Fiscal Fantasy Island: NSFT spends over half its Out Of Trust Acute (OOA) Beds budget in first two months of the year

NSFT is Fiscal Fantasy-Island with badges

The number of out of trust acute (OOA) bed days has nearly doubled: from 332 days in April 2016 to 647 days in May 2016.

Most of these patients are being sent to the expensive, remote and private Mundesley Hospital, where it seems that none of the medical staff have passed the exams of the Royal College of Psychiatrists or hold Certificates of Completion of Training (CCT) from the General Medical Council (GMC). We don’t consider that psychiatric treatment justifying detention. We raised this important issue at the last NSFT Board meeting.

In the first two months of the financial year, Norfolk and Suffolk NHS Foundation Trust (NSFT) has spent £530,000 on out of trust beds.

The out of trust acute beds budget for the entire financial year is £1 million.

If NSFT carries on spending at its current rate, it will spend £3 million on out of trust acute beds this financial year. That’s a £2 million overspend.

NSFT staff have been telling NSFT since 2012 that there aren’t enough beds.

Our campaign has been telling NSFT since 2013 that there aren’t enough beds.

In January 2014, NSFT and local commissioners promised that out of area bed use would stop by the end of May 2014. It never happened. Instead, the bed crisis became worse.

In June 2014, the EDP published its Map of Shame.

The NHS regulators, the Care Quality Commission (CQC) and Monitor, told NSFT in February 2015 that there weren’t enough beds. The CQC and Monitor told NSFT informally even earlier, in late 2014.

In February 2015, as part of its ‘Quality Improvement Plans’ (QIPs), NSFT promised its regulators that it would have enough beds within twelve months: it still doesn’t.

Although NSFT reopened some beds on Thurne Ward at Hellesdon Hospital, it also closed Waveney Acute Services at Carlton Court and tried to close the Fermoy Unit in King’s Lynn before our campaign exposed the plans. The number of beds in King’s Lynn has been cut by a quarter.

At the last Board meeting, we challenged NSFT, asking whether it had enough beds, as we have done repeatedly over the past three years:

3) It was questioned when the Trust would realise that there are not enough beds to meet demand as staff have been voicing this since 2012.

Now, three weeks before the CQC is due to arrive, the papers for tomorrow’s Board meeting indicate that the NSFT Board has finally realised that it hasn’t done what it promised Monitor and the CQC in February 2015 and ended the use of out of area beds:

3.3 There are four QIPs that are currently at red status:

• Review of in-patient bed requirement (QO031 and 031a): there are many interdependencies involved, and this QIP is now a priority for the Estates Mobilisation Board. An external review of bed provision is being arranged to inform an options appraisal on bed numbers.

NSFT is only now ‘mobilising’ on this issue in June 2016:


The NSFT Board’s ‘game plan’ is to scrape a ‘Requires Improvement’ in the CQC Inspection by having written plans to correct the failings the CQC highlighted eighteen months ago. Plans alone simply aren’t good enough.

  • How can NSFT be delivering safe and effective care when it doesn’t have enough beds?
  • How can NSFT be responsive and well-led when it does next to nothing about the bed crisis for eighteen months despite being told explicitly that it needed to address this issue by its regulators?
  • How is NSFT’s Board caring when it appears that it couldn’t care less?

An effective Board delivers services, not apologetic plans. It doesn’t live on Fantasy Island.

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