Monitor investigates major London trust

King’s took over PRUH in 2013 after the dissolution of South London Healthcare Trust. It was agreed that King’s would receive £192m of transitional support over the five years following the takeover; however the trust has already seen its costs increase through making improvements at the hospital.

It recently received £10m from the NHS Trust Development Authority, according to its January board papers.

HSJ reported last month that the trust had appointed a turnaround director to tackle its finance and performance issues.

Monitor has concerns that patients are waiting too long for accident and emergency treatment and routine operations, and over the trust’s £42.5m deficit.

The regulator says the decline in the trust’s operational and financial performance comes after having to make unexpected urgent improvements to the quality of care at PRUH.

These improvements include increasing the nurse-to-patient ratio by recruiting 260 new nurses, which has contributed to its large deficit.

It also has high spending on agency staff because of a large number of vacancies.

The trust has struggled to meet the four hour accident and emergency target for over a year. It also has one of the largest backlogs of patients waiting over 18 weeks for elective treatment.

The trust said that problems with the financial and operational performance of the hospital were “greater than anticipated”, and it has been working with Monitor over the last few months to determine the best way to resolve these. 

Mark Turner, regional director at Monitor, said: “King’s has been working hard to improve the quality of care provided at [PRUH], but it is clear that the challenge is much greater than originally anticipated.

“Our investigation will help us decide what resources and support King’s needs to deal with its financial problems and reduce waiting times for patients.”

Trust chief executive Tim Smart said: “We have made every effort to improve the quality of care at PRUH and we are proud of what our hardworking staff across all sites have achieved over the last 18 months.

“However, the underlying financial and operational challenges we inherited when we acquired the hospital have proven greater than was anticipated at the time. We have been working closely with Monitor for some months to try and resolve these issues, and we welcome the decision by Monitor to launch a formal investigation so that we can establish solutions to these challenges.”

At a Commons health select committee hearing in December, Monitor chief executive David Bennett cited King’s as an example of a successful trust that could struggle following a takeover.