The deputy chief executive of a former ‘special measures’ trust has been appointed to lead a new major Monitor directorate tasked with driving performance improvement in NHS providers, the regulator announced today.

  • Adam Sewell-Jones, former deputy chief executive of Basildon and Thurrock University Hospitals FT, will become director of Monitor’s new provider sustainability division
  • His appointment comes as Monitor’s business plan highlights the ‘mismatch’ between its regulatory role and the pressure it is under to directly performance manage struggling providers
  • New division will provide practical support to providers with operational problems. Will also take “in house” the work of contingency planning teams, currently bought in from consultancies that aid reconfiguration in seriously challenged providers
  • Mr Sewell-Jones described as “instrumental” in the turnaround that saw Basildon become the first trust to emerge from special measures

Adam Sewell-Jones, the former finance director and deputy chief executive of Basildon and Thurrock University Hospitals Foundation Trust, will become the first ever director of Monitor’s new provider sustainability division.

As HSJ revealed in February, the directorate will be tasked with supporting trusts to tackle operational problems like high agency staffing bills and poor accident and emergency performance. It will also be responsible for leading Monitor’s work on implementing the new care models backed by the NHS Five Year Forward View, in particular “hospital chains” and Moorfields style single service franchises.

Adam Sewell-Jones

Adam Sewell-Jones was “instrumental” in turning around Basildon

The team will also seek to bring “in house” the work of Monitor’s contingency planning teams – currently hired in from consultancies which are sent into seriously challenged FTs to diagnose structural problems and help reconfigure services.

The news came as Monitor’s 2015-16 business plan, published this afternoon, appeared to highlight a tension between its role as a regulator and the political pressure it has come under – amid sharply declining performance in the provider sector – to intervene more directly in struggling providers.

The plan states that there “has emerged a mismatch between Monitor’s powers, resources and the regulatory regime within which we operate, and that for which we are by de facto being held to account”.

It warns: “It is important that these are brought into line if we are to be fully effective as an organisation.”

The business plan also hints that the regulator will examine whether changes to the current NHS competition regime would aid necessary restructuring of services. It states: “[Monitor] will look at how the current approach to mergers is working and consider whether any changes would help in facilitating the reconfiguration of services, including how choice and competition might most effectively contribute to driving improvement in the new provider landscape”.

Mr Sewell-Jones became Basildon’s finance director in 2007 and was appointed deputy chief executive in 2012. The trust was placed in special measures in 2013 following the Keogh review, but also became in 2014 the first trust to be taken out of the regime – following what health secretary Jeremy Hunt called a “remarkable turnaround”.

Monitor said in a statement that Mr Sewell-Jones “was instrumental in turning around a trust which had been subject to regulatory action for a number of years as part of the special measures programme”.

Since emerging from special measures, however, Basildon has seen a decline in its finances. A Monitor investigation launched at the end of last year found “shortcomings” in the trust’s financial management, and that the trust was predicting a £20m deficit for 2014-15.

Trust chief executive Clare Panniker said at the time that achieving a “good” rating from the Care Quality Commission had “come at a cost – we have employed many more doctors and nurses – and like most of the NHS we are feeling the financial impact of the huge demand for our services”.

Special measures boss to lead Monitor 'provider sustainability' division