Revealed: NHS holds 'risk summits' over A&E concern

Ben Clover

Pressures in accident and emergency have been the largest single trigger for “risk summit” meetings which are being called to address quality, safety and performance concerns under the new NHS system, HSJ research reveals.

HSJ has identified that summits have been held in relation to 26 trusts since October, when they were introduced.

The quality risk summits and their themes are shown on the map below.

Click the circles to see details of the summits.

Under Department of Health guidance setting out how quality and safety would be maintained during the commissioning reorganisation and in the reformed NHS, a summit is called when “there are concerns that a provider is potentially or actually experiencing serious quality failure”. These can be highlighted by regulators or commissioners.

Of those held so far, the largest single reason was emergency care problems at hospital providers, which has been the subject of nine summits.

There has been a high level of concern about A&E performance in recent months, and many providers have failed to meet the four hour waiting time target.

Other reasons for summits range from the sustainability of obstetric services to the training of surgeons.

Summits held last week include one about Kettering General Hospital Foundation Trust’s A&E performance; Shrewsbury and Telford Hospital Trust’s “emergency care service performance and organisational culture indicators”; and paediatric services at Bedford Hospital Trust.

Some organisations complained to HSJ that the risk summit process did not involve providers enough, and that they were not given feedback.

One provider chief executive told HSJ: “The reality is that the commissioners meet in secret and the providers get no feedback. It can’t be right in this age of openness and transparency.”

One of the 26 trusts covered by the summits, Bolton Hospital Foundation Trust, said in a statement: “The trust was not invited to be present at the summits, which were looking at the organisation having being put in breach of its authorisation by Monitor and progress on the particular issues raised.”

NHS England said risk summits were due to be held in the near future about the 14 trusts which are subject to its review of those with higher than expected mortality rates.