PERFORMANCE: Doncaster and Bassetlaw Hospitals Foundation Trust could be found in breach of its authorisation by Monitor after poor performance.

It has been red rated for governance since last December and Monitor has warned it could be found in breach of its authorisation, following an escalation meeting last month.

The trust could have incurred a £5.7m penalty from commissioners for missing targets for Clostridium difficile cases – although it says it has reached agreement with commissioners on its main contractual penalties.

Board papers show it is struggling with a number of national targets. In February, only just over 80 per cent of patients were admitted for elective treatment within 18 weeks of referral and performance was just 56 per cent in general surgery.  

The trust is failing to meet the four hour A&E target with its year-to-date performance around 94 per cent and a drop in February’s performance to 91.2 per cent and even lower in early March. The trust has been non-compliant with the 95 per cent target for several months.

Clostridium difficile infections are another cause of concern with 63 cases so far this year (to mid March) against a maximum of 48.

Doncaster and Bassetlaw is an extreme outlier among trusts in the Yorks and Humber region as 18 out of 68 specimens found to be type 027 across the region come from the trust.

The trust has been carrying out root cause analysis to pinpoint contributory factors: the top five are failure to isolate quickly, environmental contamination, poor antimicrobial stewardship , cross infection and inappropriate staffing levels. 

The trust is carrying out a rolling programme of deep cleaning – although it has encountered some difficulties in decanting patients – and is increasing prescribing audits, among other measures.

It is opening new beds which will help with deep cleaning and allow for speedier admissions of non-elective patients – in some months its bed occupancy rate has been above 100.