Jeremy Hunt has today said he believes that “in certain cases unacceptable compromises were made on staffing” by aspirant foundation trusts.
The health secretary said the former Mid Staffordshire General Trust was one such case and there were “strong indications that might have happened in Morecambe Bay as well”.
The notorious care failings at Mid Staffordshire have been subject to investigation by Robert Francis QC, in a report published in February this year. An inquiry investigating care failings at University Hospitals of Morecambe Bay Foundation Trust is due to begin this autumn.
Mr Hunt’s comments constitute the first time a sitting health secretary has explicitly linked care failures to the drive to get all trusts to foundation trusts status.
Speaking at a press conference discussing the 11 trusts in “special measures”, Mr Hunt said: “We didn’t pick up problems as well as we should have and we have learned from that.
“There was too much of a sense in the system that the way you became an FT was that you got into surplus. In certain cases unacceptable compromises were made on staffing.”
He said the government was still strongly committed to the foundation trust policy but added: “The uncomfortable reality is that six [of the 11 trusts in ‘special measures’] are foundation trusts… it is clear that some things will have to change.”
Mr Hunt said some of the trusts that had attained foundation status had subsequently declined and others should not have been authorised in the first place.
Asked if his new approach and the results of the Keogh reviews meant the existing regulatory system had failed he replied “yes”, adding “we are making some very profound and significant changes.”
Approximately half of NHS trusts have achieved foundation trust status, and are regulated by Monitor, with the remainder regulated by the NHS Trust Development Authority, an arm’s-length body reporting to the Department of Health.
Asked whether the Keogh review of trusts with high death rates and the package of measures announced today indicated a significant failure of the regulatory system, Mr Hunt replied “yes”. He added that the chief inspector of hospitals regime showed his determination to change this.
Mr Hunt appeared alongside NHS Trust Development Authority chief executive David Flory and Monitor chief executive David Bennett to announce the government’s “tough new approach to transform ‘special measures’ hospitals”.
The 11 trusts in question are drawn from the 14 that were inspected by Sir Bruce Keogh’s teams earlier this year as part of the government’s response to the Francis Inquiry.
Mr Hunt said the trusts would be partnered with higher performing trusts (see table below) to help them improve but said this the “turn-around” was likely to take between three and five years.
He said improving board capability was “not an instant thing, much to my frustration”. Mr Flory said a “knee-jerk” sacking of managers should be avoided.
The Department of Health said the 11 trusts were in “special measures”, which would see “freedom to operate as an autonomous body suspended”.
In practice, this means the trust is monitored monthly and an “improvement director” is appointed.
Monitor has already altered the operating license of some of the foundation trusts in question.
Mr Hunt added that he expected more trusts would be placed in “special measures” and that no trust would be authorised as a foundation trust unless it had achieved a “good” or “outstanding” rating from chief inspector of hospitals Sir Mike Richards’ inspection regime. The health secretary said he would ask the CQC to prioritise trusts which were nearing the end of the accreditation process.
However, at the CQC board meeting yesterday the regulator said it could take some time to develop the rating system.
Each of the 11 trusts will be monitored against a set of targets set out by the TDA or Monitor. Mr Hunt pledged to hold a quarterly press conference to update the public on their progress.
|NHS Trust/Foundation Trust in special measures||Partnering organisation|
|North Cumbria University Hospitals Trust||Northumbria Healthcare Foundation Trust|
|United Lincolnshire Hospitals Trust||Sheffield Teaching Hospitals Foundation Trust|
|East Lancashire Hospitals Trust||Newcastle-upon-Tyne Hospitals Foundation Trust|
|George Eliot Hospital Trust||University Hospitals Birmingham Foundation Trust|
|Buckinghamshire Healthcare Trust||Salford Royal Foundation Trust|
|Tameside Hospitals Foundation Trust||University Hospital of South Manchester Foundation Trust|
|Basildon and Thurrock University Hospitals Foundation Trust||Royal Free London Foundation Trust|
|Burton Hospitals Foundation Trust||University Hospitals Birmingham Foundation Trust|
|Medway Foundation Trust||Partner to be confirmed|
|Northern Lincolnshire and Goole Hospitals Foundation Trust||Partner to be confirmed|
|Sherwood Forest Hospitals Foundation Trust||(specifically on complaints) Barnsley Hospital Foundation Trust|
More to follow