PERFORMANCE: Greater Manchester’s hospitals could share responsibility for meeting cancer hospital the Christie’s 62 day waiting target, under a deal proposed by the government’s cancer tsar.
The proposal came after the foundation trust’s chair wrote to care services minister Paul Burstow saying the hospital faced being red rated for governance by regulator Monitor on the basis of the “completely flawed” target.
Jim Martin argued that other hospitals - from which the Christie Foundation Trust receives most of its referrals - were leaving the cancer specialist with just 10 or 12 days to complete treatment.
On 28 January, national clinical director for cancer Sir Mike Richards held a summit with the Christie, Greater Manchester and Cheshire cancer network, and NHS North West to offer the hospitals a risk sharing deal.
He proposed that greater Manchester should monitor the point at which patients were referred to the Christie by other hospitals. If the patient was referred by the 38th day from first referral, the Christie would take responsibility for meeting the target - if it was after that point, any breach would sit with the referring hospital. The Christie would still have to do everything it could to treat all patients within 62 days.
Sir Mike told HSJ: “I would very much expect that, as a result of this, performance reported for the Christie will improve, and that therefore there will be no need for them to be red rated.”
The proposal came after an “extensive analysis” by Sir Mike’s office of the situation in greater Manchester, which began following an earlier appeal by the Christie. It found that “performance against the 62 day standard is poor for that whole network”, at just 83.5 per cent, compared with almost 87 per cent across the country as a whole, he said.
He added that if there was a league table” of performance against the target, Greater Manchester would be “towards the bottom”. The area had a “very centralised model” of cancer care, with a higher proportion of patients referred on to tertiary hospitals, which was known to make it more difficult to hit this target.
Professor Richards said there was unanimous support for his approach at the summit, and NHS North West was now sharing his report with the commissioners and hospitals that were not present. He said the meeting agreed that the deal would have to be finalised before 31 March.
The Christie’s performance against the target between October and December was 65.8 per cent, against a target of 79 per cent, according to its January board papers.
Monitor gave the trust an amber-red rating for the second quarter of 2010-11 and there were concerns it would be marked down further on the basis of the 62 day target.
But a spokesman for the regulator said it had “some discretion” to take mitigating factors into account when deciding a foundation trust’s risk ratings.
He said Sir Mike had reported to the regulator on the meeting, and it would be “considering” his feedback and submissions from the trust when deciding on its quarter three ratings, which are due in March.