The NHS in Northamptonshire has been placed in financial special measures after failing to save as much money as expected.
NHS Nene was expected to reduce costs by £40 million this year, but missed that target by £12 million
It means an overseeing body, NHS England, can come in and examine finances with the ultimate sanction of sacking the bosses in charge if the black hole does not reduce.
Darin Seiger, chair of NHS Nene, said: “We’ve never been in this situation before. This health economy has been bailed out for many years. There’s no money down the back of the sofa this time.”
NHS England is examining NHS Nene’s plans and will decide which of the three interventions it will take.
Dr Seiger said: “There are three levels of financial recovery. The first is monitoring, the second is a support team.
“Then there’s intervention when the top team gets sacked, I get sacked. A new team come in and they will just be accountants who won’t have the clinical leadership.
“To avoid intervention we have to say we have clear plans of where we want to get to.
“If they don’t feel the top tier are able to turn around the organisation, they will replace you. So it has to work.”
NHS Nene said it was likely that its plan would include bringing cost-saving schemes scheduled for next year forward, such as schemes to reorganise musculoskeletal services.
It is also hoping to negotiate with Northampton and Kettering General Hospitals about handing them a budget for planned operations rather than paying per operation.
Dr Seiger said: “We will cover all their staff costs because the last thing we want is for the hospitals to fall down. We are saying ‘what are your true costs’ versus ‘what you can charge the system’.”
‘If health budgets were fair, we would be £75m better off’
HEALTH budgets in Northamptonshire are £75 million lower than its population deserves, the chair of NHS Nene has said.
When current NHS budgets were worked out, Northamptonshire had a much smaller population. Although the number of people in the county has risen faster than other areas, the funding ratio has remained static.
According to the latest Fair Share calculation, Northamptonshire has the biggest disparity in the country.
Dr Darin Seiger said: “We are the county furthest away from its Fair Share budget. That gap this year is £75 million.
“If we had that I’d be talking about how we’d be investing £35 million into services.
“But if you say that to the Department of Health, they’ll just say, ‘well you don’t have it’. They just say get on with it.”
Dr Seiger said he accepted nothing could be done at the moment to redress the balance because of the effect on other NHS areas which now rely on the extra cash they have always received.
He said: “In the growth years they should have equalised it; overfunded areas should have got a one per cent increase and underfunded areas maybe a 15 per cent increase year on year, but they didn’t do it. What they have now said is it can be done over the next 20 years.
“The options are you either increase taxes or you charge, or you get the NHS to run more efficiently. When they have these debates, they are not going to increase taxes because that’s political suicide, they won’t charge because it’s against the NHS constitution, so they just say to us ‘get on with it’.”