The NHS trust that runs Watford General Hospital expects to end the financial year with a deficit of £18.2m, county councillors have been told.

Inflation, emergency pressures and industrial action are said to be among the factors that have impacted on the finances of the West Herts Teaching Hospitals Trust, which also runs St Albans City and Hemel Hempstead hospitals.

On Friday (1 March) the trust’s chief strategy and collaboration officer Toby Hyde outlined the financial position to the council’s impact of scrutiny advisory committee.

Mr Hyde said the NHS as a whole had experienced "significant financial challenges", which also included increasing costs for staff, medicines and other supplies.

He pointed to the number of staff at the trust - which increased by around 15 per cent in the wake of the pandemic - that had initially been government-funded, but that money is no longer available.

The trust is now looking at how to “right-size” the workforce, he added.

Other factors included costs associated with mental health patient management, higher expenditure of theatre support staff, and increased out-sourcing of care.

Mr Hyde had been invited to talk to the committee about the trust’s plans for £16m of efficiencies during the 2023/24 financial year – highlighted at an earlier scrutiny of the patient experience.

Mr Hyde reported to the committee that by the end of March the Trust expected to have made £12m of the planned efficiencies – 75 per cent of the initial £16m target.

The chief strategist later catalogued a range of measures being implemented or expanded at the trust that were impacting on costs.

He pointed to the success of the expanded virtual hospital, which he said was providing better care for patients at a reduced overall cost.

The greater use of telephone and video appointments and patient-initiated follow-ups was also highlighted – reducing the need for patients to travel to hospital and increasing outpatient productivity.

Community providers were now treating up to 10 ‘999’ patients a day in their homes – rather than them being brought to A&E.

Video assessments are now provided to paramedics where a stroke is suspected – reducing the number of patients brought to hospital and the financial impact across the health system.

Meanwhile trust chief nurse Kelly McGovern told councillors the trust had saved a significant amount in recent months by moving staff around the hospital to reduce agency costs.

Councillors had asked for detail about the plans for efficiencies  to see how they could be achieved “without negatively impacting on the patient experience”.

Chief nurse Kelly McGovern pointed to the "clinical voice" in the trust  – stressing the importance of care, safety and quality, and systems in place to monitor performance data and patient feedback.

Meanwhile Mr Hyde said that 2023/24 would be the first year in four that he trust had not broken even.

Liberal Democrat Cllr Sandy Walkington raised reports that the trust would require £60m for basic maintenance of buildings.

Acknowledging the estate “especially at Watford General”, Mr Hyde said it spent “a huge amount of money every year” on maintaining the estate.

He said the imperative was keeping it safe for staff and patients, which “carries a significant financial burden for the organisation”.

And referencing the redevelopment plans, he added: “We have major ambitions around redevelopment of our site.

“It’s great that there is some really good progress on the work at St Albans. That’s all very live at the moment – with a huge amount of construction work.

“We are  really pleased to have positive progress on our redevelopment plans for Watford – and hoping that we can get into clearing the site ahead of construction starting in 2026.

“So all of that I think creates hope of a really great future for the organisation.”