Royal National Hospital for Rheumatic Diseases NHS Foundation Trust

Population 177,000
Beds 46
Income £21,024k
Comprehensive Surplus £61k
Operating Surplus £90k
PPI Cap 1.3%
PPI £164k
Public Members 1,021

In 2011/12 the trust received a qualified audit certificate from their external auditors [1]:

this relates to Monitor finding the trust in significant breach in May 2012 as a result of the trust facing significant structural challenges in 2011/12 resulting in financial problems, many of which are beyond its immediate control.

The website says that it has private patients for its Complex Regional Pain Syndrome services, [2] although it does not guarantee a single room or queue jumping:

We are also able to accept private patient referrals for those who are unable to access this service via the NHS funding routes. This will enable the purchaser to access the normal NHS service and will not expedite referrals, guarantee a single room or any other additional services outside of normal routine care.

The Annual Report [3] says that the previous year’s plans included:

to deliver the financial plan for 2011/12 to include:
– maximising private patient income

On this objective, the Annual Report says:

The Trust achieved private patient income in 2011/12 of £164k, an increase of £18k, compared with total private patient income received of £146k in 2010/11. This is equivalent to 0.90% of total income (0.78% in 2010/11).

In the Forward Plan [4] the trust indicates that there have been a reduced number of referrals due to local private providers, and they expect this to continue:

There are two local private providers of Neurorehabilitation services that are taking referrals that previously came in to the RNHRD, this change in referral practice contributed to a 5.7% reduction in occupied bed days from 5,908 in 2010/11 to 5,573 in 2011/12. A further significant reduction in neurorehabilitation referral levels is anticipated in 2012/13 due to increased competition from other specialist independent providers of neurorehabilitation and the independent sectors ability to provide many of the neurorehabilitaton services in more appropriate, accessible accommodation.

The Forward plan also indicates that commissioners have changed their policy and are now using private providers more; it lists as a threat:

Changing commissioner referral patterns for endoscopy services to local Independent Treatment Centres

The trust also says that the commissioner referral patterns are changing faster than the trust can handle:

The loss in income across all services is proceeding at a pace faster than the Trust’s ability to reduce costs, the Trust faces a disproportionately high overhead cost relative to turnover.

The trust says that to achieve its financial strategy it will:

Seeking external support where it is in the best interests of the services and local health economy to do so.

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