Lincolnshire hospitals boss in the hot seat over £21m deficit and agency staff reliance

The acting chief executive of the trust which runs Lincolnshire hospitals was today grilled over its quarter-year deficit of more than £21.6 million, with councillors questioning their reliance on ‘expensive’ agency staff.

A report presented by United Lincolnshire Hospitals NHS Trust’s acting chief executive Kevin Turner was brought before the county’s Health and Scrutiny Committee on Wednesday, September 16.

The trust has recorded a deficit of £21.679 million for the period April 1 to July 31 2015, a position which is £7.825 million worse than the planned figures at this point in the year.

The July deficit was recorded as £4.140 million, after a June figure of £4.993 million, £6.255 million in May and £6.291 million in April.

Since early predictions warned of a £75 million deficit scenario by the year’s end, the monthly recorded deficit has decreased.

The first quarter figure however already amounts to half of the £40.3 million total deficit target for the end of the financial year.

The trust's deficit (red) against the predicted monthly position.

The trust’s deficit (red) against the predicted monthly position.

Pay expenditure on staffing at the trust was £102.132 million, £5.934 million over the budget.

Of the pay bill for the first quarter of the year, a total of £5,369,245 was paid out to agency doctors alone – with Lincoln County Hospital accounting for the majority of the spend.

ULHT acting chief executive Kevin Turner admitted at the meeting that the biggest expense is on pay, with a growing dependence on agency staff to “fill the gaps”.

He said: “I have worked in the NHS for quite some time and I have never witnessed such unprecedented pressures on finances.

“One of the main reasons for our financial position is related to our spend on nurses and doctors, and specifically down to high number of vacancies.

“We need to continue to recruit more nurses and we have a recovery plan in place. Forecasts at best at the minute are looking to be around a £44.3 million deficit at the year’s end, but we are still working towards the £40.3 million target.”

Many councillors on the committee argued that the NHS offer does not compete with that of agency careers. Councillor Judith Mary Renshaw said: “There’s not a shortage of nurses , just those employed by the NHS”.

Others argued that agency staff were paid double and sometimes up to three times more than NHS staff.

Dr Brian Wookey of Healthwatch Lincolnshire added: “There are improvements at the trust month by month and that needs to be recognised. As far as staff expenditure goes there is no immediate remedy.

“If the trust used no agency staff they’d still have a staffing dilemma. It’s a question of quality over expenditure.”

A recent ULHT recruitment drive has led to the appointment of 90 new nurses for hospitals in the county, the majority of which coming from the University of Lincoln.

Some 23 nurses will go to Pilgrim, 65 to Lincoln and two to Grantham, with a further two at a later date.

The trust is also attending recruitment fairs, hosting a round of open days and the first cohort of return to practise nurses started their courses with ULHT last month.