Wide range of services set to be affected as Western Trust aims to cut £12.5m

By Ciaran O’Neill

The Western Trust proposal to reduce £12.5m from its budget before the end of next March covers a wide range of services.

The Trust has described some of the cutbacks as ‘low impact’ while others are described as ‘major and or controversial’.

The proposals described as ‘major and or controversial’ are:

• - Reduction in high cost and non-NHS locums, nursing agency and agency Social work staff – total savings £1.630m. The Trust says that it uses a considerable number of locum medical staff, agency nurses, social workers and allied health professionals, primarily in their acute hospitals, but also in their community services, due to the difficultly in permanently recruiting medical, nursing and other staff. The cutback proposal places particular emphasis on reducing or removing the reliance on staff employed through noncontracted agencies that have significantly higher premiums or rates. The Trust says that this will result in closure of approximately 30 beds/care spaces across medical and care of the elderly wards. There will be an increase in waiting times for routine care within hospitals.
• - The Trust will temporarily reduce routine elective activity and consolidate daycase elective surgery - total savings £1.780m Action: Routine elective (non-emergency) surgery across the Trust will be reduced by 50% for daycase and be downturned for routine inpatients in Altnagelvin and the South West Area Hospital (SWAH) in Enniskillen, resulting in bed closures associated with elective care. The Trust says that it will continue to prioritise the highest risk patients awaiting surgery.
• - The Trust will introduce a cap on locum payment rates – total savings £700,000. The Trust says it will aim to reduce the money paid to high cost locums in key specialties.
• - The Trust plans to temporarily reduce the provision of domiciliary care and nursing home packages - total savings £1.16m. The Trust says that it currently spends £36.2m on domiciliary care in-house and with contracted out providers. The Trust proposes that domiciliary care services will be targeted at the highest risk clients and a recommendation will be made on a regional basis to revise eligibility criteria to enable a reduction in expenditure. As a result, the Trust estimates that 275 Domiciliary Care Packages will not be put in place, equating to 2,745 care hours per week and 8- 10 nursing home beds.
• - The Trust plans to ‘consolidate services onto fewer sites and rationalise existing services in order to maximise the efficient use of resources’ - total savings £170,000. The Trust says it proposes to consolidate the services in the Derry/Londonderry area provided by William Street and Rectory Field Residential Homes onto fewer sites. This effectively would lead to the closure of one of the homes.
• - The Trust will revise its arrangements for enabling staff to carry over annual leave to the following year. Staff will be required to use all annual leave in-year. There will also be a delay in recruiting new staff – total savings £1m.
• - The Trust says that it will temporarily reduce or delay some services/service developments - total savings £2.49. The Trust proposes that where it has been allocated investment to take forward the development of new services, it will delay the start date of the service investment, including staff taking up post.
• - The Trust proposed to ‘remodel services on a temporary basis’ – total savings £470,000. The Trust proposes to take forward 2 proposals:- Reform neonatal service provision at SWAH to a transitional care based service. This will mean babies that require special care services being managed within the Paediatric Ward with a Specialist Neonatal Nurse in attendance, and may impact on capacity in the Paediatric ward in SWAH. The Trust will also reform the Older Persons Assessment and Liaison Service (OPALS) in its hospitals in order it says to maximise the efficient use of resources.

The Trust says that the ‘major and or controversial’ cutbacks will result in a total saving of £9.4m.

The rest of the proposed £12.5m reduction in budget will be made of ‘low impact’ issues, which include:

• - The Trust says that it will apply ‘significant additional constraints’ to goods and services budgets – total savings £740,000. The Trust will reduce the usage of a range of external service providers, and put in place a range of controls on limiting expenditure.
• - The Trust will apply ‘significant additional vacancy controls’ in administration, corporate and support services – total savings £510,000. This proposal refers to further constraint on pay budgets, including vacancy control across a range of support services, including cleaning, medical records, clinical coding and estates services. Staff will be deployed to cover gaps on rotas/vacancies.
• - The Trust says that it will accelerate projects which will deliver ‘increased efficiency and reduced costs’ - total savings £950,000.
• - The Trust plans to increase income where possible – total savings £900,000. The Trust proposes to increase the hourly rate for paid carparking at its three hospital sites within a new tiered charging scheme and revisit revenue schemes to secure savings where possible. The Trust says that approximately 70% of its carparking spaces are currently free of charge.

The Trust says that the ‘low impact’ issues identified will reduce its budget by £3.1m.

The Trust said that it has systems in place to support staff through the proposed changes.

A Trust spokesperson said: “A communication plan will make sure that staff are kept informed of any proposed action and developments.

“Staff will also have meetings with their managers to discuss plans, influence the planning process and air their concerns.

“The Trust will work in partnership with trade unions to assess the impact on staff and to put robust mitigating measures in place.

“The Trust is committed to consulting with staff and their representatives to provide support and minimise the impact of change and change processes.”