King's College Hospital NHS Foundation Trust
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King's College Hospital NHS Foundation Trust is an
NHS trust An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...
in
London London is the Capital city, capital and List of urban areas in the United Kingdom, largest city of both England and the United Kingdom, with a population of in . London metropolitan area, Its wider metropolitan area is the largest in Wester ...
,
England England is a Countries of the United Kingdom, country that is part of the United Kingdom. It is located on the island of Great Britain, of which it covers about 62%, and List of islands of England, more than 100 smaller adjacent islands. It ...
. It is closely involved with
Guy's and St Thomas' NHS Foundation Trust Guy's and St Thomas' NHS Foundation Trust is an NHS foundation trust of the English National Health Service, one of the prestigious Shelford Group. It runs Guy's Hospital in London Bridge, St Thomas' Hospital in Waterloo, Evelina London Child ...
, with which it shares its chair, Sir Hugh Taylor, its strategy director and IT director. It is assumed that the two organisations will eventually merge.


History

The newly formed King's Healthcare Trust took over management of the King's College Hospital in 1993. After being awarded foundation trust status, it became the King's College Hospital NHS Foundation Trust in 2006.


Performance

In March 2015 it had a very large backlog of patients waiting more than 18 weeks for treatment.
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launched an investigation into the trust because of 'long standing problems' at
Princess Royal University Hospital Princess Royal University Hospital or PRUH is a large acute district general hospital situated in Locksbottom, near Farnborough, in the London Borough of Bromley. It is managed by King's College Hospital NHS Foundation Trust. History The hosp ...
in March 2015. Financial problems are attributed to urgent improvements to the quality of care there, including increasing the nurse-to-patient ratio by recruiting 260 new nurses. In March 2018 it was the eleventh worst performer in A&E in England, with only 61.8% of patients in the main A&E seen within 4 hours. In February 2019 it had 331 patients waiting more than 52 weeks for treatment, mostly in orthopaedics and
bariatric surgery Bariatric surgery (also known as metabolic surgery or weight loss surgery) is a surgical procedure used to manage obesity and obesity-related conditions. Long term weight loss with bariatric surgery may be achieved through alteration of gut ho ...
, twice as many as any other trust in England. It plans to outsource some of the bariatric work to Princess Grace Hospital, run by HCA Healthcare and some to Chelsea and Westminster Hospital NHS Foundation Trust.


Finance

The trust expected to finish 2015–16 with a deficit of more than £65 million partly as a result of changes to the NHS tariff. It was said to be the least efficient hospital in England according to Lord Carter's review of NHS efficiency, with potential savings of £154 million a year. In December 2017 it was placed in financial
special measures Special measures is a status applied by regulators of public services in Britain to providers who fall short of acceptable standards. In education (England and Wales) Ofsted, the schools inspection agency for England and some British Overseas Ter ...
and Lord
Bob Kerslake Robert Walter Kerslake, Baron Kerslake, (28 February 1955 – 1 July 2023) was a British senior civil servant. He was the head of the Home Civil Service from 2011 to 2014, succeeding Sir Gus O'Donnell. Early life Kerslake was born on 28 Feb ...
, Chair of the trust, resigned. The organisation's
chief operating officer A chief operating officer (COO), also called chief operations officer, is an executive in charge of the daily operations of an organization (i.e. personnel, resources, and logistics). COOs are usually second-in-command immediately after the C ...
and finance director had resigned in November. The Chief Executive resigned in March 2018 at a point when the annual forecast deficit is expected to worsen to more than £100 million. The trust is carrying underlying debts of more than £600 million. It forecast a deficit of £156 million for 2018-19 - the largest of any NHS trust. The chief executive, chair, finance director and chief operating officer all resigned in 2017–8. By March 2019 the projected deficit was around £191 million.


Commercial ventures

The trust used its commercial arm, KCH Management, to open a clinic in
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in November 2014. KCH along with its investment management company Ashmore Group opened a 100-bed inpatient and hospital in Dubai in 2019. It has an agreement with Indo UK Healthcare Private to create an institute of health in New Chandigarh where a 500-bed hospital, trauma centre and day surgery centre will also be built. The trust will be paid by a fixed fee, profit share arrangements, equity stakes and consultancy work and hopes to generate £40m over 15 years. The trust is a partner in
Viapath Synnovis, formerly GSTS Pathology and Viapath, is a London-based provider of pathology services. It is a partnership between Guy's and St Thomas' NHS Foundation Trust, King's College Hospital NHS Foundation Trust, and SYNLAB UK & Ireland. Servi ...
a London-based provider of pathology services jointly owned with
Serco Serco Group plc is a British multinational corporation, multinational military, defence, Healthcare, health, Space industry, space, private prison, justice, Human migration, migration, customer service, customer services, and transport company ...
, and
Guy's and St Thomas' NHS Foundation Trust Guy's and St Thomas' NHS Foundation Trust is an NHS foundation trust of the English National Health Service, one of the prestigious Shelford Group. It runs Guy's Hospital in London Bridge, St Thomas' Hospital in Waterloo, Evelina London Child ...
. In 2011 it was reported that the trust was paid around £1m for the sale of NHS donor livers to overseas private patients. Controversy arose around this practice after a 2009 review by the Organ Donations Taskforce, commissioned by the UK government's Department of Health had already recommended a ban on the practice and stated that 'Financial gain from the transplant of donated organs feels morally wrong'. In 2016 the trust established a subsidiary company, King's Interventional Facilities Management LLP, jointly owned by the trust and its subsidiary Kings Commercial Services Ltd, to which 99 estates and facilities staff were transferred. The intention was to achieve VAT benefits, as well as pay bill savings, by recruiting new staff on less expensive non-NHS contracts. VAT benefits arise because NHS trusts can only claim VAT back on a small subset of goods and services they buy. The
Value Added Tax Act 1994 The Value Added Tax Act 1994 (c. 23) is a UK tax law, concerning taxation of goods and services that fall within the scope of Value Added Tax (VAT). It came into force on 1 September 1994. The Value Added Tax Act 1983 was repealed and replaced by ...
provides a mechanism through which NHS trusts can qualify for refunds on contracted out services. The trust expanded its private patient unit from 21 to 46 beds in 2017. About 45% of the revenue comes from overseas, mainly from liver transplants. It sold its assisted conception unit to the Fetal Medicine Foundation and a company called King's Fertility for a total of £26 million in June 2017. Kypros Nicolaides, a foetal medicine consultant at the trust, is a director of both organisations. In 2018-19 the trust wrote off overseas patient debts of £4.3 million and British private patient debts of £800,000. Its total private patient income was £20.6 million.


Tertiary care specialities

It is one of the biggest provider of specialised services in England, which generated an income of £308.8 million in 2014–5. King's
Liver The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...
Unit is the most comprehensive service of its kind in the world, with a strong interest in paediatric liver cancers. King's also operates the largest
liver transplant Liver transplantation or hepatic transplantation is the replacement of a Liver disease, diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for Cirrhosis, end-stage liver disease and ...
ion programme in Europe. There is a great deal of expertise within King's Department of
Neurology Neurology (from , "string, nerve" and the suffix wikt:-logia, -logia, "study of") is the branch of specialty (medicine) , medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous syst ...
/Neurosciences. There is a large outpatient movement disorder clinic, specialising in multidisciplinary team management of
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a neurodegenerative disease primarily of the central nervous system, affecting both motor system, motor and non-motor systems. Symptoms typically develop gradually and non-motor issues become ...
,
dystonia Dystonia is a neurology, neurological Hyperkinesia, hyperkinetic Movement disorders, movement disorder in which sustained or repetitive muscle contractions occur involuntarily, resulting in twisting and repetitive movements or abnormal fixed po ...
,
progressive supranuclear palsy Progressive supranuclear palsy (PSP) is a late-onset neurodegenerative disease involving the gradual deterioration and death of specific volumes of the brain, linked to 4-repeat tau pathology. The condition leads to symptoms including Balance di ...
, and related diseases. It is one of only five centres in the
European Union The European Union (EU) is a supranational union, supranational political union, political and economic union of Member state of the European Union, member states that are Geography of the European Union, located primarily in Europe. The u ...
designated a "Centre of Excellence" by the National Parkinson Foundation. In 1995 the hospital established the UK's first specialist
Motor Neurone Disease Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND) or—in the United States—Lou Gehrig's disease (LGD), is a rare, terminal neurodegenerative disorder that results in the progressive loss of both upper and low ...
Care & Research Centre, a model of care which has since been reproduced at other centres throughout the United Kingdom. The hospital is also home to the only dedicated diverticular disease clinic.


References


External links


King's College Hospital NHS Foundation Trust
{{Authority control NHS foundation trusts Health in London Shelford Group