As reported by Andy McNicoll in Community Care, Oxfordshire
County Council have been developing a ‘big plan’ for its services for people
with learning disabilities, and it seems likely that this plan does not include
a further contract with Southern Health NHS Foundation Trust for learning
disability services in Oxfordshire (see http://www.communitycare.co.uk/2015/03/13/southern-health-set-lose-5m-learning-disability-contract-significant-concern-care/
).
Oh frabjous day! Callooh! Callay! Has the Jabberwock been
slain? And if is has, is it planning to whiffle off back to the tulgey wood
with a big stash of cash in its claws that catch?
As @sarasiobhan first suggested last September (https://mydaftlife.wordpress.com/2014/09/01/sunshine-and-shade/
), is it possible that the loss of its Oxfordshire learning disability contract
may result in a financial windfall for Southern Health without any future
hassle from those ‘non-Hampshire’ awkward types? If it loses the contract, does
it get to keep (and sell off) the sites of its learning disability services in
Oxfordshire, often in potentially lucrative locations? As yet the answer to
that question isn’t clear (to me, anyway). However, on the basis that past
behaviour is the best guide to future behaviour, I’ve been looking through
Southern Health’s Board papers for clues about their financial strategy when it
comes to learning disability services in Oxfordshire.
My template for looking at this is the behaviour of an asset
stripping venture capital company, with stages something like this:
1) Identify a financially struggling company and
acquire it at a knock-down price.
2) Reduce running costs as much as possible and don’t make expensive investments into the company.
3) Sell off the assets piecemeal under there’s nothing left except for any highly profitable elements that can be absorbed into other company or sold at a huge profit.
2) Reduce running costs as much as possible and don’t make expensive investments into the company.
3) Sell off the assets piecemeal under there’s nothing left except for any highly profitable elements that can be absorbed into other company or sold at a huge profit.
This blogpost focuses on Stage 1 – what the papers say about
the merger/acquisition/absorption of Ridgeway. A later post will focus on what happened
after the merger/acquisition/absorption.
Surely an NHS Trust wouldn’t (and wouldn’t be allowed to)
behave like this? Well, let’s see…
Stage 1) Find the limping wildebeest
Part of this story lies far back in the mists of time
(probably around 2010/11). At this point, the plan (bound into the Health and
Social Care Bill 2012) was for ALL NHS Trusts to become Foundation Trusts,
largely on the basis of plans for financial viability.
Ridgeway (also known as the Oxfordshire Learning
Disabilities NHS Trust), a relatively small, specialist learning disability NHS
Trust spread across Oxfordshire, Buckinghamshire, Wiltshire, Dorset and North
East Somerset, was always going to struggle to meet the largely financial
criteria that would enable them to go it alone as a Foundation Trust, and were
running a substantial financial deficit of up to £1 million in 2011/12 (http://www.lgcplus.com/sponsored-sections/capsticks-social-enterprise/ridgeway-to-be-taken-over-by-non-neighbouring-ft/5040963.article#
). Clearly a limping wildebeest in the pack.
Ridgeway therefore were compelled to seek a ‘merger’ (although
it was more often referred to as an absorption or acquisition) with a Trust
that had already reached Foundation Trust status. My guess is that this was
instigating and managed by the local Strategic Health Authority, South Central
SHA, and they wanted as many loose ends tied up as possible before they went
out of existence in March 2013, in the Year Zero of the Health and Social Care
Act (see http://www.nhsconfed.org/resources/2013/03/service-redesign-case-study-the-southern-health-acquisition-of-ridgeway
). From 13 initial bids for Ridgeway, 6 were longlisted. These were whittled
down to Calderstones and Southern Health (itself the result of a recent merger),
with Southern Health named as the ‘preferred partner’ for Ridgeway in March
2012 (http://www.southernhealth.nhs.uk/EasysiteWeb/getresource.axd?AssetID=39988&type=full&servicetype=Inline
) for the absorption to happen in some haste, November 2012, just before Year
Zero.
Why was this ‘financially struggling’ Trust so attractive to
so many bidders?
First, in the world of NHS absorptions, you don’t have to
pay over any cash for your acquisitions.
Second, it looks like the Strategic Health Authority pumped
an unspecified amount of money into Ridgeway in its last year, perhaps to
sweeten the deal.
So, the final accounts for the old Ridgeway Trust for 1st
April – 31st October 2012 (actually produced by Southern Trust after
the absorption and available in the Southern Health Board papers for 29th
May 2013 http://www.southernhealth.nhs.uk/EasysiteWeb/getresource.axd?AssetID=71931&type=full&servicetype=Inline ) say this:
“The seven months to 31
October 2012 continued to be a challenging year financially with the Trust
(Ridgeway) finding it difficult to reduce operating costs to match the
reduction in income following the
wholesale retendering of social care services by Oxfordshire County Council in
2011/2012 [all italics my emphasis].
As a result NHS South Central continued
to provide transitional funding whilst the Trust worked with Southern
Health to review and refine operating plans ahead of their formal acquisition
on the 1 November 2012. Whilst the Trust
was able to deliver a financial surplus over the seven months with the help of
this financial support, this was slightly less than planned.”
Third, there was some heavy investment in two specific sites
before the absorption, amounting to £1.9 million (these quotes also from the accounts):
“Building work was completed on the expansion and upgrade of
the Assessment and Treatment services at Postern House in Marlborough. This was
a major scheme that created six additional beds in a series of phases. It has
also addressed longstanding issues around the fabric of the building, such as
the roof, and improved the patient experience through improvements to the
environment.
The refurbishment and expansion of the Assessment and
Treatment services at the Ridgeway Centre (formerly 309 Cressex Road) at High
Wycombe in Buckinghamshire was completed and opened in September 2012. This
refurbishment programme makes this building a unique facility in the region and
will provide a high quality, safe environment for patients that will be
attractive to commissioners across a wide geographical area. This initiative
supports the ambition to improve the strategic estate whilst delivering a
planned vacation of leased estate thus reducing occupation costs.”
[Quite why the priority for investment was in expending Assessment
and Treatment Units whilst government priorities pointed in exactly the
opposite direction is a question for another day – perhaps building these up so
other, shabbier ones, could be closed?]
A fourth element of the sweetened deal was an initial list
of four buildings that Ridgeway had earmarked for sale but were not actually
sold until after the absorption, with the proceeds planned to go to Southern
Health rather than Ridgeway:
“Ridgeway had a number of buildings that have been declared
surplus to requirement and are disclosed as ‘assets held for sale’ within the
Trust’s Statement of Financial Position.
Wadham Court Contracts due to
exchange in May 2013
Sellbrook Villa Contracts due to
exchange in June 2013
Northview bungalow Being Marketed
in June 2013
Lanterns Being Marketed in June
2013”
It will perhaps not surprise you that “The Trust worked
closely with Southern Health on the development of a Ridgeway Estate strategy
to support the operational requirements of the organisation.”
Finally, at the time of Ridgeway’s absorption by Southern
Health, the value of the Trust’s property, plant and equipment amounted to
£16.8 million. Southern Health’s annual report for 2012/13 (see here for
details http://chrishatton.blogspot.co.uk/2014/03/a-public-accounting.html
) reports that fully £8.8 million of this amount was in the form of a
‘revaluation reserve’.
For some reason Mrs Merton’s question to Debbie McGee seems
appropriate here: ”So, what first attracted you to the millionaire Paul
Daniels?”
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