• NHS Improvement considering new “special measures” category for operational performance including A&E
  • Comes as English hospital sector records worst quarter one A&E performance since 2003
  • HSJ analysis shows worst performing 40 trusts responsible for 63 per cent of year on year decline

NHS Improvement is considering a new category of “special measures” for trusts with the worst performance on high profile access targets such as accident and emergency.

The regulator is expected to make a decision over the next fortnight as to whether to introduce the category for organisations which are seriously failing the target of seeing 95 per cent of attendances within four hours.

Nurses pushing trolley

Nurses pushing trolley

NHS Improvement said ‘patients and staff are being let down’

It is not known what being placed in special measures would entail, but earlier this year five trusts were placed in a new “financial special measures” regime.

The news comes as the English NHS recorded the worst performance against the target since 2003, with 90.3 per cent of people attending A&E being seen within four hours in quarter one of 2016-17. In quarter one of the last financial year performance was 94.1 per cent.

A spokesman for NHS Improvement said: “It is clear that a small number of providers are not giving this the attention it deserves and their patients and staff are being let down as a result.

“In order to address the ongoing issues with A&E performance at this small number of providers, we are considering introducing special measures for operational performance.

“We need to see those consistently poor performers, those trusts not giving this the focus it requires, implementing the advice and support provided. They have to sort this out, urgently.”

Analysis of the quarterly data shows some trusts contributing disproportionately to the decline in national performance, including Princess Alexandra Hospital Trust in Essex and Nottingham University Hospitals Trust. Hull and East Yorkshire Hospitals Trust had the biggest improvement from last year’s position.

However, of the 3.8 percentage point performance decline year on year, only 2.4 per cent related to the 40 worst performing trusts.

HSJ analysis shows that even if those trusts had maintained their previous performance – contributing no more breaches to the national total than they did last year – the more generalised decline in the sector would still have led to the steepest decline in five years.