PERFORMANCE: The foundation only avoided being rated “red” for governance over missed cancer waiting targets at the discretion of foundation trust regulator Monitor, documents released under the Freedom of Information Act show.

The report from Gill Heaton, chief nurse and director of patient services, stated that in the third quarter of 2010-11 the foundation failed to meet its cancer referral-to-treatment targets for both patients referred from screening, and patients referred from GPs.

“The referral from screening programme [target] had not been delivered in the previous two quarters which meant that the penalty score within the Monitor governance framework was tripled,” it explained. “This mathematically would automatically raise the trust’s governance risk rating to ‘red’ as the trust would potentially be in significant breach of its terms of authorisation.”

However, the report adds, “Monitor has discretion in its application of escalation” to take into account “specific circumstances and plans of redress”.

“To this end, the senior compliance officer at Monitor held a teleconference with the trust’s executive director of patient services/chief nurse and the director of performance on 3 February”.

In this conversation, the foundation trust representatives told Monitor about “operational issues around the newly implemented bowel screening service” and “its strategy to deal with the backlog of patients… through greater capacity and pathway streaming”.

The report continues: “Subsequent to the teleconference Monitor have reported that the trust will not be formally escalated at this time and therefore the governance risk rating will be amber-red until the trust achieves the target or Monitor reviews its decision to escalate again.”

A spokeswoman for CMFT said teleconferences of this kind were a standard part of Monitor’s risk rating assessment process.