Issue - meetings

Report and presentation attached.

The Director of Financial; Operations at BHRUT explained that financial problems in 2017/18 had meant the Trust had assumed more income than it received in reality and had stopped paying suppliers for a period. The Trust had to obtain emergency loans and posted a £49m end of year deficit.

The Trust’s financial recovery plans had now been agreed and shared with the Clinical Commissioning Groups. A financial governance steering group had been set up and there was now more detailed and transparent financial reporting to the Trust board.

For 2018/19, the Trust had planned a deficit of £52.5m and it was emphasised that any deficit would not impact front line services. The Trust had recruited a new director of finance and established a cost improvement programme of £39m. All proposed savings had been checked to ensure that they did not have any impact on medical quality. The Trust had also taken a further loan from the Department of Health in order to cover any shortfall. Savings had included a reduction in the clinical negligence premium for maternity services which had led to a rebate of more than £1m.

The Trust was also working to reduce the use of agency staff.  Savings had also been established from having greater control pf procurement and by the use of text reminders to reduce the number of patients not attending appointments.

Detailed NHS guidance on health tourism had now been released. NHS care was free to ordinary residents of the UK and overseas patients would be treated in cases of emergency or if maternity services were required. It was accepted however that it could be difficult to obtain payment from patients for this treatment.

Only a small proportion of BHRUT work related to cases of health tourism. In 2016/17, there had been some 570 cases with a £3m charge of which £249k had been recovered. In 2017/18, this had reduced to 378 cases with £2.5 charges of which £249k had been recovered.

An action plan to increase collection rates had been developed and best practice in this area at other Trusts had been considered. More detailed questioning was now given to overseas patients and credit card payment for treatment as now able to be taken on all wards. BHRUT was also in the top quartile for identifying patients using the European Health Identification Card. It was accepted that health tourism was a notional issue but the Trust felt it did now have a pro-active action plan.

The Trust made clear to patients that they would be charged for treatment and offices agreed that it was important to collect the money whilst a patient was still in the country. The issues around health tourism were now given more emphasis in hospital staff education and i9ndction etc.

The Sub-Committee noted the update.