Mid Staffs board wants to be stripped of FT status

It has told health secretary Andy Burnham that removing the status would help it improve performance and regain public trust.

The board have now made strong representations to me that they do not expect their clinical and financial problems to be resolved in the near term and that they consider de-authorisation to be a real prospect

A letter from Mr Burnham to Monitor interim chair Chris Mellor, dated 24 March, makes clear that he also believes de-authorising Mid Staffs is necessary.

Mr Burnham, as well as pointing to the trust’s ongoing problems with safety, says it will make faster progress if it is directly responsible to NHS West Midlands, which is already providing it with financial support.

In the letter, placed in the Commons library last week, he says there need to be “substantial changes to the clinical configuration of services”, which “need to happen in partnership with other NHS organisations in the area, potentially including options to merge with other NHS organisations, under the guidance of the strategic health authority”.

Mr Burnham says: “The board have now made strong representations to me that they do not expect their clinical and financial problems to be resolved in the near term and that they consider de-authorisation to be a real prospect; indeed they would welcome it in order to give certainty to the board and staff of the organisation.”

The letter reveals Mr Burnham has commissioned an SHA-led review of services in the Staffordshire area to report to himself and Monitor in the summer.

He says the case for deauthorisation “is not about the safety of care provided currently” but that “the earlier breaches of the FT’s terms of authorisation are so serious as to necessitate removing foundation trust status” and that “the configuration of clinical services at the trust is driving the financial problems and that these can only be resolved by looking at the optimal configuration [of services] across the local area”.

There have been calls for Mid Staffs’ foundation status to be removed – particularly from local campaigners and politicians – since the serious failings in Stafford Hospital’s emergency services were publicised in March 2009.

The government has since fast-tracked plans that allow it to ask regulator Monitor to consider such a move – before the Health Act 2009 de-authorisation was not possible.

While the plans were in development, foundation trusts expressed concern they could allow ministers to intervene “over a whole range of regulatory issues”, undermining the independence of Monitor and the trusts, which are not directly accountable to SHAs and the Department of Health.

The regulator is currently consulting on how the process will work and it is expected to be put in place in the summer.

Monitor has said it will not consider any deauthorisations until then, which Mr Burnham has supported. The letter was copied to MPs in the Staffordshire area, to Mid Staffs, NHS West Midlands and the Care Quality Commission.

Mr Mellor’s reply, dated 30 March and seen by HSJ, says: “I have taken careful note at this stage of the grounds you set out in your letter to support your view that Monitor should consider de-authorising this trust.

“Presumably you will write again to us to make this request formally when the relevant statutory powers come into effect in the coming months. “

Mr Mellor says Monitor is “pleased to accept your invitation to engage with the review you have commissioned from the SHA on the optimal configuration of services in the Staffordshire area”.

Mid Staffs chief executive Antony Sumara told HSJ the board had asked that, if it were to be deauthorised, it happen a month ago when the Francis inquiry was published, instead of it remaining as a threat and later generating more negative coverage. He said: “At this stage being a foundation or not does not help me do the job. What does not help is getting another publicity stunt in six months time by saying we are deauthorised.”