A district general hospital has become the latest organisation to abandon plans to become a standalone foundation trust.

  • Princess Alexandra Hospital Trust would not be viable as an FT.
  • Essex trust looking at “horizontal” and “vertical” integration.
  • Organisation faces financial and A&E performance problems.

Princess Alexandra Hospital Trust in Harlow, Essex, is now looking to become an integrated care organisation and is investigating both “horizontal” and “vertical” integration with other health bodies.

The development was revealed in a paper presented to West Essex Clinical Commissioning Group’s board at the end of last month.

It is the first time an NHS body has said publicly that the £177m-turnover organisation would not viable as a standalone FT.

The report said: “Strategic review work carried out by [the trust] in conjunction with PwC concluded that a standalone route to foundation trust status is not achievable. Instead, the trust needs to undertake structural reform aligned to the underlying causes of its sustainability challenge.”

It is not clear if the “vertical integration” mentioned in the document refers to the trust merging with a larger trust or with primary care and other local services.

In the minutes of the trust’s January board meeting, chief executive Phil Morley said: “In its present form it [is] not financially viable and was becoming clinically unsustainable.”

A trust spokeswoman told HSJ today that it “sees a possible future for delivering better healthcare and sustainable services through becoming part of an ‘integrated care organisation’”.

She added: “Although early days, we are making a joint commitment [with local partners] over the next six months to test how this might work in practical terms, with a view to pursuing this as a viable long term model of care.”

In April last year chair Douglas Smallwood indicated that he still wanted to pursue FT status. He said: “I think it is important that we can show that we can pass the test as well as secure the benefits of the increased self-determination it brings. In particular, striving for FT status is an important demonstration of ambition around quality.”

The trust faces multiple performance and financial problems.

It is going to arbitration with West Essex CCG over £6.5m in fines and penalties relating to the 2014-15 financial year and is predicting a deficit of £28.5m for 2015-16.

The organisation has one of the worst accident and emergency performances in the country. Its performance against the four hour target dropped from 94 per cent in 2013-14 to 88 per cent in 2014-15. This came as overall attendance fell by 2.3 per cent.

The trust is also one of eight nationally that are unable to report their waiting times for elective patients to the Department of Health.

A recent data validation exercise found 35 patients who appeared to have waited more than a year for elective treatment – making it one of the worst in the country for breaching this target. The last reported figures put the national total of year-plus waiters at 347.

The trust is currently undertaking an internal inquiry into whether any of the 14 patients who are still waiting for treatment after more than a year have suffered harm as a result.

Exclusive: District general hospital gives up standalone FT bid