THE Western Trust will have to reduce its expenditure by £2.7 million each month from now until the end of March 2015 to reach its projected year end deficit of £6.9 million.

Throughout the course of this year the Western Trust has continuously projected a year end deficit of £29.8 million -- the largest in its six year history.

But thanks to £14.8 million worth of funding provided through Stormont’s monitoring rounds in June and October, the deficit was halved.

A contingency plan too, ordered by the Health and Social Care Board (HSCB), further reduced the projected year end deficit.

And at the end of October the Trust was reporting a deficit of £11.051 million.

But the question of whether the Trust can achieve the newly reduced year end deficit of £6.9 million is still very much up in the air following the latest Trust Board meeting.

And in her report to Board Members, Lesley Mitchell, Director of Finance for the Western Trust revealed that even now the Trust and the HSCB are debating over exactly how much money is expected to be saved through the planned contingency measures.

Her report included a table which outlines a difference of £700,000 between the Trust’s projected deficit and what the HSCB expects the Trust’s projected deficit should be.

“A letter dated November 25 2014 has been received from the HSCB on the differences between the Trust and the HSCB in respect of the year end deficit and further information is to be supplied and discussed over coming weeks,” said Ms. Mitchell in her report.

She made it clear, too, that reaching the reduced year end deficit was not absolute.

“The projected deficit does not include any assumptions for financial pressures which may arise over the winter months,” she warned.

Ms. Mitchell added that achievement of this position is dependent on the delivery in full of: a £18 million contingency plan; £6 million reduction programme on workforce issues; £3.8 million Transforming Your Care cash release savings; and the £8.3 million contingency plan agreed with the HSCB.

“To achieve the planned deficit of £6.9 million in year this will require the expenditure of the Trust to reduce monthly by at least £2.7 million each month until the end of the financial year,” said Ms. Mitchell.

“Therefore, it is imperative that Directorates close their financial savings plan gaps and take urgent action to reduce expenditure and put focus and pace on the range of additional contingency measures which have now been agreed both internally and with the HSCB.” She added that the plan did not include £272,000 worth of pressure for Shared Services.

The Trust is in discussion with the Business Services Organisation (BSO) in relation to the Shared Services recharge and is disputing any charge in excess of the Trust’s funding. As a result, the additional pressure of £272,000 has not been included in the latest financial report.

And in terms of the £18 million Contingent Measures, the Financial Director said a gap remained of £0.9 million.

“Directorates are finding it extremely difficult to find in-year measures, as there are limited opportunities available, for example, low level of vacancies, limited income solutions.” At the end of October acute services was reporting an overspend of over £6.3 million for the first seven months of the financial year.

The overspend here reduced by £0.4 million from the month prior mainly due to the application of non-recurring funding from the HSCB.

The pay overspend in acute services continues to be caused by, among other things, medical pressures of £2.4 million due to agency cover to sustain the Emergency Department medical rotas in Altnagelvin and South West Acute Hospital (SWAH).

Within nursing there is an overspend of £2.9 million which is due to service demand in SWAH, resulting in additional unfunded beds being open on an ongoing basis in general medicine and general surgery and escalation beds have been required in unscheduled care.

There are also pressures associated with managing risk and governance issues in the Emergency Department and covering sickness and maternity leave across services.

In Women and Children’s Services there was an overspend of over £4.5 million by the end of October.

Part of this is to do with an unfunded middle tier of medical staff in Obstetrics and Gynaecology at SWAH which are all required to ensure a safe medical rota.

And the growth in the demand for the Looked after Children Service has contributed to the financial pressure within social services salaries, where there are high levels of band, as well as agency and unfunded staff.