Plans to publish a list of NHS trusts unlikely to have a future as independent organisations have been put on hold, the NHS Trust Development Authority has indicated.
- TDA misses deadline for publishing list of trusts unsustainable as standalone providers
- Authority says decision about whether to complete work now up to NHS Improvement
- Publication of list urged by Dalton review and HSJ Future of NHS Leadership inquiry
The TDA had pledged to publish the list, which categorises the 88 trusts it oversees according to their prospects for sustainability, in the summer.
However, the publication of the information is now in doubt after a TDA spokeswoman told HSJ that the decision about whether to complete the work would have to be taken by NHS Improvement – the new body to be created by the merger of the TDA and Monitor.
The TDA first said it had started work on “segmenting” NHS trusts into different categories in September last year, and a first draft of the information was completed last November.
Trusts were placed into “six broad groups” according to their “likely trajectory towards a sustainable organisational form”.
These categories (see box, below) indicate which of the trusts – many of which are struggling to provide good care and balance their books – are expected to have to be acquired by another provider or managed via a management contract or franchise. For those expected to be able to achieve foundation status, the categories show how quickly this is predicted to be achieved.
The TDA’s trust categories
- A1 and A2: Organisations with a “clear and credible plan” for becoming FTs in less than two years are in category A1. Those predicted to achieve foundation status in less than four years are in A2.
- A3: Trusts with the potential to reach foundation status but that lack “a clear and credible plan and timeline for doing so”.
- B1: Category B1 is for trusts where acquisition by another organisation is likely to be the “best route to sustainability”. It also includes categories for trusts that cannot become FTs in their current form.
- B2: Trusts where a “franchise, management contract or other innovative organisational form” is the recommended option.
- C: Organisations where further work is needed to determine their future.
The information is likely to be sensitive because it indicates how many and which NHS trusts are unlikely to have an independent future. Although it does not mean their services will close, this is often unpopular with supporters of the organisations, and in some cases indicates major service change is required.
HSJ first requested the information from the TDA in January, but was told the process was ongoing. In March the arm’s length body said it would not publish the results until after the general election. It said the list would be “set out publicly in summer 2015” after the completion of the planning round, which had been delayed by the 2015-16 tariff row.
Last week the TDA told HSJ the decision about whether to complete the work would now be up to NHS Improvement, which is not due to come into existence until April 2016.
A TDA spokeswoman said: “The draft segmentation work that we started was focused purely on the NHS trust sector.
“However, since then, providers overall are facing significantly greater challenges and therefore it would need to be for NHS Improvement to consider whether they would want to see this work through to completion in the future.”
Sir David Dalton, the chief executive of Salford Royal Foundation Trust, led a government review on NHS provider organisational forms last year, which recommended the TDA should publish the list “at the earliest opportunity”.