Graphic: Missed targets and a deficit – why Norfolk’s NHS is under scrutiny

Patient Flow board in the Norfolk and Norwich University Hospital Operation Centre. Picture: James B

Patient Flow board in the Norfolk and Norwich University Hospital Operation Centre. Picture: James Bass. - Credit: Evening News © 2009

Two Norfolk health trusts have come to the regulator's attention for the wrong reasons. Where have they gone wrong?

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NHS balance sheets and treatment times often fail to grab the public's attention – but they are the reasons why the health regulator is sitting up and taking notice of the trusts running our biggest hospital and mental health services.

As revealed in yesterday's EDP, Monitor launched the probe on Thursday into the Norfolk and Suffolk Foundation Trust's cash problems and the Norfolk and Norwich University Hospital (N&N) for missing waiting time targets.

The N&N's problems with hitting waiting times for A&E and cancer treatment have been known for months.

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Monitor said yesterday it was concerned that some patients waiting too long for treatment could indicate 'underlying problems' in the way the hospital is run.

The N&N hit a low for A&E waiting times in October, treating 87pc of patients within four hours, far below the target of 95pc.

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That is down to the rapid leap in demand for emergency care. The N&N was so busy it was put on 'black alert' earlier this week - the hospital's highest escalation level.

While more people are coming through the door, the hospital is also struggling to clear people out the other side.

Delayed discharges have soared since June with an average of 60 beds a day in October taken up by healthy patients. That is down to delays in finding care home spaces or returning the patient home.

The second big target the N&N is missing is treating cancer patients within 62 days of referral from a GP.

It should see 85pc of patients within this time. It is seeing 66pc of patients – a figure which is worsening.

The hospital puts the failure down to a lack of capacity for surgery of head and neck cancers and gynaecology.

Monitor is also concerned about the lack of patients the N&N is seeing within 18 weeks of GP referral.

It should see 90pc of patients within that time, but it is just under that. It means that more than 800 patients are currently waiting longer than they should for treatment - a figure which jumped by 50pc in October.

Care minister and North Norfolk MP Norman Lamb said he was concerned that Monitor was investigating the two trusts but said he still regarded the N&N as a 'very good' hospital.

But he added: 'Standards are important and it is obviously the right thing for Monitor to do.'

Problems at the Norfolk and Suffolk Foundation Trust (NSFT) have also had widespread coverage for months. There Monitor is more interested in cash than the wait for care.

The trust was expecting to break even this financial year, but it is already around £2 million in deficit - a number which could rise to close to £4 million by March 2015.

It is spending a fortune - £13 million so far since April - on hiring temporary staff to cover for shortages and sicknesses.

The trust has suffered from low staff morale and a high sickness rate of 5.3pc. It wants to get that down to 4.5pc by 2016.

The trust is also forking out to send patients out of Norfolk and Suffolk - a practice which has been widely criticised for care as well as financial reasons – and the NSFT has got the number of patients in out-of-area beds down to 32.

But it has already spent £1.72 million this financial year on out-of-area placements and that could rise by another £1.4 million by the end of March 2015.

The first steps of the two investigations will lead to a report early next year when Monitor will decide if it needs to take any further action.

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