Dorset County Hospital bosses address £8.6million overspend

The income and expenditure figures were presented to hospital governors at their meeting in Dorchester. The figure is less than 5 per cent of turnover.

Part of the variation was caused by the government agreeing a higher than expected pay award and an increase in patients. The hospital has also continued to struggle to recruit with staff shortages forcing the hospital to spend more than it hoped for on agency nursing staff.

The hospital’s capital spending of £8.6 million was in line with target.

Deputy director of finance Rebecca King told governors in her report that the hospital had also received less government grant than hoped for some work.

Governors also heard that the hospital had recently failed to achieve the four hour standard for emergency admissions and had reached the stage where a public warning had to be issued asking people not to attend unless their condition was extremely serious.

Chief executive Patricia Miller admitted it was a puzzle why the last six months of the financial year had seen big increases in admissions – against the national trend. She said more of the work being undertaken was now of a more serious nature and the pressures on the hospital had been compounded by delayed discharges now running at double the rate they were, which also impacted on costs.

She speculated that some of the problems in A&E were due to people admitting themselves to accident and emergency because they were unable to see their own GPs quickly enough and believed that others, faced with using walk-in services at Weymouth late in the day, were opting to come straight to Dorchester, fearful that they would end up there anyway if not seen in time.

But she said that much more work needed to be done to explore why there had been so much pressure for emergency admissions in recent months.

She said the situation of, in her words, having the hospital ‘running hot’, was not ideal for staff or patients.

“If we are running hot all the time it leads to pressures to make quick solutions. We need to relieve the pressure and we need to find solutions to workforce gaps,” she said.

The chief officer said that an early look at the figures showed an increase in ‘minor’ A&E admissions shortly after the time that most GP surgeries closed. She said there was also a question over some advice given by the 111 service and an expectation among many people that they must have an instant answer to whatever their problem was, even if it was something which could wait, or advice could be offered by a GP or pharmacist.

“But that’s the way society is now, where we Google things and get an instant answer, and we, as an organisation perhaps have to recognise that,” she said.

Jenny Bubb from the clinical commissioning group acknowledged the issue: “There has been a lot of research about why people go to A&E and it seems that most are appropriate.

“People don’t want to wait and they know that if they go to A&E they will be seen. There is a lot of work to be done on managing people’s expectations,” she said.

Several governors said that, in some areas, people were now waiting three or four weeks to see a GP, a situation which had worsened since the summer. They praised the work of local GPs and their staff who they claimed were struggling to meet demand with a lack of resources.

The meeting acknowledged that the hospital campaign to recruit overseas nursing staff might now have to be followed by an overseas campaign to encourage doctors to come to Dorchester – as attempts to recruit within the UK were still falling short, many medics preferring city locations to further their careers.