Managers fearful over DH hit list

The NHS performance framework, published last week by the Department of Health, named eight hospital trusts as “underperforming” and 22 hospital and four ambulance trusts as having their “performance under review”.

The list will be repeated each quarter and if the trusts fail to improve, the DH and strategic health authorities can, for example, replace board members or arrange for trusts to be merged.

But managers warned misuse of the powers could lead to a continuation of the “revolving doors” replacement of managers at trusts that need stability. NHS Confederation senior policy manager Joe Farrington-Douglas said the regime should be used to “get the best people in the most difficult jobs”, but not continue the “revolving doors of interim managers” seen at some failing trusts.

He said: “If it is used to identify where there are longstanding problems – and often problems lie in health economies rather than organisations – and get some progress, that will be welcomed. You need good plans and strategies in place [for those areas] but they need to be followed through, with continuity of good leadership.”

The confederation will be asking trusts about their experience of the framework, including whether ratings have been seized on by local press as evidence of failure.

NHS East of England strategy director Stephen Dunn said those implementing it needed to be “sensitive” to where trusts were marked as underperforming but already had robust improvement plans.

Ipswich Hospital trust chief executive Andrew Reed said his trust was listed as having its “performance under review” largely because it was reducing a large “backlog” of long-waiting elective care patients identified in February. He said: “Hopefully [the framework] will reflect…this is a problem we are facing in the right way.”

The DH said the regime would be applied to PCTs, provider arms and mental health trusts “in coming months”.