There have already been nearly 50 leadership changes at the 14 hospital trusts placed in “special measures” last year, new figures show.

A report published by Monitor and the NHS Trust Development Authority today reveals that in addition to 49 board level managers leaving, the trusts have recruited 650 extra nurses or nursing assistants, and 130 additional doctors. 

Special measures were first applied to 11 trusts in July 2013 following NHS England medical director Sir Bruce Keogh’s review of hospitals with high mortality rates.

An additional three trusts have been put into special measures since October after concerns were raised by the Care Quality Commission. 

In the space of just seven months the trusts have collectively seen the replacement of four chairs, five chief executives, 11 non-executive directors, seven medical directors, four nurse directors and 18 other directors.

“Special measures” were introduced to the NHS last year and are intended to turn around a failing hospital when the regulatory authorities believe those leading it are unable to resolve problems without intensive support.

Trusts in special measures have their leadership reviewed and become subject to intense scrutiny by the regulator responsible for them (the TDA for NHS trusts and Monitor for foundation trusts).

Options for the support a trust receives include “buddying” arrangements with a high performing trust, and appointment of an external improvement director to hold its leadership to account against delivery of an improvement plan which the trusts are required to publish.

If the provider is a foundation trust, it can also have some of its freedoms suspended.

In the TDA and Monitor’s joint progress report on special measures trusts, they say that of the 244 actions within the 14 improvement plans, 82 (34 per cent) have already been delivered and 127 (52 per cent) are on track to be completed on time.

The 35 (14 per cent) remaining actions are either subject to delay or not on track, and fall across four providers: Medway Foundation Trust, Buckinghamshire Healthcare Trust, North Cumbria University Hospitals Trust and Queen Elizabeth Hospital King’s Lynn Hospital Foundation Trust.

Of these four, King’s Lynn accounts for the vast majority of the actions behind plan (26 in total), although the report notes that because it entered special measures in October it is at a “much earlier stage” than most of the other trusts.

The Department of Health said the regulators’ update showed the trusts had made “significant strides” to improving care, but that “more still needs to be done”.

The report is released to coincide with the DH’s announcement that the former chief executive of Marks & Spencer Sir Stuart Rose will be reviewing how the NHS can attract and retain top quality leaders to transform the culture in under-performing hospitals. Sir Stuart will be focusing in particular on the trusts in special measures.