Government\'s unveils vision to turn failing NHS trusts around

Health Secretary, Jeremy Hunt, today set out the Government’s plans to help prevent future failures of care and safety at NHS hospitals.

In the wake of the scandal over standards at Mid Staffordshire NHS Foundation Trust and the subsequent Keogh Review, which looked at 14 NHS trusts with high mortality rates, 11 of those trusts have already been placed in ‘special measures’.

Now, the Health Secretary has set out a new approach to ensure progress at those NHS trusts, which could be applied to any NHS trust that is placed in special measures under a new, tougher inspection regime.

In future, NHS hospitals with the highest standards of patient care and safety will help those with problems. Each of the 11 trusts will be partnered with one of the best in the country in innovative improvement contracts.

The high-performing hospitals will enter into contracts with the NHS Trust Development Authority or Monitor to support the special measures trusts. They will be reimbursed for their time, and will have access to a special incentive fund, through which, where appropriate, they could be paid extra, if their help produces real results.

For too long, patients have had to put up with poor care because it was inconvenient to expose and tackle failure. I am committing to total transparency on progress in these hospitals, and to leave no stone unturned in our mission to turn them round

NHS foundation trusts placed in special measures will have their freedom to operate as an autonomous body suspended. Exactly what form this takes in each hospital will be up to Monitor, but this could mean losing the freedom to appoint their own executive teams or to set their own operating plans.

NHS trusts which aspire to become foundation trusts will in future no longer be able to do so unless and until they have achieved a ‘good’ or an ‘outstanding’ rating under the new Care Quality Commission inspection regime.

The capability of leaders of all 11 trusts is under ongoing review. Changes to the management of failing trusts will be made if necessary to ensure that the leadership is best placed to drive the required improvements to the quality of services throughout the special measures period and beyond. Improvements will not be held back by leaving weak leaderships in place.

Each of the 11 trusts will also have an improvement director, appointed and accountable to either Monitor or the NHS Trust Development Authority, depending on whether they are a foundation trust or not. These directors will work with each of the and their high-performing partners to monitor improvement against the action plan.

From now each of the 11 trusts will also publish their improvement plans via NHS Choices, and will update them on a monthly basis so that the public can see what progress is being made. The Health Secretary will then give updates to the media as part of the Government’s commitment to a new era of transparency over care failures.

More senior clinicians, as well as fresh talent from outside the NHS, will be recruited to manage NHS hospitals under a new fast-track leadership programme to include time at a leading business school. Graduates of the programme are expected to go on to make rapid entry and promotion to be NHS senior managers and chief executives.

With the help of inspiring NHS leaders and their teams from our leading hospitals, I am confident that we can get these hospitals out of special measures and on the road to recovery

Hunt said: “Turning special measures hospitals round is my top priority. For too long, patients have had to put up with poor care because it was inconvenient to expose and tackle failure. So today I am committing to total transparency on progress in these hospitals, and to leave no stone unturned in our mission to turn them round.

“In place of the old approach of paying management consultants to analyse the problems, we are giving contracts to the best in the NHS to implement solutions they have tried and tested. With the help of inspiring NHS leaders and their teams from our leading hospitals, I am confident that we can get these hospitals out of special measures and on the road to recovery.”

The 11 NHS trusts and their partners are:

• North Cumbria University Hospitals NHS Trust and Northumbria Healthcare NHS Foundation Trust
• United Lincolnshire Hospitals NHS Trust and Sheffield Teaching Hospitals NHS Foundation Trust
• East Lancashire Hospitals NHS Trust and Newcastle-upon-Tyne Hospitals NHS Foundation Trust
• George Eliot Hospital NHS Trust and University Hospitals Birmingham NHS Foundation Trust
• Buckinghamshire Healthcare NHS Trust and Salford Royal NHS Foundation Trust
• Tameside Hospitals NHS Foundation Trust and University Hospital of South Manchester NHS Foundation Trust
• Basildon and Thurrock University Hospitals NHS Foundation Trust and Royal Free London NHS Foundation Trust
• Burton Hospitals NHS Foundation Trust and University Hospitals Birmingham NHS Foundation Trust
• Medway NHS Foundation Trust (partner to be confirmed)
• Northern Lincolnshire and Goole Hospitals NHS Foundation Trust (partner to be confirmed)
• Sherwood Forest Hospitals NHS Foundation Trust (specifically on complaints) and Barnsley Hospital NHS Foundation Trust

Initiatives that the hospitals are already making to improve quality of care include:

• Basildon and Thurrock University Hospitals NHS Foundation Trust has appointed an extra 200 nurses and is building a new respiratory ward opening on December 1
• East Lancashire Hospitals NHS Trust offers all patients or carers who raise a complaint a face-to-face meeting with the doctors and nurses responsible for their care to talk through their concerns
• United Lincolnshire Hospitals NHS Trust is investing well over £4m in extra nursing staff
• Tameside Foundation Trust has invested in increasing senior clinical cover in their A&E department and acute medical unit
• George Eliot Hospitals NHS Trust has created a new senior post charged with looking at trust-wide issues of patient care and safety and mortality