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Royal Free Trust's annual report reveals it hasn't met referral targets in two years and needs to take out more loans

PUBLISHED: 07:00 22 August 2019

The Royal Free Hospital. Picture: Ken Mears

The Royal Free Hospital. Picture: Ken Mears

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The Royal Free London NHS Trust has not met referral to treatment targets in two years and needs to borrow a further £75million from the government to stay afloat, according to its annual report.

Its poor record of treating patients on time was laid bare as figures showed it hasn't met referral to treatment targets since July 2017.

The trust is also looking to expand by taking 10 to 15 hospitals under its wing, despite auditor PricewaterhouseCoopers saying there was "significant doubt" as to whether the group and trust were able to operate as a "going concern".

PwC raised concerns after the trust borrowed an additional £53million from the Department of Health and Social Care in this financial year. It plans to ask an additional £75m from it over the next financial year, taking its total owings to the government to £243.9m at the end of 2019/20.

The report goes on to say £30m is due to repayment in 2020/21, on top of the trust needing to cut £45.9m to meet its financial improvement plan. The auditor said the extent of support from the government was "uncertain".

"These conditions [...] indicate the existence of a material uncertainty which may cast significant doubt about the group's and trust's ability to continue as a going concern."

In the report, the trust also concedes its parlous financial position limits its capacity to pay creditors on time.

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Meanwhile, patients should have access to consultant-led treatment services within 18-weeks of referral, and NHS England stipulates that 92 per cent of patients should begin treatment within 18 weeks. But the trust last met that target in July 2017, and saw a nadir in December 2018 of 73.2pc.

It is currently undergoing a 12-month overhaul of its patient tracking list, in a bid to speed up referral times.

The trust has outlined its ambitions to grow the Royal Free Group to include the extra hospitals, under a single management board. Currently, since the group was established in 2015, only the North Middlesex hospital trust and West Hertfordshire have joined as clinical partners, under a separate board.

The trust's mortality rates continue to stay low compared to other trusts nationally.

Previous trust chief exec Sir David Sloman left in February and was replaced by former deputy and director of finance Caroline Clarke. In May the CQC downgraded the trust to "requires improvement" over safety, responsiveness and its finances.

A spokesperson for the Royal Free said: "We are one of the largest trusts in the country and, like many others, have a number of loans with the Department of Health and Social Care, including funds required for the redevelopment of the emergency department at the Royal Free Hospital. These loans are for the trust's essential day-to-day business.

"We have an annual turnover of just over £1 billion and achieved a £43 million saving in 2018/19 by identifying opportunities to become more efficient and reducing waste. This year we have a financial improvement plan in place to reduce our spending by £49.5m.

"The Royal Free London was one of four NHS hospital trusts chosen to set up and lead a group of NHS providers who will share services and resources in order to improve the experience of our staff and patients. Our group model is already starting to show real benefits to patients, reducing the length of stay for hip and knee operations and keeping more mothers and babies together by reducing admissions to our neonatal unit.

We recognise that 2019/20 is a year when we need to consolidate and focus on ensuring that our financial and operational performance - including referral to treatment times - matches the high standards of care for which we pride ourselves."

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