Kerslake quits as hospital trust chair in funding protest

11 Dec 17

Former civil service head and CIPFA member Lord Kerslake has quit as chair of the Kings College Hospital NHS Foundation Trust, accusing the regulator NHS Improvement of failing to understand its financial position.

Lord Kerslake, a former permanent secretary at the Department for Communities & Local Government, said in an article in the Observer newspaper: “I have concluded that the government and its regulator, NHS Improvement, are simply not facing up to the enormous challenges that the NHS is currently facing.

“This is especially true in London where the demands of a rapidly growing population are not being matched by the extra resources we need.”

He said the trust had struggled financially since it took on Bromley’s Princess Royal University hospital in 2013.

Lord Kerslake said King’s had moved significantly away from the financial targets demanded by NHS Improvement for this year, and “the secretary of state and the regulator normally extract a price for this at the top and King’s will be no different.

“We could fight back, but this puts King’s future at even greater risk. The right thing for me to do therefore is to step down and to do so publicly.”

Lord Kerslake said NHS funding and organisation “desperately need a fundamental rethink, until then we are simply kicking the can down the road”.

An NHS Improvement spokesperson said: "King's financial performance is unacceptable and continues to deteriorate. 

"We are considering a range of actions, including entry to our financial special measures regime, which means King's will be subject to greater scrutiny and extra support from NHS Improvement. “

Lord Kerslake would be replaced by “a highly experienced new chair”, they added.

“As a former head of the civil service and highly experienced accountant, it is noteworthy that Lord Kerslake has resigned citing that in his view government and regulators do not recognise the scale of pressures facing the NHS.

CIPFA chief executive Rob Whiteman said: “Pressure in health will be aggravated by the desperate position of social care funding, which was noticeably not addressed by the chancellor in the Budget.

“At present, now five years on from Dilnot, there is no strategy to adequately fund adult care.

“Lord Kerslake’s resignation, therefore, highlights the broader concerns of many professionals that many services are under the greatest pressure ever seen.”

Niall Dickson, chief executive of the NHS Confederation, said: “What is unarguable is that demand is growing beyond our capacity to meet it - and ironically the current constraints are slowing down our capacity to reform the way care is delivered.

“As a society we have to decide whether or not we are prepared to take a hard look at what will be needed, embrace reform and provide the resources needed to deliver it.”

UPDATE at 5pm on 11/12/17:

Since Lord Kerslake’s resignation over the weekend, the King’s College Hospital NHS Foundation Trust has been placed in special measures by regulator NHS Improvement.

It said the trust had agreed a budget deficit of £38m for 2017-18 but this was now forecast to reach £92m.

NHS Improvement chief executive Ian Dalton said he intended to appoint Ian Smith as interim trust chair and to install a financial improvement director.

Dalton said: “The financial situation at King’s has deteriorated very seriously over recent months and we have now placed the trust in special measures to maximise the amount of scrutiny and support that it receives.”

He said the NHS faced financial challenges but no other part of it had “shown the sheer scale and pace of the deterioration at King’s”.  

Dalton added: “It is not acceptable for individual organisations to run up such significant deficits when the majority of the sector is working extremely hard to hit their financial plans, and in many cases have made real progress.”

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