A vision to expand the Norfolk and Norwich hospital and improve patient care is being put in jeopardy by the threat of up to £10m in fines, its chief executive warned today.
Mark Davies said the N&N is 'full' and needs more space, but he fears plans to build new facilities could be affected by the trust being forced to pay fines for missing patient targets in 2015/16.
As demand rises, the hospital is not meeting key targets in A&E, cancer, and referral to treatment, leaving patients waiting longer for treatment.
To stop this spiral, Mr Davies wants to build a new day surgery and diagnostic unit and expand A&E.
'This expansion is crucial,' Mr Davies said. 'We're setting aside money for the expansion which we need to treat patients more speedily, but we face having to spend the money on paying these fines instead.
'It's a double-whammy.'
The fines are issued by Norfolk's clinical commissioning groups (CCGs), who are responsible for buying health services on behalf of patients.
But the CCGs have to fine trusts that miss targets under rules set by NHS England, the body which regulates CCGs.
The final value of the fines is currently being negotiated by the CCGs and N&N. Mr Davies said: 'My question is: 'Is this the most sensible thing we should be doing as a collective health service?''
While Mr Davies stressed he was not blaming Norfolk's CCGs, he urged them to reinvest any money gained in fines straight back into the hospital.
CCGs can spend the money accrued in fines on any area of the local NHS.
In the past seven years the N&N trust has seen the number of outpatients rise by 39pc, day case procedures rise by 46pc, A&E attendances rise by 42pc, and emergency admissions rise by 34pc.
However, the trust was last month found to be the most efficient acute teaching hospital in England in an NHS review by Lord Carter.
Mr Davies said this showed the CCGs were getting 'excellent value for money'.
NHS England said it was suspending the practice of CCGs fining hospitals and ambulance trusts for missing targets during the next financial year, which starts tomorrow.
CCGs used to be able to waive the fines if they decided trusts had a good reason for missing targets, but that changed last April.
This January NHS England said CCGs could use the income generated by fines to improve their own finances, as well as reinvest money back into the local NHS.
A spokesman for North Norfolk CCG, the lead commissioner for acute hospitals, said: 'The contract between Norfolk CCGs and NNUH is worth in excess of £280m per year and is governed by a set of complex national payment rules. There are inevitably a small number of queries about payments made under such a large contract – these total a very small percentage of the total value.'
Have you got a health story? Email nicholas.carding@archant.co.uk
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here