Hinchingbrooke Hospital

Hinchingbrooke Hospital is a small district general hospital in Hinchingbrooke near Huntingdon, Cambridgeshire. Opened in 1983, it serves the Huntingdonshire area, and has a range of specialities as well as an Accident and Emergency.[1] The hospital is managed by the North West Anglia NHS Foundation Trust.

Hinchingbrooke Hospital
North West Anglia NHS Foundation Trust
Location in Cambridgeshire
Geography
LocationHinchingbrooke Park, Huntingdon, Cambridgeshire, England, United Kingdom
Coordinates52.3329°N 0.2011°W / 52.3329; -0.2011
Organisation
Care systemPublic NHS
TypeGeneral
Services
Emergency departmentYes Accident & Emergency
Beds266
History
Opened1983
Links
Websitewww.nwangliaft.nhs.uk/our-hospitals/hinchingbrooke-hospital/
ListsHospitals in England

History

Formation

The hospital was opened in 1983 to replace Huntingdon County Hospital which closed that year.[2] It was administered by Hinchingbrooke Health Care NHS Trust which developed financial problems and was obliged to borrow £27.3 million in Public Dividend Capital in the year ended 31 March 2007.[3]

Private sector management

In accordance with the powers contained in the National Health Service Acts 2001 and 2006 and the Health and Social Care Act 2001, the Government decided that this was an opportunity "to bring in another person or organisation to manage an NHS hospital".[4] A completion was arranged by the NHS East of England Strategic Projects Team.[5]

It was announced on 25 November 2010 that Circle Health had been selected to manage the hospital under a 10-year contract.[6][7] Mitie continued to provide domestic cleaning services, waste collection, pest control and external window cleaning at the hospital.[8] Although the hospital was managed privately, the buildings remained in the ownership of the NHS. This process was widely criticised as a significant step in the privatisation of the NHS in England.[9]

BBC Newsnight produced a programme about the hospital in August 2012 where Ali Parsa of Circle Health showed how "reactive, motivated staff treat patients better; happy, well-fed patients heal better".[10] However in November 2012 a National Audit Office (NAO) report into the franchising arrangement was published. It found that while Circle had made early improvements in some clinical areas, the projected deficit for the year ending 31 March 2013 was already £2.2 million higher than planned. Circle would have to make unprecedented levels of savings to eliminate the deficit and most of those savings were expected in the later years of the ten-year franchise, so the value for money of the project would not be capable of being easily be assessed for some time. The NAO also found that while NHS East of England had assessed bidders' savings proposals, the relative risks had not been fully considered, which had the potential to encourage over-optimistic bids.[11][12]

Matters started to deteriorate further. In the 2013 NHS staff survey involving 28 key findings, Hinchingbrooke came out worse than the NHS average on two-thirds of the findings (19 of them), and was in the lowest 20% of trusts in almost half of the findings (13 of them).[13]

In April 2014 it was reported that the hospital was likely to record a deficit in the region of £600,000 to £700,000 for the year ending 31 March 2014[14] and in July 2014 Hinchingbrooke Hospital was referred to the Secretary of State for Health for failure to meet their statutory duty to break-even financially.[15]

The hospital made an offer in September 2014 to pay local GPs a £50 'administrative fee' for surgery referrals in an email, signed by Hinchingbrooke chief executive Hisham Abdel-Rahman, which was rapidly withdrawn when the company was accused of bribery.[16]

A visit by inspectors from the Care Quality Commission in September 2014 highlighted severe issues with patient care: inspectors observed that "staff treat patients in an undignified and emotionally abusive manner" and they spoke to patients who had been "told to soil themselves".[17][18]

In November 2014 Jenny Raine the chief financial officer left.[19] UNISON called for Circle to be 'sacked', claiming that papers tabled for the Board meeting in October - which did not include a financial report - showed the organisation faced (i) potential penalties of up to £200,000 per month for failure to meet targets for patients waiting longer than four hours in the accident and emergency department (ii) potential penalties for failing to reach electronic discharge summary targets which already stood at £138,000 and (iii) potential penalties of a further £150,000 for failing to increase the number of patients discharged at weekends. The Union said staff turnover was more than 13 per cent. In response Circle said: "We are a bit bemused as we haven't changed our financial forecasts for the year and Hinchingbrooke's clinical outcomes remain very strong."[20]

Withdraw of Circle Health from the contract

In January 2015 Circle Health announced that, because Hinchingbrooke Hospital was "no longer [financially] viable under current terms", it wanted to withdraw from operating the hospital under the exit terms of the contract.[21] Later the same day it was revealed that the Care Quality Commission had recommended the Trust should be placed into special measures after it was rated 'inadequate' on the questions of whether it was caring, safe and well led. They had concerns about the Trust's leadership because both the Circle Health management team and the Trust Board said that the other was responsible for holding the Trust's executive team to account. Circle Health's chief executive Steve Melton said before the report was published: “We understand their report will be published soon, and fully expect it to be unbalanced and to disagree with many of its conclusions".[22] He said the pressures on the Trust could only be resolved through "joined up reform in Cambridgeshire across hospitals, GPs and community services".[23]

Dr Suzanne Hamilton, chair of the Medical Advisory Committee at the hospital wrote to the local paper to say that the CQC report was not consistent with "the vast reams of verified statistical data" about the hospital.[24] Fiona Allinson, head of hospital inspection told the CQC board meeting "It was one of the worst inspections that I had ever been to. I drove home and wanted to drive back again with my nurse's uniform on to sort it out."[25][26]

In January 2015 Hinchingbrooke was said to be the second least efficient hospital in England, according to Lord Carter's review of NHS efficiency, with potential savings that could have been made of £20.5 million a year.[27]

Circle Health handed the management of the hospital back to the NHS on 31 March 2015.[28] The Trust then announced in April 2015 that it expected the deficit for the year ended 31 March 2015 to be £14 million, which was considerably worse than had been forecast by Circle. This was attributed to (i) reductions in local prices during commissioning negotiations costing the Trust in excess of £3 million (ii) a high demand for agency staff generated by increased volumes and acuity of non-elective patients increasing the interim staffing bill by nearly £12 million for the year (iii) the impact of failed cost improvement programme schemes and (iv) a charge of £1.3 million being Hinchingbrooke’s share of the losses of the Pathology Partnership joint venture.[29]

Developments

The hospital came out of special measures with a rating of 'good' in August 2016. This was one of the fastest exits from special measures in England and, at the time, this was the first time that a Trust had exited with a rating of 'good'. Despite this the small size of the Trust was making it hard to sustain high quality clinical services and so alternative management solutions were sought. Accordingly in April 2017 Hinchingbrooke Health Care NHS Trust merged with Peterborough and Stamford Hospitals NHS Foundation Trust to form the North West Anglia NHS Foundation Trust.[30]

In 2019 it was announced that trauma work would be moved to Peterborough City Hospital and Addenbrooke's Hospital as Hinchingbrooke did not meet the minimum volume of work needed to maintain standards of excellence, or to justify the maintenance of a 24/7 orthopaedic rota. It will, however, keep a 24/7 type 1 emergency department.[31]

See also

References
  1. hinchingbrooke.nhs.uk. Retrieved 25 November 2010
  2. "Huntingdon County Hospital". National Archives. Retrieved 16 August 2018.
  3. Lister, John (9 September 2014). "Circle: Behind the Smoke and Mirrors". Socialist Health Association. Retrieved 29 September 2014.
  4. "Hinchingbrooke Hospital". Hansard. 10 November 2011. Retrieved 16 August 2018.
  5. NHS East of England Strategic Projects Team Archived 30 November 2010 at the Wayback Machine. Retrieved 10 December 2010
  6. Nick Triggle, Private firm becomes first to run NHS hospital, BBC News, 25 November 2010
  7. Jeffreys, Branwen (10 November 2011). "Circle in deal to run Hinchingbrooke NHS hospital". BBC News. Retrieved 11 November 2011.
  8. "Mitie keeps hold of Hinchingbrooke Health Care deal". Facilities Management Journal. 17 November 2016. Retrieved 15 December 2016.
  9. Rahman, Shibley. "The privatisation of the NHS appears to be going to plan". Socialist Health Association. Archived from the original on 12 December 2013. Retrieved 8 December 2013.
  10. "Privatisation of Hinchingbrooke Hospital NHS Trust by Circle Healthcare - Newsnight". BBC Newsnight. 3 August 2012. Retrieved 19 January 2015.
  11. Jeremy Laurance (8 November 2012). "Hospital lifesaver Circle loses extra 2.2m". The Independent. Retrieved 8 November 2012.
  12. The franchising of Hinchingbrooke Health Care NHS Trust (Report). National Audit Office. 8 November 2012. HC 628. Retrieved 8 November 2012.
  13. Lister, John. "Circle: Behind the Smoke and Mirrors". Socialist Health Association. Retrieved 18 September 2014.
  14. "NHS trust under private management faces deficit again". Health Service JOurnal. 1 April 2014. Retrieved 13 April 2014.
  15. "NHS audited accounts true and fair but disclose significant financial stress". Audit Commission. Archived from the original on 21 April 2015. Retrieved 21 July 2016.
  16. "Exclusive: Hinchingbrooke backtracks on controversial £50 referrals offer". Health Service Journal. 24 July 2014. Retrieved 18 September 2014.
  17. "Hinchingbrooke patients treated in 'abusive' manner CQC says". BBC News. 26 September 2014. Retrieved 29 September 2014.
  18. "Hinchingbrooke Health Care NHS Trust Quality Report for 16 - 18 September 2014 Inspection" (PDF). CQC. Retrieved 21 July 2016.
  19. "Hinchingbrooke finance director steps down". Health Service Journal. 7 November 2014. Retrieved 11 November 2014.
  20. "Hinchingbrooke Hospital: Unison calls for health firm Circle to be 'sacked'". Cambridge News. 11 November 2014. Retrieved 11 November 2014.
  21. "Hinchingbrooke Hospital: Circle to withdraw from contract". BBC. 9 January 2015. Retrieved 9 January 2015.
  22. "Hinchingbrooke faces special measures as care judged 'inadequate'". Nursing Times. 9 January 2015. Retrieved 9 January 2015.
  23. "Updated: Circle to withdraw from Hinchingbrooke contract". Health Service Journal. 9 January 2015. Retrieved 9 January 2015.
  24. "Hinchingbrooke Hospital doctor Suzanne Hamilton says Care Quality Commission report was 'inconsistent'". Cambridge News. 20 January 2015. Retrieved 20 January 2015.
  25. Makey, Julian (28 January 2015). "Hinchingbrooke Hospital: MP Julian Huppert says privatisation was 'deeply flawed'". Cambridge News. Retrieved 21 July 2016.
  26. CQC. "Minutes of the Public Board Meeting Finsbury Tower, London, EC1Y 8TG 21 January 2015 at 09.00" (PDF). National Archive. Archived from the original (PDF) on 3 November 2015. Retrieved 21 July 2016.
  27. "Least efficient hospital trusts according to headline measure". Health Service Journal. 5 January 2015. Retrieved 28 February 2016.
  28. "First privately run hospital seeks £10m bailout from taxpayer". Financial Times. 9 February 2015. Retrieved 10 February 2015.
  29. "Hinchingbrooke reports sharp deficit rise as Circle departs". Health Service Journal. 30 April 2015. Retrieved 2 May 2015.
  30. "Hinchingbrooke and Peterborough to draw up 2017 merger plan". Health Service Journal. 22 July 2016. Retrieved 3 November 2016.
  31. "STP plans to axe all trauma services at DGH". Health Service Journal. 13 August 2019. Retrieved 30 September 2019.
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