some 26 are currently in breach of their licence, including eight trusts that are in special measures.

Monitor is also investigating a further eight trusts for potential licence breaches, including over issues such as failure on performance and financial problems.

The Midlands is the most "financially challenged" region, with 14 of its 38 trusts being in deficit, including Peterborough, Mid Staffordshire, Sherwood Forest and Milton Keynes, the report said.

Overall, 40% (33) of acute trusts, 20% (one) of ambulance trusts, 11% (two) of specialist trusts and 7% (three) of mental health trusts are in deficit.

Monitor said the overall picture was that foundation trusts were "performing well in providing quality services to patients in challenging economic times".

It said the surplus stands at £135 million so far this year, down on the planned £173 million.

The report also showed trusts had delivered "efficiency savings" of £867 million so far this year, although this is 18% (£185 million) behind what they had planned for this stage.

Jason Dorsett, financial reporting director at Monitor, said: "All trusts need to up their game in delivering efficiency savings this year in order to maintain and improve the quality of care for patients, and ensure the sustainability of services.

"The financial trust sector is doing remarkably well in tough circumstances but is looking a little frayed at the edges.

"Trusts have responded well to the challenge of A&E pressures this winter, such as finding beds to admit patients from A&E when there have been delays in discharging other patients."

Shadow health secretary Andy Burnham said: "After a decade of improvements in cancer waiting times, progress has been derailed by David Cameron's NHS reorganisation.

"We warned that focus would be lost and that is exactly what has happened.

"David Cameron said his own reorganisation could be judged on its effect on waiting times. This is more proof it has failed on every level.

"Patients with a life-threatening illness should not face these unnecessary delays.

"He wasted billions of pounds of front-line cash and now the number of hospitals in deficit has doubled in the space of a single year.

"Patients are paying the price for this Government's NHS mismanagement. It shows you can't trust the Tories with the NHS."

Shadow health secretary Andy Burnham said:"After a decade of improvements in cancer waiting times, progress has been derailed by David Cameron's NHS reorganisation.

"We warned that focus would be lost and that is exactly what has happened.

"David Cameron said his own reorganisation could be judged on its effect on waiting times. This is more proof it has failed on every level.

"Patients with a life-threatening illness should not face these unnecessary delays.

"He wasted billions of pounds of frontline cash and now the number of hospitals in deficit has doubled in the space of a single year.

"Patients are paying the price for this Government's NHS mismanagement. It shows you can't trust the Tories with the NHS."

A Conservative health spokesman said: " As Monitor themselves say, Foundation Trusts are performing well despite pressure on services, and are on the whole in surplus.

"This Government has shone a light on poor care in a way that Labour neglected to do - and which led to tragedies like Mid Staffs - in some cases putting pressure on finances as Trusts address historical issues with nursing numbers and the like.

"We are putting recovery plans in place for any Trust in financial difficulty, but as the culture within our NHS changes, we do not accept that delivering safe and compassionate care in the longer term costs more money."

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