South Reading CCG (Clinical Commissioning Group) together with the 3 other commissioning groups in Berkshire West are responsible for procuring acute medical services for the local population. The detailed contract between the CCGs and the RBHFT (one of the principal local providers) is well under way and is expected to be signed off by the end of June, according to Ed Donald, chief executive of the RBH Foundation Trust, speaking at a recent RBH Council of Governors public meeting.
Ed Donald's report gives some indication of the stresses and pressures being felt at present at the RBH, showing concern about the financial viability of Critical Care Services and Urgent Care in the A&E department and associated unplanned admissions to the hospital.
Ed Donald reported that provision was currently continuing under a Heads of Terms Agreement signed on 28th March 2013 with the CCGs. In the meantime executive-level meetings between the CCGs and the RBHFT have continued. According to Ed Donald, quality issues are largely now agreed and the key areas of focus in the discussions are the Activity, Financial and Business rules. Particular areas of focus were the funding of Critical Care Services and the funding and management arrangements for the expected growth in emergency activity (A&E attendances and unplanned admissions) in 2013/14 and the investment by the Commissioners of the penalty deductions under the national payment-by-results tariff rules. (Under these rules the hospital receives only 30% of the appropriate fee for patients treated in excess of the number for 2008-9 and no fee for patients re-admitted within 30 days of emergency admission.) Also under discussion was the number of follow-up outpatient appointments paid for as part of a given treatment.
Ed Donald stressed that one of his priorities was to see the hospital get paid in full for the work it did. So he wanted to see those penalties returning to the hospital as investment in expanded capacity.
The Council of Governors will hear a further report at their next meeting in July.