You can watch the recording of the 22/23 Annual Members’ Meeting on Microsoft Teams or on our YouTube channel. You can see the questions and responses by clicking ‘Show Q&A’ at the top of the screen or in the table below.
The Annual Report and Accounts for 22/23 is available to view here.
You can watch the video on the link on this page to hear the answers to these questions. An edited version of these full answers is set out below:
|Post amalgamation of executive boards, I understand that combined deficit will be £100m next year across the entire NLAG / HUTH institution. Is that correct? Does that mean we risk special measures again? What is being done to mitigate?
|Answer from Lee Bond, Group Chief Financial Officer: It is right we are declaring circa £100m of underlying recurrent deficit across the Group. It splits roughly 50/50 so roughly £50m for NLaG. I expect the £50m to go down. This figure is in the context of an ICB and a region and a national system where similar sized deficits, particularly in acute trusts, are being reported.
There are four things that we’re trying to do about it:
We’re trying to quantify exactly what the actual number will be when the planning guidance is finally released for next year
We are currently continuously trying to identify areas where we can reduce our cost base and principally, how can we reduce the cost of our staffing by making sure that we don’t have quite the same level of staff turnover or that we’re able to recruit to vacancies and therefore avoid costly locum or agency expenditure
We are doing a lot of work to identify areas where we can standardise the clinical products that we buy and potentially drive savings there.
We’re looking at sort of service reconfiguration and service resilience.
|Public consultation – it appears that Orthopaedics and Gynaecology will be closed down during the night – is that correct? How does that merit considering waiting lists already and moving such patients is tedious and shall take up considerable transportation services? So walk through what happens if an elderly patient breaks hip at 6pm; So walk through what happens if pregnant woman goes into labour at 6pm – where does she go?
|Answer from Ivan McConnell, Group Director of Strategy and Partnership: First, it is important to note that no decisions have been made yet on the proposals that went out to a public consultation in September last year – we are currently at the stage of analysing and considering the feedback provided. Detailed patient pathways for specific specialties are still being reviewed with clinical teams to take account of the feedback gathered through the consultation, similarly, transport solutions are also being developed and reviewed in light of the feedback provided. In terms of the specific services/scenarios highlighted, under the proposal that went out for consultation, these patients would continue to access their care in Scunthorpe – with the proposed changes only impacting on a very small proportion of patients.
a) the elderly patient who breaks their hip at 6pm – national guidance is that these patients should be operated on within 36 hours. Under the proposed changes, these patients would continue to access care via the Emergency Department in Scunthorpe and be looked after by a skilled team overnight before getting their operation the following day. The current service does not always meet the standard with some patients waiting longer than 36 hours for their operation. The proposal was designed to improve this and ensure more people are treated more quickly.
b) the pregnant woman who goes into labour at 6pm – she would continue to be cared for in the same way by the Obstetric-led team.
|Are we establishing transport services to “ferry” patients – or is this outside our remit?
|Answer from Ivan McConnell, Group Director of Strategy and Partnership: Patient transport has been raised as an issue during consultation. It is likely that up to 7 patients per day may be impacted by the potential changes. It is important to recognise that we currently transfer Stroke and Urology patients from Grimsby to Scunthorpe daily. We are working with our Ambulance and PTS providers to review any potential impact of the changes. To date assuming no efficiency in ambulance service delivery the proposed increase can be accommodated within existing service availability.
|Given our increasing elective waiting list, the priority we are expected to give to elective recovery and the significantly enhanced income generating potential of elective bed days, what steps are being taken to protect the elective bed base in the face of the ever growing pressure to facilitate acute unplanned admissions?
|Answer from Simon Nearney, Group Chief People Officer: We will continue to maintain ringfenced elective beds for all in patient activity and the continued use of our day care facilities on all 3 sites. We are working hard to continue to improve the utilisation of our theatre capacity. The work on outpatients improvement around our waiting times continues with particular focus on the transformation of follow up appointments and an improved first contact appointment combined with early access to diagnostics and the use of advice and guidance. This combination should continue to address the waiting list position but there remains the industrial action risk which has affected some of our improvement in the current year.
|What is the timeline for paying trade creditors and has there been any change in the last 2 years?
|Answer from Lee Bond, Chief Financial Officer: We aim to pay all within 30 days.
|Could the figures be split to show spend at each site rather than combined. We are told SGH is in a bad state of repair having not been maintained for years, but is this due to more spend routinely made at DPoW rather than SGH or GH? For example, it was stated 3 OR’s have been refurbished, but where?
|Answer from Lee Bond, Chief Financial Officer: Two at DPOW, one at SGH. In the capital plan for the period 23/24 to 25/26 we anticipate investing 53% of the total capital fund into SGH, compared to 31% in DPOW and 11% in Goole.
|How much the trust spent for using agency staff
|Answer from Lee Bond, Chief Financial Officer and Simon Nearney, Group Chief People Officer: At 31 December 2023 we had spent £22m on agency staff versus £22m for the same period in the previous year. In the year 22/23 NLaG spend on bank and agency was c£60m in total.
|How can vacancies mean there is non-recurrent income due to not paying the salaries, when the cost is actually increased due to the use of locum staff?
|Answer from Lee Bond, Chief Financial Officer: We do benefit from vacancies to a degree – not all vacancies are covered by agency staff. If we assume that we filled all vacancies then our spend would theoretically increase and therefore we would have a bigger financial problem.
|Whenever I’ve been at the hospital the discharge lounge has been empty, and I’ve been made to sit with relatives in a ward bed watiting for discharge for hours rather than being moved to the discharge lounge, so experience says the discharge lounge process does not seem to be used as effectively as it could in all areas.
|Answer from Simon Nearney, Group Chief People Officer: Whilst it is difficult to answer the specific reason for your individual experience, we have, since November, seen a significant increase in the use of our discharge lounges. There are sometimes clinical reasons why patients are unable to be moved for their safety to the lounge but these are small in number. In November and again in mid-January we undertook 2 discharge events which did also focus on the use of the discharge lounges and they have helped improve the use of these. I am sorry about your individual experience and would be happy to meet with you to understand your individual circumstances better and use that to help our teams learn.
|Sounds like better understanding and promotion of the use of the discharge lounge across staff has improved that situation, which would probably be the point of the question maybe
|Answer from Simon Nearney, Group Chief People Officer: We would agree there is a constant need to promote the approach to discharge and the use of discharge supportive resources. The Site and Patient Flow team do support this daily across the hospital but agree more needs to be undertaken, and learning from the experience and feedback we receive is really important in getting this to where it needs to be.
|Radio Humberside recently reported that North Lincolnshire Council may consider asking for a Judicial review regarding the proposed changes to SGH and DPOW. Any comment
|Answer from Ivan McConnell, Group Director of Strategy and Partnership: Any significant reconfiguration programme of NHS services is required to comply with a number of pieces of statutory guidance. As part of that legal process Local Authorities can exercise their rights under that legislation to challenge any change programme. That must focus on either the engagement/consultation process or the outcome of a decision. North Lincolnshire Council has highlighted its concerns regarding the impact on local people. Under the current legislation, that would require a formal submission to the Secretary of State in the first instance.