Franchise trusts claim to be victims of 'more NHS bashing'

NHS chief executives have accused the government and media of 'misrepresenting' the achievements of four trusts whose management is to be franchised to more successful trust chief executives.

On Monday, it was announced that management at Dartford and Gravesham, Ashford and St Peter's, Barnet and Chase Farm and Portsmouth Hospitals would be opened up to bids for a threeyear franchise from chief executives of three-star trusts.

The trusts say that they have made substantial improvements since they were given a zero-star rating last year, and the Department of Health itself expects them all to achieve at least one star in the next rating round yet has claimed they 'have failed to improve'.

And while health secretary Alan Milburn, announcing the franchises, said 'despite the best efforts of staff, underperformance continues', NHS chief executive Nigel Crisp wrote to trust chairs congratulating them on their progress.

One chief executive said the announcement was a combination of 'more NHS bashing' and a 'recruitment process by another name'.

In a letter to staff at Ashford and St Peter's accepting the trust's action plan and congratulating them on their hard work, Mr Crisp admits that the franchising may cause 'shock' and 'uncertainty in your organisation'.

He goes on to say that the only reason for the franchise is to replace the interim chief executives with fulltime replacements.

Andrew Morris, interim chief executive of Ashford and St Peter's as well as chief executive at threestar Frimley Park Hospitals trust, says he will not be applying for the franchise. 'My contract runs out on 31 March, then I am going back to Frimley Park.'

Mr Morris expressed the anger felt privately by other senior managers at the way the announcement was presented.

'I think that the media has misrepresented the position of these trusts. It is difficult to keep morale high when I have been telling people that we are turning things around and people have been running extra services on Saturdays and Sundays, and then you are labelled a failure.'

Dartford and Gravesham trust interim chief executive Sue Jennings, from three-star Basildon and Thurrock General Hospitals trust, was non-commital about applying for the franchise. She said that media coverage had been 'unfair' and the trust expects a two-star rating.

'We are not a failing trust, ' she said. 'Staff have said they wanted a period of stability.'

At Portsmouth Hospitals trust, interim chief executive Alan Bedford said he would consider applying once the details of the franchise scheme emerged.

Mr Crisp says he expects new chief executives to be appointed within the next three months.

However, a DoH spokesperson said detailed guidance on the franchise process would not appear for 'about a month', so prospective candidates have only a short time to draw up bids, which will have to include a three-year business plan.

As the franchise announcement was made, Paul O'Connor started his first day as interim chief executive at Barnet and Chase Farm trust.

The trust said it supports any initiative that drives up standards in hospitals, but looked forward to more details of the franchise process.

Tensions revealed between CHI and Department of Health The launch of the first investigation by the Commission for Health Improvement sparked by a clinical governance review has revealed tensions in the relationship between the commission and the Department of Health.

The announcement of the investigation into a backlog of 2,700 ultrasounds at Barnet and Chase Farm Hospitals trust has been surrounded by controversy.The trust's claims that it alerted CHI in November have been hotly disputed by CHI, which says it was only made aware of the problem days before its review took place in January.

But the handling of the announcement also seems to have demonstrated a gulf between CHI and the DoH.Last week, CHI gave HSJ a briefing under embargo on the understanding the story would be published a day after the announcement was due, and alerted the trust and London regional office to the fact.But despite several calls to the trust and London region, both eventually said they were unable to comment, at which point the DoH put out a brief statement.

One DoH source said CHI had passed information to HSJ when it should not have done.The apparent micro-management continued as the story broke, with responses to questions put to Enfield primary care trust having to be cleared by both the acute trust and London region.

Meanwhile, sources on both sides of the divide were critical of how the issue was handled.Some blamed CHI for being 'more interested in publicity for itself ' than the interests of the services it examined.Others criticised the trust and the region for not being more open in their communications, and for failing to learn from a similar incident two years ago in which 800 scans were not carried out.