Analysis: Fall in number of trusts top-rated by NHS Improvement

Last October, each trust was placed in one of four categories based on the level of support they required from NHS Improvement. The segmentation formed part of the regulator’s Single Oversight Framework, which affects how they are regulated.

NHS Improvement’s most recent updated list of ratings shows 30 trusts have been given the top rating of ‘one’ for care quality, operational and financial performance, compared to 35 last year.

There has also been a small improvement in those placed in the worst category, four. Twenty trusts are in this category - which means they have very serious or complex issues - compared to 22 in September last year when the data was first published.

Overall 17 trusts have received a worse rating in the latest round compared to the first, while 19 have improved. No trust has seen their rating rise or fall by more than one segment.

All the six trusts that have dropped from segment 3 to 4 have also been placed in CQC special measures since September 2016, bar one, University Hospitals of North Midlands Trust. The CQC last inspected this hospital in 2015 and rated it requires improvement. It has however confirmed to HSJ that it is planning another inspection of the trust in the future but cannot confirm a date as it will be an unannounced inspection.

Of the eight trusts that have seen their rating raised from four to three, again all of them except for one have also come out of CQC special measures since the single outcome framework programme was first implemented.

The exception, Croydon Health Services NHS Trust, was rated requires improvement in October 2015 and hasn’t been re-rated since, although the CQC confirmed that it too will have an unannounced future inspection. The trust has never been placed in special measures.

Two trusts have also been newly formed since the first tranche of data was published in October.

The newly created Birmingham Women’s and Children’s NHS Foundation Trust has been rated two overall, which is a fall from category one for Birmingham Children’s Hospital NHS Foundation Trust’s one rating. Birmingham Women’s NHS Foundation Trust was rated two prior to the merger.

Hinchingbrooke Health Care NHS Trust and Peterborough and Stamford Hospitals NHS Foundation Trust were both rated three prior to their merger into North West Anglia NHS Foundation Trust. The newly formed trust is also rated three by NHS Improvement.

A spokesman for NHS Improvement told HSJ that the regulatory regular updates a trust’s SOF segmentation as part of its ongoing regulatory work, but this latest data publication is the first since the first week of the 2017-18 financial year and the latest round of trust’s placed in CQC special measures.

Each trust is given a single outcome framework segmentation number according to the level of support the trust is deemed to need.

To decide which category to place each trust in, NHS Improvement reviews providers across five themes: quality of care; finance and use of resources; operational performance; strategic change and leadership and improvement capability.

Segement one is for trusts where there is no support needs identified, two is for providers that may NHS Improvement suggest may need support in one or more of the above themes. Those in sectors three and four are receiving mandated support for significant or serious concerns.

Trusts whose NHS Improvement rating has fallen

Trusts whose  NHS Improvement rating has improved