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Gloucestershire Hospitals Foundation Trust

Monitor directs foundation trust to tackle A&E performance

PERFORMANCE: The foundation trust regulator has stepped in at Gloucestershire Hospitals in a bid to redress its “persistent failures” to tackle long waits for accident and emergency treatment.

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Monitor this week invoked its powers of intervention to dictate “immediate action” to improve A&E waiting times at the trust.

A statement issued by the regulator said it had found Gloucestershire in significant breach of its terms of authorisation two and a half years ago, primarily for “persistent failures in meeting A&E waiting targets and weak financial performance”. Since then, the trust has repeatedly missed the key waiting target, currently set at 95 per cent of A&E attendees being seen within four hours.

The regulator has directed Gloucestershire to produce an “overall plan” for “sustainable achievement” of the target. The trust also has to commission an “intensive support team” from NHS Interim Management and Support, to approve the plan and to help implement it.

Monitor compliance director Merav Dover added: “Monitor needs to be assured that the board is able to identify and address issues at the trust quickly and we are concerned that they have not been able to do this. The trust is to commission an independent review of board governance, and we will expect the trust to address any weaknesses identified in the report.”

Monitor tracks foundation trust performance on a quarterly basis. In a letter to Gloucestershire, the regulator said the A&E target had only been hit in five of the 10 quarters since it was found in significant breach. Three of those periods were from the start of 2010-11, when the target was cut from 98 per cent to 95 per cent. “The underlying actual performance has deteriorated” since then, it added.

In February 2012, Gloucestershire’s board approved a new plan to improve A&E performance. However, that plan has since been amended to include recommendations from the intensive support team, which reviewed the trust’s emergency care at Monitor’s suggestion.

Monitor’s letter said the team review had produced a “raft” of 42 recommendations, on issues including staffing levels, care pathways and accountability.

Gloucestershire Hospitals chair Clair Chilvers said: “As a board we acknowledge that this is a very important area and that we have struggled to consistently see, treat and admit or discharge 95 per cent of patients in our A&E departments within four hours. This is a cause of frustration to patients, to our frontline staff and a cause of great regret to the board.

Professor Chilvers added: “We have stepped up our response to this problem with a detailed action plan and are confident and determined that we will be able to solve it for the benefit of patients. I would also like to reassure patients that although there have been delays in A&E, there is no suggestion that patients are receiving poor clinical care.”

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