NHS providers with even small deficits or which get their financial forecasting wrong risk being placed “under review” through the Department of Health’s new criteria for its failure regime.
The regime – published last year and now part of the Health Bill currently going through Parliament – sets out how a failing NHS organisation would be deemed “underperforming”, triggering a process which could see them taken over and potentially broken up by the DH.
The criteria is made up of the 13 financial indicators and 21 quality and patient safety indicators, which trusts will be measured on each quarter. Indicators are given different weights with targets such as A&E waiting times and MRSA rates among the most significant of the quality and patient safety indicators and actual and forecast end-of-year financial positions the most important indicators on the finance front.
The maximum possible score under quality and patient safety is 16 and trusts will be considered to be out of the failure category once they reach three.
Scores of between 2.1 and 2.4 will mean they are put under review and scores of less than 2.1 will be deemed “underperforming”. A trust could score a three by having no MRSA and no C dificile cases, and meeting one of the main waiting time targets such as 18 week referral to treatment.
There is much less scope for trusts to miss the implicit targets set in the financial criteria as the maximum score is three and trusts must similarly score over 2.4 to avoid being put “under review”.
A trust with a healthy surplus, but with poor forward planning and forecasting and which was slow to pay bills and receive payments could still be moved into the “under review” category. A trust with a deficit or unable to repay loans due to a lack of cash flow would be automatically deemed as “underperforming”.
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