Just three months into its new budget year Great Western Hospital is looking at a deficit of more than £13m by the end of March 2019.
And bosses at the trust that runs the hospital have been told that patient demand, and covering staff vacancies with agency staff and locum doctors is hitting the budget hard.
Karen Johnson, director of finance at the NHS trust, said: “We are still behind our savings plan by just over a million pounds and we are experiencing some extreme increase in high cost agency and locum spend in particular within unscheduled care. We are working on a recovery plan.”
The trust which runs GWH and its community services is expected to have an income of £308.8m this year, but thinks it will spend £332.6m.
In May, the trust spent £92,000 on hiring temporary staff for unscheduled care departments, which includes parts of the hospital like A&E.
Mrs Johnson said the hospital had more patients coming into the hospital for unscheduled care. Unlike planned care, such as hip operations that are organised weeks or months in advance, the trust is only paid around three quarters of the cost of these patients’ care.
She told fellow GWH executives: “We’ve seen a significant increase in A&E activity in month two - seven per cent above plan - which is an area of concern.
“We are looking at what’s driving that; is it a blip or is it something that is a cause for concern?”
Accountants at GWH are rewriting their financial plan for 2018/19 to national NHS bosses. Mrs Johnson told fellow hospital directors: “It means we can adjust the budgets at the start of the year to compensate for the fact we are not ahead or in line with our savings plans.”
In documents shared ahead of last week’s board meeting, Mrs Johnson said they were already drawing up crisis plans: “In order to achieve the financial control total we need to start work on a financial recovery plan now.”
The focus of the next three months would be to reduce vacancies and temporary staff costs, identify savings and embark on a financial recovery plan, the report said.
Hospital chiefs have submitted a bid worth tens of millions of pounds to expand the emergency department and acute care wards at Great Western Hospital. The outcome of the bid will be known in the autumn.
On Saturday, the Advertiser reported hospital directors estimate they need between 60 and 80 extra beds in the next 10 years. Strategy director Kevin McNamara said he was talking to Swindon Borough Council about the possibility of getting hold of housing development cash to fund hospital care.