Finney House set to close with 28 residents having to find new homes

A groundbreaking facility that helps free-up beds in the Royal Preston Hospital – and also doubles up as a care home – is to close.

Finney House will shut in phases over the coming months amid a £5m funding shortfall for the service.

It comes little more than two years after the hotel-style accommodation, on Flintoff Way, opened in its current form.

The shock move will result in the loss of 64 beds that hospital bosses have been using to reduce the number of patients stuck on the wards of the Royal Preston who are medically fit to leave, but have nowhere else to go.

It also means the 28 residents who call Finney House their permanent home will have to find somewhere new to live before the shutdown is complete in early June.

As many as 160 staff will be affected, but the NHS says “every effort” will be made to redeploy them elsewhere in order to avoid job losses.

It is understood the closure has been ordered purely for financial reasons, with the facility having been widely regarded as a success.

Eighty percent of patients who passed through Finney House were able to return to their own homes afterwards – a higher rate than average for people who have spent time in similar, so-called ‘intermediate care’ facilities.

However, both Lancashire Teaching Hospitals NHS Foundation Trust (LTH), which runs the service, and the Lancashire and South Cumbria Integrated Care Board (ICB), which plans and commissions healthcare in the region, were last month placed on an intensive financial recovery programme by NHS England.

LTH had a £58m savings target for the 2024/25 financial year – much of which had to be delivered in the latter part of that timeframe – while the ICB was trying to save £530m over the same period.

Finney House was relaunched in November 2022 as the NHS headed into what was then considered the most pressured winter period in its history.

Heralded as an innovative way of better integrating health and social care – a holy grail that has long been pursued in an attempt to ensure people get the support they need in the most appropriate environment – it saw LTH take over the lease of what was then a fully-fledged care home.

In spite of its plush facilities – which included finely-decorated ensuite bedrooms and even a cinema room and library – two thirds of Finney House was unoccupied after a series of below-par ratings from the Care Quality Commission.

When LTH took over, it gave existing fee-paying residents the chance to stay on, living in rooms on the top floor of the three-storey building – which many of them did.

Meanwhile, the remainder of the space was repurposed to house patients who had become trapped in the hospital system while they waited either for social care support back in their own homes after a spell on the wards – or for a space in a care home.

The idea was to improve the flow of patients through the Royal Preston by preventing delays in the discharge process having a knock-on effect in accident and emergency – and even on the ambulance service – when people could not be transferred into wards because of a lack of space. The trust says that, at the time, it was dealing with hundreds of people who no longer needed a hospital bed – although a recent board meeting heard that it still had “two wards’ worth” of such patients on any given day.

The Finney House opening also came against the backdrop of a push to clear backlogs of pre-planned operations and procedures that had built up during the earlier part of the pandemic.

While the principle of intermediate care is well-established in the NHS, the Finney House arrangement was presented as an innovative model for the future – both because of the way in which it was set up, with the hospital trust’s direct involvement, and also the degree to which a wraparound team of health and social care services worked together to prepare patients for a successful discharge.

Within the first five months of its operation, 550 patients had been supported at Finney House and the average length of stay during that period was just four days – enough to make a difference to capacity at the Royal Preston, but without clogging up the new unit.

The facility was also later used for ‘admission avoidance’ – a place to which people could be referred for care designed to prevent them ultimately ending up in hospital – thereby making it both a ‘step up’ and ‘step down’ service.

What happens next?

Current Finney House patients will not be affected, because beds will close gradually to new admissions from hospital and the community, meaning numbers will reduce in a planned way.

However, the 28 permanent residents of the facility – which opened as a care home in 2016 – will have to leave by the time of the full closure in less than three months. The trust says it will be working closely with Lancashire County Council and the ICB to support them to find homes elsewhere.

A letter to residents from LTH chief nursing officer Sarah Cullen – dated 12th March and seen by the LDRS – tells them that the decision “was not made lightly” and that their “comfort and safety remain our top priorities”.

The residential floor – known as ‘Orchard’ will be the final one to close – in early June – in order to allow the maximum time for alternative arrangements to be made for residents.

The middle floor, ‘Meadow’, is expected to close at the end of April 2025, followed by the ground floor,’ Buttercup’, a month later.

‘Difficult decisions’

When Finney House was acquired by LTH, the trust said community care beds like those that would be available there cost around half as much to run as acute beds in hospitals.

Last year, the LDRS revealed the facility had made a significant, although undisclosed, contribution to the trust’s savings programme – and that was before factoring in the benefits to the wider health and social care system of reduced discharge delays and more appropriate care placements.

However, it has now emerged that Finney House was nevertheless costing LTH £5m more a year to operate than it was receiving in direct income.

The LDRS understands that the decision to pull the plug came down to the fact that intermediate care is not a core responsibility of hospital trusts like LTH.

Against the backdrop of both the trust and the integrated care board being subject to national-level intervention in order to get them back on a firm financial footing, it appears the budgetary gap for Finney House could not be bridged.

The trust says that while there is “a series of discussions, health and social care partners have not been able to come up with a financially viable way of keeping it open”.

As part of the financial recovery process into which LTH, the ICB – and also the Blackpool and East Lancashire hospital trusts – have been placed, financial plans had to be submitted to NHS England by 19th February.

However, the LDRS understands they were high level documents that do not go into the details of individual service closures, such as that now facing Finney House.

Silas Nicholls, chief executive officer for Lancashire Teaching Hospitals, said of the pending demise of the service: “Back in 2022, taking over Finney House enabled us to resolve a number of issues that the health and care system was experiencing following the pandemic, so it was very much the right thing to do for patients and residents at that time.

“However, things have moved on, and as there are alternative residential and intermediate care places within the system, funding Finney House is not something our commissioners can prioritise, so sadly it will close in the summer.

“We are proud of the high-quality care that staff have provided at Finney House and would like to thank them for all that they have done for the many patients who have been cared for by them. We will be working with staff and our trade union colleagues to do all we can to find them suitable roles elsewhere.

“In addition, all partners are committed to ensuring that residents are supported to find alternative homes and we will aim to continue to provide them with a high-quality service whilst that process takes place.”

Meanwhile, Craig Harris, chief operating officer for the NHS Lancashire and South Cumbria Integrated Care Board, said: “The local NHS is needing to make difficult decisions in the short term to ensure that we get our collective finances back on track and create truly sustainable services built around the needs of our communities in the longer term.”

“Whilst we understand that there is always concern and disappointment when any facility closes, we support the trust in their decision and the work they are doing to make their services affordable.

“We have carefully considered the impact of this as an ICB working across clinical and commissioning teams. We will continue to work with the trust by working with Lancashire County Council to ensure that residents find new homes with as little inconvenience as possible and focus as a system on how we commission community services which support our communities.”

‘A decade of pressure’ explodes

The budget for Lancashire Teaching Hospitals (LTH) in the coming financial year will be so strict that if a decision is made to spend in one area, it will mean “money has to be moved” from somewhere else.

That was the warning from the organisation’s chair at its latest board meeting, as members were updated on the financial challenges facing the trust.

The gathering, last month, came just days after LTH was told it had been placed in a category known as NHS Oversight Framework Segment 4. It means the trust will receive “intensive support” from the National Recovery Support Programme and, having identified the underlying reasons for its “performance challenges”, agree how to resolve them.

LTH chair Professor Mike Smith said there could not be any “additional spending” in the year ahead, because “that’s just additional debt”.

Figures presented to the meeting revealed the scale of the budgetary pressure LTH is under. Its permitted deficit for 2024/25, agreed with NHS England, was £21.9m – for which it received funding halfway through the year. It was then aiming to break even by the end of this month.

However, LTH is now forecasting a deficit of £42.5m for the financial year, partly due to falling short of its £58m savings target. At the February meeting, it was reported that £21.7m had been delivered – £14m of which was recurrent, the remainder a one-off.

Chief executive Silas Nicholls said the situation had not “happened overnight”, but was” the culmination of…about ten years of building financial pressure within the organisation”.

He added: “As we went through [the] Covid period, when finance became less of an issue [amid] the national emergency we were facing, I think that gave the organisation [a period] of respite. Now, that Covid money has been withdrawn from not just us, but the whole of the NHS.

Mr. Nicholls said the trust was having to wrestle with “the need to live within our means…, but also dealing with ever increasing demand…driven by wider changes in society”.

“What we don’t want is to hit one financial target and then completely lose the whole point of why we’re here as a hospital,” he acknowledged.

David Stonehouse, interim chief finance officer, stressed that the budgetary situation was not as a result of “spending [being] out of control]”, but rather the challenge of “delivering a significant amount of savings”. The £58m target for 2024/25 represented seven percent of LTH’s operational expenditure for the year.

Meanwhile, looking to the longer term, Prof Smith said the aim was “to get back to doing what we do best”, with the Royal Preston delivering “exceptional” tertiary services – the most specialised care – and Chorley and South Ribble Hospital functioning as a district general.

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