Debt ridden trust has no cash to pay creditors
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《英国医生杂志》
An NHS trust, one of the 15 most efficient in England, is in such financial dire straits that it has been unable to pay its creditors or place orders for essential supplies, a report by government spending watch-dog has said. The Royal West Sussex NHS Trust, an organisation rated two stars by the Healthcare Commission, had amassed a debt of ￡20.5m ($37.4m; 30.6m) by March, the end of the last financial year, says a special report by the Audit Commission.
The crisis is so severe that the trust, which serves a largely elderly population, has been left without the cash to pay creditors. This situation could leave it without essential supplies of food or drugs, the report warns.
The report, a "section 8" or "public interest report," was ordered by the Audit Commission after the trust had consistently failed to meet its legal duty to break even financially over a three year period. It failed, despite being given five years (an extra two years' grace) to achieve financial balance. Section 8 reports, of which only a handful are done each year, are ordered if serious concerns exist over the operation of a public body.
In April, the cash crisis was so critical that the trust stopped issuing purchase orders for goods and services. Directors took the drastic action after lawyers advised they could be personally liable if they continued to order goods while the trust had such severe cash difficulties. The trust has since agreed interim arrangements with Sussex and Surrey Strategic Health Authority to allow it to resume purchasing.
The report, by Pricewater-houseCoopers, showed that the situation is spiralling out of control, saying, "The trust needs to put in place a strategy to manage its cash so that it can return to paying its suppliers promptly. It should develop a recovery plan that is robust, realistic, and achievable." A recovery plan drawn up in January was unrealistic and the board struggled from the start to achieve its aims. The budget was "extremely challenging," said the report, leaving the trust doomed to failure.
But the report also paints a picture of a trust that, instead of achieving financial balance, focused on the quality of its clinical care and achieving all clinical targets. The trust's unit costs for a wide range of NHS treatments, such as the cost of operations, are 90% of the national average. The trust's chief executive said that for too long its funding had been below the cost of actually providing services. Relationships with the local body that commissioned services, the Western Sussex Primary Care Trust, were poor, with negotiations over payments ending in arbitration for several years running.
Robert Lapraik, chief executive of the trust, said, "The fundamental issue is that the increase in activity has not been matched by an increase in income. So that, although the trust is efficient (within the top 15th percentile nationally) it is still paid significantly below its cost, leaving it with a sizeable deficit to manage."(Rebecca Coombes)
The crisis is so severe that the trust, which serves a largely elderly population, has been left without the cash to pay creditors. This situation could leave it without essential supplies of food or drugs, the report warns.
The report, a "section 8" or "public interest report," was ordered by the Audit Commission after the trust had consistently failed to meet its legal duty to break even financially over a three year period. It failed, despite being given five years (an extra two years' grace) to achieve financial balance. Section 8 reports, of which only a handful are done each year, are ordered if serious concerns exist over the operation of a public body.
In April, the cash crisis was so critical that the trust stopped issuing purchase orders for goods and services. Directors took the drastic action after lawyers advised they could be personally liable if they continued to order goods while the trust had such severe cash difficulties. The trust has since agreed interim arrangements with Sussex and Surrey Strategic Health Authority to allow it to resume purchasing.
The report, by Pricewater-houseCoopers, showed that the situation is spiralling out of control, saying, "The trust needs to put in place a strategy to manage its cash so that it can return to paying its suppliers promptly. It should develop a recovery plan that is robust, realistic, and achievable." A recovery plan drawn up in January was unrealistic and the board struggled from the start to achieve its aims. The budget was "extremely challenging," said the report, leaving the trust doomed to failure.
But the report also paints a picture of a trust that, instead of achieving financial balance, focused on the quality of its clinical care and achieving all clinical targets. The trust's unit costs for a wide range of NHS treatments, such as the cost of operations, are 90% of the national average. The trust's chief executive said that for too long its funding had been below the cost of actually providing services. Relationships with the local body that commissioned services, the Western Sussex Primary Care Trust, were poor, with negotiations over payments ending in arbitration for several years running.
Robert Lapraik, chief executive of the trust, said, "The fundamental issue is that the increase in activity has not been matched by an increase in income. So that, although the trust is efficient (within the top 15th percentile nationally) it is still paid significantly below its cost, leaving it with a sizeable deficit to manage."(Rebecca Coombes)