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Cambridge University Hospitals called into regulator's office

PERFORMANCE: Monitor has called Cambridge University Hospitals to its offices to discuss whether the foundation trust is in significant breach of the terms of its authorisation.

The trust has been failing to meet a number of national standards, including those for referral-to-treatment and accident and emergency waiting times.

However, a report to its council of governors suggests the immediate cause of the regulator’s concern is Cambridge’s failure to treat a sufficient proportion of cancer patients within 62 days of urgent referral - a target it has missed for three consecutive quarters, triggering a red rating for governance.

In the first quarter of 2012-13 Cambridge treated 78 per cent of these patients within the time limit, against a national target of 85 per cent.

Commissioners NHS Cambridgeshire have issued the trust with a contractual notice over this performance, and the trust has been fined £104,000 for missing the 62-day cancer target in quarter one.

Monitor notified the trust in late August that its board was to attend an escalation meeting this month, to “discuss governance concerns and determine whether or not the trust is in significant breach of its authorisation”, the report states. Any formal decision to put it in breach would be taken by the Monitor board.

A CUH spokesman said it was seeing “significant increased demand” for cancer services, “especially in urology where we have experienced a 20 per cent increase from the previous year”. He added: “We have taken a number of actions – including employing surgeons and increasing theatre capacity – to ensure we get back on track, and we are confident we can meet the targets by January.”

The council of governors report adds that the trust has missed the 18 week referral-to treatment target for admitted patients in three consecutive quarters, and in every month from April to July. Missing this target in three successive quarters can also trigger an automatic red rating. Cambridge does not anticipate being able to hit the target until the final quarter of 2012-13.

For the first four months of 2012-13 the foundation trust also missed the national target for the proportion of A&E patients seen within four hours, although it exceeded the target in August.

Monitor’s move comes at a time when the trust is going through significant changes in its senior leadership. Former chief executive Gareth Goodier left in June and chief nurse Karen Castille is acting as interim chief executive. The trust has not yet announced a permanent replacement, although last month it advertised for three non-executive directors.

Long-standing chair Dame Mary Archer stands down in October and will be replaced by Jane Ramsay.

Readers' comments (7)

  • I am aware of a patient who has been on a waiting list at this Trust since July 2011. In late February early March they offered him two dates that he could not make as he was on holiday. These were offered with less than two weeks notice therefore not 'reasonable', (although he was unaware of the rules at the time so did not challenge this). They took him off the list and the 18 weeks started all over again when he rang on return from his holiday.

    He has now waited over 18 weeks from that date, and despite asking PALs for help, not to jump the queue, but to get some indication of a likely month, so that he can plan his life and book another holiday, he was just told how difficult things were for the Trust.

    Excellence in clinical outcomes which CUH certainly delivers does not divest the Trust of its responsibility to put the patients at the centre and at the very least communicate with, listen to and value their feedback.

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  • tertiary centres often get caught when patients are referred halfway through the clock from a DGH. One issue (and there are many!) with the target and penalty culture is how to apportion 'blame' (I use the word advisedly) for such referrals

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  • Can we be confident that CUH have produced a comprehensive report with credible metrics that shows that their statement can be validated as opposed to a general response and a cherry picked instanced of increased demand. Is the fine reasonable? Would CUH be able to appeal or even seek litigious remedies. Where is all this quasi commercialism leading?

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  • Will the fine really help the situation on top of the 70% fine (discount) for emergency admitted patients over 08/09 level, which is just bonkers.

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  • To the first comment above: the answer is to cancel the holiday. This may sound harsh, but you cannot complain about waiting times if you choose a holiday over your health. Hospitals are the constant butt of criticism and patients are the last to take their share of the responsibility.

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  • Anonymous | 17-Sep-2012 7:41 am

    Sorry - no excuse. If you read what was said in the post, the patient had already waited beyond the 18 weeks they could have reasonably expected and was then offered two appointments which broke the rules of reasonable offers. This sounds like a Trust which has not got to grips with delivering 18 weeks and is gaming the system to get themselves out of a whole. It implies that the patient was not aware that not accepting the offer would put them to the back of the queue nor does it appear that the patient is asking for anything other than to know when they will be treated two years after their referral.

    The idea that anyone can find an excuse for this kind of behavior makes my heart sink

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  • Ironic that the person now running the trust that cannot meet the A&E target was responsible for the Emergency services collaborative (indeed was awarded her OBE for it).

    Good luck Karen!

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