• Number of trusts receiving top NHS Improvement rated dropped by 14 per cent since October 2016
  • 17 trusts have seen their rating drop, 18 have seen it improve
  • The trusts that have either entered or exited the worst rating of four closely align with the CQC’s special measures regime

The number of trusts and foundation trusts given the top rating under NHS Improvement’s performance framework has dropped by 14 per cent in eight months, analysis shows.

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

TrustSectorRegion nameSegmentation in Oct 2016Segmentation in May 2017
Isle Of Wight NHS Trust Acute South 3 4
Kettering General Hospital NHS Foundation Trust Acute Midlands and East 3 4
Northern Lincolnshire and Goole NHS Foundation Trust Acute North 3 4
St George’s University Hospitals NHS Foundation Trust Acute London 3 4
United Lincolnshire Hospitals NHS Trust Acute Midlands and East 3 4
University Hospitals Of North Midlands NHS Trust Acute Midlands and East 3 4
Shropshire Community Health NHS Trust Community Midlands and East 2 3
2Gether NHS Foundation Trust Mental Health South 1 2
Birmingham Women’s and Children’s NHS Foundation Trust Specialist Midlands and East   2
Cambridgeshire and Peterborough NHS Foundation Trust Mental Health Midlands and East 1 2
Frimley Health NHS Foundation Trust Acute South 1 2
Nottinghamshire Healthcare NHS Foundation Trust Mental Health Midlands and East 1 2
Oxford Health NHS Foundation Trust Mental Health South 1 2
Queen Victoria Hospital NHS Foundation Trust Specialist South 1 2
South Essex Partnership University NHS Foundation Trust Mental Health Midlands and East 1 2
Western Sussex Hospitals NHS Foundation Trust Acute South 1 2
Worcestershire Health and Care NHS Trust Mental Health Midlands and East 1 2

Trusts whose  NHS Improvement rating has improved

TrustSectorRegion nameSegmentation in Oct 2016Segmentation in May 2017
5 Boroughs Partnership NHS Foundation Trust Mental Health North 2 1
Devon Partnership NHS Trust Mental Health South 2 1
South Central Ambulance Service NHS Foundation Trust Ambulance South 2 1
South London and Maudsley NHS Foundation Trust Mental Health London 2 1
The Royal Marsden NHS Foundation Trust Specialist London 2 1
City Hospitals Sunderland NHS Foundation Trust Acute North 3 2
East Lancashire Hospitals NHS Trust Acute North 3 2
Leeds Community Healthcare NHS Trust Community North 3 2
Taunton and Somerset NHS Foundation Trust Acute South 3 2
University Hospital Of South Manchester NHS Foundation Trust Acute North 3 2
Yorkshire Ambulance Service NHS Trust Ambulance North 3 2
Barking, Havering and Redbridge University Hospitals NHS Trust Acute London 4 3
Cambridge University Hospitals NHS Foundation Trust Acute Midlands and East 4 3
Croydon Health Services NHS Trust Acute London 4 3
Medway NHS Foundation Trust Acute South 4 3
Norfolk and Norwich University Hospitals NHS Foundation Trust Acute Midlands and East 4 3
North Cumbria University Hospitals NHS Trust Acute North 4 3
Sherwood Forest Hospitals NHS Foundation Trust Acute Midlands and East 4 3
Wye Valley NHS Trust Acute Midlands and East 4 3