STRUCTURE: Failure to secure changes to services at Mid Staffordshire Foundation Trust before winter could be “potentially disastrous” for the local health economy, the trust’s special administrators have claimed.

The warning came in a letter to chief inspector of hospitals Sir Mike Richards following a recent inspection of the trust by the Care Quality Commission.

The letter - jointly signed by trust special administrator Hugo Mascie-Taylor, and David Bennet and David Flory, chief executives of Monitor and the Trust Development Authority respectively - stated that Sir Mike provided a “very concerning assessment of the unique fragility of services at the organisation which are heavily reliant on temporary staff to ensure safety standards are met”.

The CQC inspected the trust in response to the administrators’ concerns about its staffing levels. The full inspection report will be published next month, but a letter to the trust from Sir Mike said the FT was safe and shifts appropriately staffed.

However, he added: “I would emphasise the word ‘just’.” He also wrote that the CQC was “surprised and very concerned” no transition plan for the dissolution of the trust had been agreed.

The response letter said there was an “urgent need for a system wide transition plan [to] support the stability of services at Stafford in the immediate term whilst also securing safe and sustainable services in the future”. “To enter another winter without this change would be potentially disastrous for the local health economy,” it said.

Administrators claimed the fragility of services at Mid Staffordshire “even in the short term… [was] an unsustainable position with potentially significant consequences for the surrounding trusts, in particular [The Royal Wolverhampton Hospitals Trust, University Hospital of North Staffordshire Trust, and Walsall Healthcare Trust] should any unplanned reductions in services at Stafford be necessary”.

The FT is due to be dissolved with services at Stafford Hospital transferred to the University Hospital of North Staffordshire Trust. Cannock Hospital is to be taken over by Royal Wolverhampton Hospitals Trust.