Birmingham Children’s Hospital has been on the brink of financial distress over swingeing Government cuts to funding for specialist hospitals. Health Correspondent Alison Dayani talks to chief executive Sarah-Jane Marsh on how she has managed to turn the trust’s fortunes around.
Just six months ago, the chief executive of Birmingham Children’s Hospital faced an impending nightmare that could have seen her having to juggle services to meet millions of pounds worth of cuts from the Government.
On top of Whitehall’s imposed savings plans for all hospitals up and down the country, Sarah-Jane Marsh also faced a drastic cut to “top-up” payments on the most specialised children’s treatments.
Payments worth millions of pounds which are vital in maintaining the vast types of life-saving operations at what is now one of the largest and most specialised children’s hospitals in Europe.
In a reversal of fortunes, a compromise has now been reached with the Department of Health and the Children’s Hospital is in a perfect position to become a major centre for cardiac, trauma and neurosurgery services, all of which are being reviewed nationwide.
“There was a huge debate and we worked with other specialised children’s hospitals and the Department of Health to get an agreement,” said Ms Marsh. “I am pleased with how it turned out as we get exactly the same amount of money this year as last year.
“But we don’t want to be doing these discussions every year so children’s hospitals are looking at another piece of work to get a final answer on payments. We are confident of getting a significant review on top-up payments to sort this out once and for all.”
A leaked internal memo from the Department of Health revealed in November that plans were afoot to slash “top-up” fees, or extra money given to children’s hospitals for more expensive specialist treatment, by 30 per cent.
It would have meant that if a normal NHS hospital is paid £100 to carry out an operation on an adult, Birmingham Children’s Hospital would be paid £125 instead of the previous amount of £178 for the same treatment on a child, which costs much more due to its more specialised, intricate nature.
Miss Marsh said the negotiations ended with a compromise that payments would drop by 10 per cent – from the equivalent of £178 per procedure to £160 – but hospital chiefs were appeased with more operations and procedures being classed as eligible for “top-up” payments.
It meant the amount received by trusts was, overall, practically the same as had previously been given.
“We tend to do more complex work here, so we need to plan four to five years ahead,” added Ms Marsh, who is married to Sir David Nicholson, chief executive of the NHS in England.
“There is more of a financial challenge now than in my first years as a chief executive from June 2009.
“Most of the money is the same but pressures of delivering the work is increasing, the extra cost of blood, drugs and other factors and we have to find all that out of the same amount of money.
“We are trying to drive down costs for things like stationery and bits of kit. The last thing we want is to make announcements that making hundreds of people redundant. We aren’t that kind of organisation.”
A national review is under way which will see fewer hospitals carrying out trauma, brain and heart surgery for children, therefore creating fewer centralised bases for operations and services like epilepsy surgery.
This could see Birmingham getting more patients, which Ms Marsh believes could provide new opportunities for the hospital despite coinciding with financial constraints.
“I think that it provides an opportunity for us,” added Ms Marsh. “We can start to think about expanding some areas and we are going from 20 to 30 intensive care beds, but that doesn’t mean we need half the amount of staff again if we do things differently. We are looking at how other countries do things.
“Some services cost us a lot to provide. Some hospitals may think should we do them? We have always taken the view that we should.
“We never want to get into a situation where we say we can’t offer a service because we can’t make any money from it.”