The chief executives of some of England’s most powerful hospital trusts have warned that the organisational independence of other providers should not be a barrier to them being taken over.
A conference organised by Reform, the right-wing think tank, and the Shelford Group, which represents England’s 10 most influential hospital providers, saw Central Manchester University Hospitals Foundation Trust chief executive Mike Deegan tell delegates: “Organisational sovereignty is a barrier to change.”
Mr Deegan, whose trust took over neighbouring Trafford Hospital in April 2012, said there were growing numbers of failing NHS organisations and that independent district general hospitals were “not the model to take us forward”.
He pointed to a reduced mortality indicator score at Trafford since he took it over.
But Mr Deegan said trusts’ independence impeded takeovers and got in the way of improving services. He said for making rapid change, “acquisition [is] better than merger”.
His comments at the event yesterday were echoed by University Hospitals Birmingham Foundation Trust chief executive Dame Julie Moore.
She told delegates: “Foundation trusts have created independence for independence’s sake. For patient care you can’t have people preserving organisations just because they are [currently] separate.”
The comments come weeks after outgoing NHS England chief executive Sir David Nicholson said in an HSJ interview that the government’s policy of all trusts winning foundation status was impossible and the wrong “model for the future”. Instead, providers should be able to experiment with other models, such as joining with commissioners, primary care-led providers, or organisations running “chains” of hospitals.
Salford Royal Foundation Trust chief executive Sir David Dalton is currently investigating the barriers to “chains” developing for the Department of Health.
Dame Julie told yesterday’s event that in the future there would be “fewer organisations, [but] the same number of hospitals” and said small hospitals often spent “a fortune” because the didn’t have the economies of scale available to larger trusts.
She said George Eliot Hospital Trust and Burton Hospitals Foundation Trust – the two trusts in special measures which Birmingham has been “buddied” with – had made large cuts to everything except frontline services. This included building maintenance and education, she said, and her teams were having to buy new IT systems from scratch at increased prices.
The first foundation trusts were authorised 10 years ago. They were intended to be autonomous of central control and therefore able to be more innovative.
However, the efficiency requirements on trusts seeking to achieve foundation status were singled out for criticism by Robert Francis QC in his report into care failings at Mid Staffordshire Foundation Trust. In recent years, the rate of authorisations has been very slow.
In October Monitor announced it would produce a report on the challenges facing trusts with a turnover of £300m or less. The report is expected to be published in May.
The Shelford Group is made up of the 10 largest hospital trusts which are also successful teaching trusts and regional centres.
- BURTON HOSPITALS NHS FOUNDATION TRUST
- CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST
- David Dalton
- David Nicholson
- Department of Health and Social Care (DHSC)
- Foundation trusts
- GEORGE ELIOT HOSPITAL NHS TRUST
- Julie Moore
- UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST