Brighton hospital chief takes scalpel to overspending

A Brighton hospital boss has sent an impassioned plea to his staff to help save £1 million a month.

Duncan Selbie, who runs the Royal Sussex County Hospital in Eastern Road, Brighton, ruled out redundancies for now.

But he promised tougher controls on replacing admin and support staff when they leave.

He said that there would be less bank and agency cover when staff were off sick or on holiday.

And he said that spending on senior management would be cut by 20 per cent and other payments to senior doctors would be reviewed.

Mr Selbie – with a faint echo of Charles Dickens’s Mr Micawber – said: “As a hospital we have £29 million a month to spend.

“For the first six months of 2011-12 we have spent between £30 million and £31 million a month and we are not busier than before.

“If we keep this up, by the end of the financial year we will be £19 million overspent.

“We cannot keep spending as we are.

“If we do, we surrender the right to determine our own future and all the plans and ambition we have for the modernisation and further improvement of our hospital.”

His newsletter addressed the possible response of some staff, saying: “If your instant response is to roll your eyes and say to the person next to you that you’ve heard it all before and it’s nothing to do with you, then you have completely failed to understand the severity of what this means for the hospital.

“The country is in an extremely tough spot, as is the NHS, and so are we and yet half of our 272 budget holders are overspending.

“No more rhetoric. This is about people stepping out of their denial and doing what they agreed when the budgets were set.”

Mr Selbie, the chief executive of Brighton and Sussex University Hospitals NHS Trust, which runs the Royal Sussex, said that the new nursing roster would be brought in more quickly. He also said that the ratio of nurses to patients would be reviewed.

He added: “There is no plan to reduce frontline nursing posts and the recent investment in our elderly care wards is not affected.

“No stone will be left unturned in our regaining control of our spending and I guarantee that when we do we will practice better medicine and provide better care.

“The actions of our doctors, and particularly our consultant body, are fundamental to achieving this.”

He urged his senior doctors to pull their weight too while offering a measure of reassurance, saying: “Nobody is interfering with clinical judgment but I do expect doctors to be as committed to getting the best value from every pound as they are to exercising their best clinical judgment.

“These are not separable and it is by getting the money right that everything else becomes possible.

“The next six months are going to be tough, particularly as we are heading into winter and there will be no additional funding for ‘winter pressures’.

“Mostly when we talk about the need for savings, balancing budgets and paying off debt, what people hear is that this matters more than good patient care.

“Nothing could be further from the truth.

“By being mature enough to admit that our finances are in jeopardy, and being clear about what needs doing, we are reinforcing our commitment to improving patient care by laying down the foundations that will support those improvements for years to come.

“The other myth that we need to address head on is that doctors, nurses and other clinical professions do care and managers do money, and that these are opposing positions.

“I am absolutely clear this is not about compromising clinical choices or flying in the face of common sense but it is about not spending more than we have.

“I care about this hospital and its people more than anywhere I have worked in 32 years and I will not stand idly by and let us revert to debt and all the consequences of this.

“What we need to do is entirely achievable and we will.

“The £19 million overspend is a forecast. It has not yet been spent. And what we have to do is keep it that way.”