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Trusts must invest in community care, says Monitor

Trusts must invest in community care, says Monitor

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Foundation trusts must ensure they are investing adequately in primary care and community services in order to protect patients interests, says health sector regulator Monitor.

Monitor is concerned following another sharp increase in the number of foundation trusts (FTs) failing to meet the national four hour A&E waiting times target in the last quarter.

Between January and March this year, 47 foundation trusts failed to meet the A&E target, an increase on 32 in the previous quarter, meaning that over half (58%) of all FTs with A&E units breached their target.

Reasons given by trusts included increases in the number and seriousness of A&E attendances, particularly among the elderly, discharge delays due to problems accessing community care services, and physical capacity constraints.

Performance did however improve during the first half of May, when FTs with A&E units achieved over 95%. However, Monitor is working with NHS England and the NHS Trust Development Authority to help all NHS trusts and local commissioners tackle problems with A&E and plan effectively for next winter.

Stephen Hay, Managing Director of Provider Regulation said: "Our latest monitoring of foundation trusts shows that overall A&E performance worsened over the winter. We recognise that some of the causes and answers to this problem lie outside the control of individual organisations, particularly in primary care or social care.

"Trusts should therefore work with partners in their local health economy to tackle the issues affecting A&E, but should use their own resources to fix those issues that are within the gift of hospitals in order to prevent further problems next winter."

Monitor's report also showed that a majority of foundation trusts are still not delivering promised cost savings during the financial year. For the fourth quarter in a row, delivery was substantially behind plan, amounting to one-sixth of the £1.5 billion planned.

Overall the sector delivered a £540 million surplus in 2012/13, which contributed towards £4.5 billion in cash holdings at the end of the year, equivalent to one month’s operating costs in a sector with annual turnover of almost £40 billion.

Stephen Hay said: "Financially, foundation trusts are doing reasonably well, but they need to improve their planning, particularly for capital expenditure."

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