Work to improve facilities and tackle low staff numbers has left Medway NHS Foundation Trust with a £64.1 million deficit.

Hospital bosses overspent by £30 million in the past financial year as they tried to bring Medway Maritime Hospital up to scratch.

The figures were released last week in the trust’s annual report and accounts for 2015/16.

In the report, chairman Shena Winning described the Care Quality Commission’s August inspection and subsequent report in January, which saw the trust still rated as inadequate, as “watershed moments”.

She said: “There were already a range of improvement plans in place, however it was clear that we needed to accelerate our drive to improve the quality and safety of patient care within the emergency department and throughout the hospital.

“Since then, we have made a concerted effort to enhance patients’ experience in our emergency department, reduce waiting times, improve cleanliness, and get patients home quicker.

“The accelerated drive is starting to lead to improved performance, but there remains a long way to go.”

A short inspection in March said the hospital was safer and making progress, but will remain in special measures. Another inspection will take place in six months.

In the last financial year, the trust invested £11 million in refurbishment, replacing medical equipment, IT and improving the fabric of the estate. Around £3.5 million of that went on refurbishing the overstretched emergency department.

A spokesman for the trust said: “Like many other trusts, we experienced a difficult financial position in 2015/16, with an increase on our original deficit. The deficit increased mainly because we introduced a number of initiatives to improve patient safety at a time when we faced a lot of pressure in the hospital.

“Our emergency department handles twice as many people as it was originally built for, while we also experienced elderly people remaining in wards because they had nowhere to go to, even though they are medically fit and ready to be discharged.

“We have to be realistic and recognise that reducing the deficit will take some time and cannot be done in a few weeks or a couple of months.

“However, there are a number of steps we are taking to improve our financial position, such as prioritising the recruitment of permanent staff to reduce dependency on agency workers, and improving our procurement and contract management.”

Having to hire agency staff to fill vacant positions across the hospital meant the trust spent an extra £18.1 million on pay.

Other costs were also higher than usual, with an extra £1.2 million spent on drugs, £2.9 million on clinical supplies, £1.5 million on consultants’ fees, and £5 million on undelivered improvement programmes.

The report also revealed the amount spent on commissioning a range of services from Bolt Partners, including Timothy Bolot, who served as interim director of finance between June 2014 and December 2015. The total cost of the support services from Bolt Partners was £749,350, almost £75,000 more than the £674,575 spent the previous year.

What happened in 2015/2016:

- The hospital saw almost half a million patients; with more than 105,000 emergency department attendances, more than 62,000 admissions, more than 315,000 outpatients attendances and more than 5,100 babies born.

- 84.79% of patients were diagnosed, treated and discharged from A&E within four hours of arrival – short of the national target of 95%.

- A dedicated cancer patient tracker list has been introduced to ensure people are not waiting more than two weeks for referrals – in the last quarter 95% were seen within two weeks, compared with 72% in the first.

- The refurbishment of A&E continued with a separate minor injuries area opened in November and a new waiting area for the majors unit opened in February.

- A triage process was introduced in February, with all patients seeing a senior clinician within 15 minutes of arrival in A&E.

- Frail elderly patients are now seen by a specialist geriatric team upon arrival. The service was launched in April 2015 and extended to seven days a week in March 2016.

- To fill staff shortages, 15 nurses arrived from Spain, Italy and Greece, with on-site accommodation refurbished to house them.

- The women and children’s directorate was rated as good by the CQC; a maternity enhanced care unit opened in August; research has been developed to screen babies for Down’s syndrome safely; and work started on a bereavement suite.

- A “medical model” was introduced to improve patient care and reduce their length of stay, with a single, named consultant taking responsibility for each patient who is given an expected date of discharge on admission.

- The Parliamentary and Health Service Ombudsman investigated and closed 19 cases, one was upheld, eight were partly upheld and 10 were not upheld. The trust paid compensation to six complainants with amounts ranging from £200 to £1,500.