Mental health trust investigated by health watchdog after racking up £1.7m deficit

A mental health trust that was at the centre of claims from social workers that cuts to services had led to ‘unsafe’ care earlier this year is to be investigated by health watchdog Monitor over concerns with its finances.

The investigation will consider whether Norfolk and Suffolk NHS Foundation Trust has breached the terms of its license after the trust racked up an unplanned £1.72m deficit in the first six months of 2014-15. The deficit has been driven by pressures on inpatient beds and high use of temporary staff. The trust says the deficit currently stands at £2.3m.

In March, social workers at the trust, which serves care minister Norman Lamb’s constituency, wrote to the minister to warn that a lack of inpatient beds for patients meant they could “no longer operate on a legal basis”. A staff and service-user led campaign has also repeatedly voiced concerns with services over the past 12 months.

The trust said it welcomed Monitor’s review and acknowledged it was under “intense pressure”.

In a letter to the trust, seen by Community Care, Laura Mills, deputy regional director of Monitor, said that the investigation had also been triggered by early feedback from a recent Care Quality Commission inspection of services and concerns over the trust’s governance that had been found by an external review. The CQC had identified issues requiring “swift remedial action”, according to Mills’ letter.

“Monitor is concerned about how these issues have escalated and whether they could indicate a governance failure and a potential breach of the Trust’s licence,” she wrote.

Norfolk and Suffolk NHS Foundation Trust chief executive Michael Scott said: “We are all well aware that the NHS both locally and nationally is under intense pressure both in terms of demand for services and funding and we too are facing considerable challenges.

“There are particular funding problems facing us in mental health and we welcome Monitor’s review.

“In the interests of our service users and staff, we are determined to see a fairer deal for mental health and we’re working to improve the culture and leadership of the trust. We look forward to working with our regulator and commissioners to make sure we get back on track financially.”

Scott has previously said that the trust has been ‘underfunded’ by £30m over the past four years.

Unison said it had been warning about the impact of cuts to services for almost two years. In January 2013, the union wrote to the Care Quality Commission warning that Approved Mental Health Professionals were struggling to get local beds for patients in need.

Emma Corlett, spokeperson for the trust’s Unison branch and a mental health nurse, said: “As we have long warned it is simply not possible to cut services at a time when demand is increasing without the quality of services suffering. The board of NSFT have been placed in an impossible position having to “balance the books” under such circumstances.

“The millions spent each month on temporary staffing and out of area acute beds, just to maintain a basic level of safety, is financially crippling. It is appalling that the local clinical commissioning groups, NHS England and our local MP and minister of state Norman Lamb have between them not managed to provide any financial assistance to avert this crisis.

“We wholeheartedly support the comments of NSFT Chief Executive Michael Scott that we are underfunded to the tune of £30 million and look forward to working with him and the board to fight for fair funding for our mental health services.”

The trust is required to make £40m of savings by 2018. Concerns have been voiced over a disparity between the funding of mental health and physical health services in the trust’s area. Figures obtained by the Campaign to Save Mental Health Services in Norfolk Suffolk found that acute hospitals had seen funding from commissioners rise by 15% since 2010, while mental health services had seen budgets drop by 3%.

A spokesman for the campaign told the BBC: “It is vital that those who depend on mental health services do not pay the price of underfunding of NSFT [the trust].

“If mental health had enjoyed the same increase in funding as physical health since 2010, NSFT would have an annual budget £30m higher than it does today.

“Mental health services in Norfolk and Suffolk need money not soundbites.”