Maximising Resources, Joe Rafferty, Chief Executive

Financial Matters

Anyone who has kept in touch with the news recently will know that NHS finances are a hot topic. Many commentators have had their say on what should be done to improve health care services and that spilled over into the Houses of Parliament this week with a feisty exchange between the Prime Minister, Theresa May MP, and the Leader of the Opposition, Jeremy Corbyn MP.

I found it particularly interesting that both parties agreed that no one with a mental health condition should be taken to a police cell, which of course is something we are working hard to prevent in our partnership with the Merseyside Police with the triage car service.

The main focus of the debate, though, was the funding made available to the NHS in general and mental health in particular. I know the government has pledged extra funding for mental health but at Mersey Care, we are yet to see much of that extra funding cascade down to our services.

What is not in doubt is that given the current uncertainty regarding the finances of the UK, NHS trusts like ourselves have to work much harder to make the tax pound go further. The current situation has forced everyone to take stock and look at how we can deliver services in different way, thinking outside the box to allow the tax pound to work harder for our patients, service users, carers and staff.



Many acute trusts would regard the fact that we are running at a surplus as being inefficient, but we would argue we are using our resources efficiently. For example, despite the economic crisis, we have managed to build and open Clock View Hospital that has won awards for its design and has trusts from around the country and the world wanting to visit to see what we’ve done. We also have plans to build two more hospitals, one on the current site of Mossley Hill Hospital, and another in Southport, while we have successfully restored the former Walton Library into the stunning building that is the Life Rooms.

Each year we agree the level of income we need with our commissioners. We then set our budgets to manage all costs within this agreed income. As you would imagine this is very difficult given the increasing demands placed upon our services, but we achieve this by working closely with services to improve efficiency and identifying new service pressures that may need to be funded. 

We try to set our budgets at a level that will generate a small surplus. Normally this is about 2-3% of our £250m. The surplus gives us some flexibility should pressures arise in year, but it also ensures we deliver our statutory ' break even' duty to balance our budgets. 

We are able to carry forward any surplus and build up cash in the trust’s bank account, which is then reinvested in patient care. Our plans are to use this resource to improve our estate and ensure we minimise any borrowings. Using our own cash is much more efficient than borrowing monies and helps to maintain a healthy financial position. 

As we move forward, all trusts in the NHS are required to deliver financial balance. Those not able to generate a surplus are under increasing scrutiny and have several constraints placed upon them. Working in the way we do is good financial management and needs to provide a sound and stable base from which to deliver safe and effective services. Our strong financial position has allowed as to attain Foundation Trust status and provided a platform from which to bid for new business and grow the Trust.