Croydon’s biggest hospital’s finances remain a mess, but progress is being made on the wards, which could be compromised by an announcement expected at tomorrow’s Croydon CCG meeting, as JAMES KILLDARE, our health correspondent, reports

The hospital’s finances are in intesnive care

Croydon is in the uniquely bad position of having its hospital and its GP-led CCG – the Clinical Commissioning Group – both placed in the sin bin of “financial special measures”. No other part of the country has such a dual set of black marks against its local NHS.

Thus it will be interesting to see just what information will be given at tomorrow’s annual meeting of the Croydon CCG, to be held at Croydon College, as to how services will need to be cut.

One senior GP practising locally has told Inside Croydon that the cuts proposed for patient care are “ruthless” and that the supposed devolution of power to GPs by government is proving pretty meaningless.

Mayday Hospital, officially the Croydon Health Services NHS Trust, which has just had its own AGM, is vulnerable to such cuts, with £184 million of its funds coming from the CCG.

Mike Bell, the chairman of what they insist on calling Croydon University Hospital, aspires to there being “a beautiful understanding” with the CCG about reduced funding.

Mayday’s board, which itself costs £1.244 million a year to run, is already facing another year of reduced finances at a hospital that is otherwise celebrating some successes and improvements in efficiency and clinical practice. But such advances have to be placed in the context of a troubling number of serious medical incidents and a damning report from auditors.

In the last financial year, Mayday’s expected accumulated deficit of £34.5 million was £12 million worse than expected. With brakes on spending and no plan beyond March 2017, it is hoped that the hospital’s deficit will only widen by another £5.3 million this year.

A highly critical audit by Grant Thornton concludes that they “are not satisfied that, in all significant respects, the Croydon Health Services NHS Trust put in place proper arrangements to secure economy, efficiency and effectiveness in the use of its resources”.

The Trust struggles with cash shortages and was at times reliant on using emergency working capital facility to pay its creditors.

The Care Quality Commission found that all but one department at Mayday needs improvement for safety and that there were a staggering 6,905 adverse clinical and non-clinical events – some of which may include patient deaths – in the hospital over the past 12month period, requiring £12 million to be paid out in compensation for clinical negligence. That’s another increased cost, up by almost £4 million on the previous year.

Patient safety is being promoted through better diagnosis with specialists, early senior consultations, better and friendlier relationships between GPs and the hospital and avoidance of missed medication. This is being achieved by accelerating key needy patients through the emergency department to the Edgecoombe unit. The unit also means that 20 fewer patients a day are admitted to the actual hospital, saving some cash.

Patient approval rates are up a lot from being the worst in the country, with nine out of 10 (of the admittedly modest number of) patients who responded to surveys saying they would recommend the hospital to friends and family.

The number of painful pressure ulcers, sometimes exacerbated by poor care for the bed-ridden, have been halved – another indicator of improved standards of care on the hospital’s wards.

Mayday will have its £21.5 million new Emergency Department open next year; the hospital is thinking of not going with the currently proposed colour scheme of red and black, the usual campaigning colours of anarchists, which is perhaps not so suited to an organised and calm A&E.

The use of expensive agency staff has been reduced and the hospital now has 280 more doctors, nurses and therapists on site than it did in 2014-2015, while the maternity unit celebrated delivering 3,997 babies, 500 more than in the previous year. That’s 17 more classrooms needed.

It may seem only modest progress, but it is still progress of sorts. But such improvements could be compromised if, at its meeting tomorrow, the CCG announces cuts to its hospital funding.

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