Four foundation trusts have had their governance ratings set to amber and been ordered to comply with hygiene standards after failing to meet the criteria for full registration with the Care Quality Commission.

The trusts are among 21 organisations that have had conditions attached to their registration with the CQC, the new health and social care regulator which came into force last week.

Until improvements are made, governance risks will be rated amber at the four foundation trusts: Alder Hey Children’s, Kettering General Hospital, Leeds Partnerships, and Medway.

This is a downgrading for green-rated Alder Hey and Leeds Partnerships.

A Monitor spokeswoman said: “If the conditions of registration, as set out by the CQC, are not met within set time-scales, the trust will be in breach of its authorisation. Monitor will consider whether to take further regulatory action.”

Under scrutiny

The rating means Monitor, the foundation trust regulator, will scrutinise the trusts’ performance and review action plans. If performance does not improve in line with the action plan, Monitor can force the trust to “seek external advice”.

Monitor said it would consider whether failures indicate poor governance within the trust before taking any action.

In 13 of the 21 organisations with conditions, managers acknowledged they were not meeting hygiene standards and were already taking action.

But Isle of Wight primary care trust chief nurse Carol Alstrom was worried the conditions would be seen as meaning wards were dirty. The PCT was failing on ambulance cleaning plans and discharge procedures.

Ms Alstrom said: “It’s not about dirty wards. Our wards are clean. To be faced with that interpretation, when it’s actually about systems and processes that you haven’t quite got right, is heartbreaking.”

The other eight trusts were found to be repeatedly flouting infection control regulations, had high infection rates or were posing potential safety risks.

The CQC was not confident that these trusts had identified the improvements needed or would take prompt action.

One of the foundation trusts - Kettering General Hospital - falls into this category. It declined to comment.

The rest of the 388 registered trusts met all the standards.

Without registering, trusts are not licensed to provide services.

l This week the CQC has been forced to defend chief executive Cynthia Bower against criticism by the Conservatives of her role in the Mid Staffordshire foundation trust crisis.

Shadow health secretary Andrew Lansley said it was “impossible” to have confidence in Ms Bower without an independent inquiry into what went wrong at Stafford hospital.

The CQC said she was passionate, had years of experience and “is perfectly placed to lead our drive to improve services

on behalf of patients and the public”.

Trusts registered with conditions

TrustSummary of conditionsDeadline
Alder Hey Children’s foundation trust
  • Anti-microbial practice 
  • Anti-microbial prescribing
  • Compliance with policy

31 May 2009

30 December 2009

Barking, Havering and Redbridge University Hospitals trustIsolation policyImmediate
Barnet, Enfield And Haringey Mental Health trust

Healthcare Commission improvement notice covering:

  • Cleanliness of wards
  • Management structures



1 May 2009

1 June 2009

Barts And The London trustSupervision of staff31 May 2009
Coventry And Warwickshire Partnership trust
  • Decontamination of equipment
  • Expertise of interim lead for decontamination

30 September 2009


Herefordshire PCT
  • Local decontamination of surgical equipment
  • Sustained decontamination compliance
  • Endoscopy washing
30 April 2009
Isle of Wight PCT

Ambulance cleaning plans

Policies including decontamination of reusable medical devices

31 July 2009

30 May 2009

Kettering General Hospital foundation trustBoard assurance of cleanliness standards30 April 2009
Leeds Partnerships foundation trustMicrobiology lab reports30 June 2009
Leeds Teaching Hospitals trustAudit of compliance with DH saving lives programme30 June 2009
Lewisham PCTGaps in work plan30 June 2009
Manchester PCTAction plan addressing areas of non-compliance30 April 2009
Medway foundation trustCleaning standards in high risk areas31 May 2009
North Bristol trust

Healthcare Commission improvement notice covering:

  • Infection prevention training
  • strategic objectives for infection control
30 June 2009
Plymouth Hospitals trustCleanliness of wards and patient equipmentImmediate
Royal Surrey County Hospital trustImplement action plan of 18 February 200930 June 2009
Somerset PCT

Occupational Health and environmental policies

Training programmes

30 September 2009
South West London And St George’s Mental Health trustAction plan for healthcare associated infectionsNone specified
United Lincolnshire Hospitals trust

Decontamination of equipment

Actions identified in hygiene code inspection visit

30 June 2009
West Sussex PCT

Cleanliness audits

Patients’ risk assessments

Corporate risk register

Staff training

Infection control staffing levels

31 May 2009
Yorkshire Ambulance Service trust

Recording HCAI risks

infection prevention and control policies

Uniform policies

Cleaning protocols of contractors

Equipment cleaning

30 June 2009