The Royal Marsden Foundation Trust showed “significant weakness in governance arrangements” when it donated £9m to its charity, auditors have said.
The cancer specialist trust shifted the funds out of the NHS this year without the permission of NHS England or the Treasury, said Deloitte.
Papers presented to the FT’s governors’ meeting this month said: “The trust entered into an agreement with the Royal Marsden CC [charity] on March 2023, under which the trust committed to pay £9m to the charity as a gift to support the charity’s ‘modern patient environments’ and ‘state-of-the-art equipment’ themes.”
The annual report from Deloitte said: “Although the trust took legal advice as to its ability to enter into the transaction, it did not consult with NHS England or seek approval from HM Treasury.
“There are characteristics of the transaction that indicate it may require approval (and may possibly not receive approval), including that it could be determined to be a gift, a novel transaction or designed to enable compliance with spending controls.”
It is unclear why the transfer was made in March, but it would be likely to mean the funds can be used by the Marsden in future, rather than offsetting deficits elsewhere in the South West London Integrated Care System at the end of 2022-23.
Number crunchers… and safety champions?
Financial directors should be as responsible for patient safety as the person in charge of that agenda within each trust, leaders of the Health Services Safety Investigations Body said at its launch on Wednesday.
The Healthcare Safety Investigation Branch is now an independent body – and has been renamed HSSIB – although maternity investigations are hosted by the Care Quality Commission.
Interim chief investigator Rosie Benneyworth said: “Often you see the finance director and safety lead don’t work effectively together and we need to change that.”
Dr Benneyworth said progress will not be made unless operational delivery, financial delivery and safety are tackled “in the same breath”.
HSSIB’s new chair Ted Baker also called for safety to become a core part of running services “in the way running the accounts is”, as it is currently still seen “as an add-on”.
“The problems facing services at the moment are many and they are complex and we do not have any simple solutions to them, but any solutions that will succeed, I am sure, must have safety at their core.”
In response to questions about the impact of HSSIB’s work, Dr Benneyworth and Professor Baker stressed the new body would be looking more at how they follow up the work they have done and better understand where it is making a difference.