Richard talks about: Finalising our plans for the new financial year

Richard Beeken, Chief Executive

It is that time of the year when we are working through our priorities to confirm what we will deliver and how during 2023/24.

All this, in the background of huge financial strain felt not only by us, but other organisations across our host integrated care system and beyond.

National expectations about how our services are more safely staffed and the cost implications of managing COVID have significantly increased our cost base and so now the Trust is facing a recurrent financial deficit for the first time in its history. We are in the process of setting out the exact size of that deficit and also setting out how we are going to minimise it.

Our approaches to reducing the size of the deficit include:

• Securing the additional money on the recurrent basis from our commissioners that we need in order to safely and effectively deliver the benefits of the new Midland Metropolitan care model

• Securing the additional money on the recurrent basis from NHS England to pay for the capital charges of the Midland Met

• Improving our recruitment so that we rely on temporary staffing far less than we do at the moment and therefore reduce our increasingly high agency costs

• Deliver an elective care production plan which ensures that we treat more patients on elective pathways than we did in 2019/20 (a min of 104 per cent is expected)

• Invest in quality improvement that will allow local leaders and team members to reduce waste in their departments and services, whilst maintaining or improving the quality of care we provide to our patients

• Taking a different approach to managing investment in clinical service developments, so that we only invest on the grounds of patient safety/risk or where we think there will be a clear financial return on that investment.

RICHARD'S LAST WORD

We remain clear that our plans will be aligned to our strategic objectives – People –Patients – Population

The plans will also be aligned with system targets that have been set out in national NHS guidance. Here are some highlights:

Urgent and emergency care

We are expected to improve A&E waiting times so that no less than 76 per cent of patients are seen within 4 hours by March 2024 with further improvement in 2024/25.

Community health services

To empower patients to take control of their healthcare and reduce unnecessary burden on primary care, especially GP appointments.

Elective care

With 104 week waits for inpatient services virtually eliminated, a revised target to eradicate 65 week waits by March 2024 has been included in the guidance.

In addition, systems are expected to plan to deliver 30 per cent more elective activity by 2024/25, based on the prepandemic baseline.

Cancer services

There is an expectation that by March 2024, 75 per cent of patients who have been urgently referred by their GP for suspected cancer are diagnosed or have cancer ruled out within 28 days.

Diagnostics

Roll-out of additional diagnostic capacity through community diagnostic centres and other diagnostic service transformation remains a priority. There is a requirement for 10 per cent productivity growth by 2024/25.

Maternity and neonatal services

A single national delivery plan for maternity and neonatal services will be funded by an additional £165 million which will go into baselines from 2023/24. This is additional to the £93 million added to baseline allocation in 2022/23 which was intended to invest in workforce and support the implementation of actions from the Ockendon report, funding more than 1,500 midwifery posts.

Workforce

System wide workforce plans should already be in place and need to focus on recruitment and retention and increasing productivity of staff by ensuring appropriate roles and responsibilities.

Local empowerment and accountability

A rolling five-year joint forward plan is required at the start of each financial year, which should align local and national priorities and delivery plans.

Use of resources

The delivery of an NHS wide balanced net system financial position whilst meeting the national objectives outlined will require systems to meet a 2.2 per cent efficiency target. This is in addition to expectations of improved productivity.

There is an expectation that efficiency and productivity plans will be developed at system level with strong oversight and governance arrangements to drive delivery. The guidance sets out a range of measures to be considered by systems within these plans, including reducing agency expenditure to 3.7 per cent of the total pay bill.

This is a huge agenda but one we can achieve as we are already delivering or projected to deliver in many areas. You will all have your part to play in achieving these measures which will be managed and monitored via a soon to be established system productivity and value group.

And of course, safely opening Midland Met is central to all the work we are doing as we progress nearer to our opening date. In October we began implementing the Midland Met programme company that increases the capacity and leadership of this vital programme. The programme company has set up deliverable actions across all of its workstreams, including critical milestones during 2022/23. During the year ahead, the interaction between the core organisation and the MMUH programme will become ever closer.