Fiscal Fantasy Island: NSFT spends record £2.42 million on temporary staff as out of area bed days nearly double

Having wasted £17.25 million of taxpayers’ money getting rid of staff it needed, Norfolk & Suffolk NHS Foundation Trust (NSFT) spent nearly £2.5 million on temporary staff in May alone. This is a new record, even for NSFT. 68 per cent of this expenditure was on expensive agency staff and the reliance on temporary staff is disastrous for staff morale, continuity of care and the delivery of high quality services.

NSFT has a temporary staff budget of £17 million for this year. It spent £4.5 million on temporary staffing in the first two months. If expenditure continues in this fashion, temporary staffing costs will add £10 million to NSFT’s projected deficit of £9.4 million. Monitor has already warned that NSFT’s budget is out of control.

But matters are worse. The number of out of area (OOA) bed days nearly doubled: from 381 days in April to 713 days in May. NSFT has no funding from the Norfolk CCGs for out of area bed use. The CCGs and NSFT promised back in January 2014 that the use of out of area beds would end by the end of April 2014. Instead, matters have got much worse. Transporting people across the country, often in cages in private vehicles, is scandalous: it is inhumane, it is distressing for the person in crisis, distressing for their family, distressing for the professionals involved. The CQC was very clear that NSFT must ensure that it has enough local inpatient beds for local people. NSFT is running wards with more than 100 per cent bed occupancy rates when the Royal College of Psychiatrists recommends no more than 85 per cent occupancy rates.

NSFT’s own figures have shown that the average cost of out of area beds is £552 per bed per night. In April and May this year, NSFT spent £530,000 on out of area beds. It has no money from the commissioners to pay for these private hospital beds. If this situation continues, it will add another £2.2 million to the deficit. But the bed crisis is likely to become worse when the Waveney Acute Services beds at Carlton Court are closed, as Great Yarmouth and Waveney CCG says ‘We’re alright, Jack‘ to the rest of Norfolk.

If NSFT attempts to cut back on staff numbers in its community teams, already under severe strain due to the lack of inpatient beds, to reduce its out of control temporary pay bill, this will increase the frequency of crisis situations requiring inpatient treatment. From the beginning of our campaign, we have said that it was a terrible mistake to create a vicious circle by cutting beds and community teams simultaneously. The mental health system in Norfolk and Suffolk cannot be stabilised until NSFT has enough beds to support properly-staffed community and crisis teams.

NSFT’s latest finance report indicates that much of its Cost Improvement Programme (CIP) looks doubtful, that out of area bed days and the temporary staffing budget are out of control. If mental health services are not to be destroyed, NSFT’s deficit looks more likely to be £21.6 million than £9.4 million: double the current forecast.

Now is the time to face facts: NSFT doesn’t have sufficient funding from commissioners, it doesn’t have enough inpatient beds, it doesn’t have enough community staff, it doesn’t have a competent Board. NSFT needs the additional £30 million it would have to spend had it received funding on the same basis as the physical health trusts and it needs a competent management team capable of spending the money wisely and restoring the confidence of staff, service users, carers and the public.

The Establishment could find £46 billion to rescue the greedy bankers who worked with Gary Page at Royal Bank of Scotland. Why can’t the Department of Health find the £30 million to put mental health services in Norfolk & Suffolk on a sound financial footing? Instead, NSFT Chief Executive, Michael Scott, is now promising a further £36 million of cuts on top of the £44 million of cuts which caused the crisis in the first place.

We’ll be at the NSFT Board of Directors meeting today demanding answers.