East Cheshire NHS trust is unsustainable

John Wilbraham, chief executive at East Cheshire NHS Trust has told councillors that the trust, which runs Macclesfield Hospital, is unsustainable – but it is doing all it can to offer quality care for patients.

The trust’s board had made the same submission five years ago was repeated as a Cheshire East Council scrutiny committee was told about how the trust is dealing with the pressures of running the hospitals in Macclesfield, Congleton and Knutsford.

Mr Wilbraham said: “While money is an issue for the system, some of the sustainability issues are not about money, because actually I am spending more money than I should. These are genuine, real problems that are faced by every organisation.”

He continued: “What we are trying to do is sustain a local service as best we can. But if we have to – to protect safety and the quality for patients – give a service away, then I think it is right and proper to do that.”

East Cheshire NHS Trust has been the subject of scrutiny by Cheshire East’s Health and Social Care Overview and Scrutiny Committee on previous occasions.

Those meetings followed problems maintaining the level of services at Macclesfield Hospital in areas such as specialist neonatal services for higher risk pregnancies, Parkinson’s care and orthodontics.

Mr Wilbraham went on to say: “What we need to do is make sure we can provide that service in a sustainable way. Where we can do that independently we do – that is our aim. Where we can’t do it ourselves, what we prefer to do is have a partner to provide it on our site. Where we can’t, and we can’t get providers to provide on the site, then reluctantly we will make the decision to transfer patients to other places.”

The trust is facing the same pressures which are evident in NHS trusts throughout the country – rising demand for health services, over-stretched budgets, recruitment issues and an ageing population.

Councillors were told that East Cheshire NHS Trust is more vulnerable to pressures due to it being such a small organisation – half the size of Mid Cheshire NHS Trust which runs Leighton Hospital.

Cllr Stewart Gardiner, Conservative member for Knutsford, said: “Reading this report, it doesn’t make for positive reading towards the future. My reading is that East Cheshire Trust is probably close to demise. Would it not be better for you to recognise this and perhaps amalgamate with another trust? Albeit you would still be delivering services at hospital in Macclesfield in the way that services are currently delivered by your trust on its sites.”

“I think it is time for us all to be honest and adult in this room and recognise that health provision has moved on significantly since the 1950s. In doing so, we need to be honest with the public about what we can and cannot achieve.”

Mr Wilbraham insisted the trust is being honest about its future saying: “Let’s be frank – the East Cheshire board in 2015 said it was not sustainable as an organisation. So when you say ‘be honest’ – we have said as a board five years ago that the current regime and our scale we cannot sustain as an organisation. What we are focused on is making sure there is a vibrant set of clinical services on offer at the Macclesfield site.”

“So there are conversations about the future organisational form, but that should follow what the clinical services are.That is in the public domain, but it was said so long ago that people have perhaps forgotten that. We have said that we are not viable as a stand-alone organisation.”

Mr Wilbraham advised the committee that while the trust’s organisational form may change in the future, Macclesfield Hospital would continue to provide the best care it could.