Hospital Fined for Treating Too Many Patients

An NHS hospital has been penalised for treating its patients too quickly – losing nearly £2.5 million, the cost of the care it provided outside an agreed contract. Ipswich Hospital NHS Trust, which finished the year £16.7 million in the red, had been doing so well with waiting list targets that in one department patients were waiting only a week to see a consultant.

But that was too fast and too costly for East Suffolk Primary Care Trusts (PCTs), which provide the money for patient care. They had introduced a minimum wait to manage demand, requiring patients to wait at least 122 days before seeing a consultant.

The non-payment of £2.5 million by the PCTs for treatment provided for Suffolk patients was revealed in an independent audit by PriceWaterhouseCoopers, called in by the hospital to review its financial problems.

The report said: “The trust had spare capacity and, to ensure its resources were utilised, treated a number of patients in advance of the 122-day rule.” That cost the hospital £240,000 in 2004-05 and rose ten-fold to £2.4 million in 2005-06.

Hospital staff, pleased with their ability to treat patients quickly, are exasperated. The hospital’s joint unions said: “The PCTs wanted the work done; we did it and now they should pay for it.”

Jan Rowsell, a spokesman for Ipswich Hospital, said that no one needing urgent or emergency treatment had been affected by the rule. “Anyone deemed to be clinically urgent would be seen earlier. This rule is there for people who are waiting for planned surgery.”

She said the hospital had effectively breached its agreement with the Suffolk East PCTs by treating people more quickly. “Although you can understand the reasons why we did it, the background is that we went against our commissioning agreement.”

Carole Taylor-Brown, the chief executive of Suffolk East PCTs, said they wanted a system that was fair to all patients and that worked within the budget.
“The principle is to make sure that patients are seen in turn as they go through the system and to level out waiting times. It is also about making best use of the money that we have available throughout the year.

“It would be great if we were fully resourced to do everything. But we are given a certain amount for the year and we have to make sure we are using it efficiently.

“This is something that we agreed with the hospital, not just something that was imposed on them, and the most important thing is that we have brought waiting times down.

“Not long ago people had to wait up to 18 months for an operation. Now nobody waits more than six months.”

Miss Taylor-Brown said the 122-day rule had been cut to 98 days in the current year.

Andrew Lansley, the shadow health secretary, said: “It is outrageous that Ipswich Hospital is being penalised for improving on the Government’s target, especially when the trust is crippled by deficit. The Government is more obsessed with meeting its targets than the interests of patients.

“In some cases it may be in the interests of a patient to wait longer than the target time and in some cases for a shorter time. Either way, targets should not override clinical decision making.”

Nigel Edwards, of the NHS Confederation, which represents NHS organisations, said he expected more minimum waiting times to be set as hospitals worked through their waiting list backlogs, allowing them to see new patients more quickly.

The Department of Health said that health authorities were free to manage their finances in the best interests of patients “as long as patients are seen and treated within the six-month [maximum] target”.