'Dirty dozen'chief speaks out

A former trust chief executive who left his post one day before his organisation received a zero star-rating has spoken out against the government's naming and shaming policy.

Stephen Fash, who was chief executive of Ashford and St Peter's Hospital trust in Surrey until a day before the trust joined the socalled 'dirty dozen' in September 2001, said the way the results were announced caused 'untold distress' to thousands of staff and millions of patients.

Speaking to HSJ as he took up a new post as head of claims for the Medical Defence Union, Mr Fash denied that he had left the trust because of the low performance rating.

'I had been there 12 years and it was time to move on, ' he said. He left the trust on secondment to oversee delayed discharges in South East region.

But he was highly critical of the way that the performance rating had been carried out and how it was used.Mr Fash said: 'When we went into the performance rating none of us knew precisely what criteria were going to be used to measure us against. They were being modified throughout that year almost right up to the point where the ratings were made.'

He supported performance measures as a way of highlighting issues that needed exploring, but added: 'The star system was used in such a destructive way in terms of the publicity. When you have newspapers claiming that your hospital is on a list of shame you are not in a position which lends itself to an objective and contextualised discussion about the performance assessment system.'

Mr Fash defended the performance of Ashford and St Peter's trust, which had received a good Commission for Health Improvement report and high marks in other measures, and called on the government not to use the same tactics with this year's star-ratings.

A Department of Health spokesperson said: 'The star-ratings system is not about punishing trusts. It is about improving performance and strengthening organisations which have had difficulties by putting robust management arrangements in place to make sure that those trusts get out of trouble and stay out of trouble.

'Both health secretary Alan Milburn and NHS chief executive Nigel Crisp have acknowledged the tremendous hard work and achievement of the staff in these trusts and we are determined to make sure they have all the support they need to provide highquality services for patients.'