Thirty hospital trusts and four ambulance trusts have been identified as not meeting minimum standards under the NHS performance regime.

The Department of Health’s first The Quarter publication for 2009-10 designates 22 hospital and four ambulance trusts as having their “performance under review”.

A further eight hospital trusts are “underperforming”. They have been categorised by a points-based system covering finance, standards and targets, user experience and quality and safety.

It is the first time trusts’ status under the performance regime, published in May last year, has been published. Under the policy, those in the first category should be required to improve by their commissioners. If after three months there are still problems they will become “underperforming”.

Trusts which are “underperforming” will be managed by their strategic health authority to improve. If they are “underperforming” for three consecutive quarters they will be designated as “challenged”.

Once challenged, trusts will receive an external review of governance and board capability. The SHA can then impose temporary appointments or suspend or remove members of the board.

If these trusts do not improve the Department of Health can trigger the Regime for Unsustainable Providers, or “failure regime”.

That would see a “special trust administrator” take over and, following a short consultation, the health secretary would take action such as removing the board or ordering a merger or acquisition with another trust.

Guidance issued in April said: “While there are no prescribed thresholds, there are certain features that ‘challenged’ organisations are likely to exhibit.

“These would include some or all of the following: local attempts to improve performance have been consistently unsuccessful, there are serious concerns about quality and safety of patient care, there are serious concerns about the Board or governance more broadly, there are wider health economy issues, for example over capacity.

“It will be essential for the NHS chief executive to exercise his judgement, advised by the SHA, to balance concerns relating to the organisation against the impact of categorising it as challenged.

“This flexibility is required as some organisations may be on the verge of turning their performance around while others may be subject to intractable problems.”

The Quarter says the performance regime will be applied to PCT commissioners and providers and mental health trusts “in coming months”.

Performance under review


EALING HOSPITAL TRUST
EAST AND NORTH HERTFORDSHIRE TRUST
EAST LANCASHIRE HOSPITALS TRUST
IPSWICH HOSPITAL TRUST
ISLE OF WIGHT PCT
MAIDSTONE AND TUNBRIDGE WELLS TRUST
MAYDAY HEALTHCARE TRUST
MID ESSEX HOSPITAL SERVICES TRUST
NEWHAM UNIVERSITY HOSPITAL TRUST
NORTH MIDDLESEX UNIVERSITY HOSPITAL TRUST
NORTH WEST LONDON HOSPITALS TRUST
NORTHAMPTON GENERAL HOSPITAL TRUST
PLYMOUTH HOSPITALS TRUST
PORTSMOUTH HOSPITALS TRUST
ROYAL FREE HAMPSTEAD TRUST
ROYAL NATIONAL ORTHOPAEDIC HOSPITAL TRUST
THE PRINCESS ALEXANDRA HOSPITAL TRUST
THE WHITTINGTON HOSPITAL TRUST
TRAFFORD HEALTHCARE TRUST
UNITED LINCOLNSHIRE HOSPITALS TRUST
WESTON AREA HEALTH TRUST
WHIPPS CROSS UNIVERSITY HOSPITAL TRUST


EAST OF ENGLAND AMBULANCE SERVICE TRUST
LONDON AMBULANCE SERVICE
SOUTH CENTRAL AMBULANCE SERVICE TRUST
YORKSHIRE AMBULANCE SERVICE TRUST


Underperforming


BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS TRUST
BARTS AND THE LONDON TRUST
HINCHINGBROOKE HEALTH CARE TRUST
NORTH BRISTOL TRUST
ROYAL CORNWALL HOSPITALS TRUST
SOUTH LONDON HEALTHCARE TRUST
THE LEWISHAM HOSPITAL TRUST
WEST MIDDLESEX UNIVERSITY HOSPITAL TRUST