‘Difficult decisions’ ahead, admits new hospitals chief
East Kent’s new hospitals chief is confident he can drag the beleaguered trust out of the doldrums.
Matthew Kershaw – nicknamed “The Axeman” at his previous trust – admits “difficult decisions” lie ahead.
He inherits a trust on a monitored programme of required improvements known as “special measures” that were introduced by government watchdog the Care Quality Commission after it identified under-performing emergency care, managerial failings, and a culture of staff bullying.
On top of that, the East Kent Hospitals University Foundation Trust is running at close to a £40 million deficit. But he says improvements were made by interim predecessor Chris Bown, and he intends to build on those.
CHALLENGES Mr Kershaw said the trust needs to improve emergency care flow, in terms of what comes to the hospitals in the first place; how the hospitals operate and how patients then get discharged. He also said “positive progress” needs to be made on the trust’s finances and to ensure that the quality of care provided is as good as it can be.
SPECIAL MEASURES He says the trust made real progress under Chris Bown’s leadership in coming out of special measures, with a followup CQC inspection moving the trust moved from “inadequate” to “requires improvement”, although it remains in special measures. He said the trust needs to improve emergency care and the way staff feel about working for it. He said: “I hope that when the CQC come back next year we will be removed from special measures – but that’s a CQC judgement, not mine. If we carry on doing the good work that’s been started, continue the progress that’s under way, then I hope and expect we’d get out of special measures.
FINANCES Mr Kershaw said although a £40 million deficit was forecast, on a budget in excess of £500 million, the likely deficit by the end of the year is likely to be £37 million. He said it would take some considerable time and some quite challenging work to get that size of deficit back under control, but that was crucial.
CUTS He said: “I think we need to be careful when we describe ‘cuts’ because it worries patients, the population and staff, sometimes unnecessarily. In my previous trust we made some difficult decisions, as I’ve done in other places that I’ve worked. I would not describe them as cutting services.”
STAFF While hundreds of staff were needed to provide care, the trust needs to find ways of reducing its reliance on temporary agency staff which was would cost it “multiple millions of pounds this year”. He said reducing that figure reduces the cost of the staff, not reducing the numbers of staff.
SAVING MONEY Mr Kershaw said the trust needed to be more efficient in lots of other parts of the hospitals – in how it uses operating theatres, the outpatients departments and its purchasing policies regarding supplies and equipment – on which tens and tens of millions of pounds are spent each year.
STAFF JOBS He said: “Clearly we are making, and will need to continue making, changes to how we work. And that will impact on individual people because it’s individual people who run our services. My work here is to invest and support staff to allow us to provide even better care to our patients. But we’ve got to do that in a way that works financially.”
‘SUPERHOSPITAL’ He said that while a single-site hospital for the whole of east Kent has been talked about, it is not something that is currently being actively pursued – but what is being examined is looking at how services across the whole of east Kent are provided in a “safe and sustainable way”.
CHANGES Mr Kershaw was unable to pinpoint specific changes as work is still under way in the process of looking at options for the future.
OPTIONS He said: “Obviously your options are about maintaining it as it is now or changing the focus of one or more of those hospitals to still provide services but to provide different sorts of services in different ways and perhaps concentrate some of the other services in one, two or three of those sites.
HIS ARRIVAL Since he took over his new role Mr Kershaw said he had spent a lot of time meeting staff, to introduce himself and to understand what the issues are from their perspective and identifying priorities.
New hospital trust chief executive Matthew Kershaw