The Care Quality Commission has warned 47 NHS trusts that they must improve significantly over the next year to be allowed to register with the health regulator and avoid sanctions.
On releasing the 2008/2009 performance ratings for of all 392 NHS trusts in England, the regulator said it would be focusing on improving the standards at persistently under performing trusts (see list below).
The ratings, which are developed from information provided by trusts, inspections and audits, reveal a mixed picture.
More patients were seen in A&E within four hours, more received treatment within 18 weeks of referral and more were screened for chlamydia. There were also big reductions in the number of MRSA and Clostridium Difficile cases, and improvement in the financial management of trusts.
Trusts are given ratings from ‘weak’ to ‘excellent’ based on how they score on quality of care and financial management.
Fewer trusts scored ‘excellent’ for the quality of their care compared with last year’s figures. The drop in ratings was worst among acute hospital trusts.
Cynthia Bower, CQC chief executive, said: “The NHS has performed well on quality, which is good news in the face of a rigorous assessment. But it is clear that some trusts are struggling and that some issues are proving tough nuts to crack.
“My biggest concern is those trusts that are ‘weak’ and persistently ‘weak’ or ‘fair’. They must do better for their patients.
“I want to ring the alarm bell in the boardrooms of these organisations. Next year, all trusts must register with us to legally function. It is clear that many have significant work to do and a short time in which to do it.”
Next year, all trusts will have to register with the CQC to be allowed to legally function. They will have to meet basic standards in order to achieve this.
CQC said compliance with core standards is a good indication of whether a trust is ready for registration. Overall compliance with standards increased from 95% to 96%. However, compliance with fully meeting all core standards in the acute sector fell from 69% last year to 59% this year.
If trusts fail to reach those benchmarks the regulator can impose a range of sanctions including prosecution and closing a service down.
Niall Dickson, chief executive of the Kings Fund, said: “The worry is the 32 trusts who year after year fail to meet these standards. Unfortunately, the ratings on their own do not shed light on why some trusts perform well and others do not.
“Patients served by the hospitals and other services that consistently rank at the bottom have a right to know why these organisations are not providing the quality of services that is expected from them. We need to understand whether the problems are managerial or structural, and what is being done to help them raise their game.”
NHS Confederation chief executive, Steve Barnett, said: “It is extremely heartening to see that for the first time ever, more than 100 trusts scored excellent for financial management - at the same time it is concerning that some continue to experience performance issues.
“With the NHS entering the most demanding period of financial pressure in its history the reasons for this need to be understood if the performance of the best trusts is to be reflected across the whole of the system.”
Read more on the ratings.
The 47 organisations in the following two lists face a tough challenge to meet the requirements of the CQC’s new registration system (five appear on both lists).
Trusts rated ‘weak’ on quality
Royal Cornwall Hospitals NHS Trust
Maidstone and Tunbridge Wells NHS Trust
West London Mental Health NHS Trust
Mid Staffordshire NHS Foundation Trust
Great Western Ambulance Service NHS Trust
Yorkshire Ambulance Service NHS Trust
Royal West Sussex NHS Trust
The Dudley Group of Hospitals NHS Foundation Trust
Redbridge Primary Care Trust
Cumbria Partnership NHS Foundation Trust
South West London and St George’s Mental Health NHS Trust
South Central Ambulance Service NHS Trust
North Bristol NHS Trust
Barking, Havering and Redbridge Hospitals NHS Trust
Barts and the London NHS Trust
Havering Primary Care Trust
Tower Hamlets Primary Care Trust
Barking and Dagenham Primary Care Trust
Coventry and Warwickshire Partnership NHS Trust
Worcestershire Mental Health Partnership NHS Trust
Trusts that have never scored above ‘fair’ for quality and finance
Barking, Havering and Redbridge Hospitals NHS Trust
Bedfordshire Primary Care Trust
Buckinghamshire Primary Care Trust
Cambridgeshire Primary Care Trust
East and North Hertfordshire Primary Care Trust
East Sussex Downs and Weald Primary Care Trust
Enfield Primary Care Trust
Great Western Ambulance Service NHS Trust
Havering Primary Care Trust
Hillingdon Primary Care Trust
Hounslow Primary Care Trust
Hull Teaching Primary Care Trust
Leeds Teaching Hospitals NHS Trust
Lewisham Primary Care Trust
Luton Primary Care Trust
Maidstone and Tunbridge Wells NHS Trust
Norfolk Primary Care Trust
North Lancashire Teaching Primary Care Trust
North Staffordshire Primary Care Trust
North Yorkshire and York Primary Care Trust
Royal Cornwall Hospitals NHS Trust
Royal National Orthopaedic Hospital NHS Trust
Sandwell Primary Care Trust
Scarborough and North East Yorkshire Health Care NHS Trust
Stoke On Trent Primary Care Trust
Surrey and Sussex Healthcare NHS Trust
Surrey Primary Care Trust
Waltham Forest Primary Care Trust
Warwickshire Primary Care Trust
West Hertfordshire Primary Care Trust
West Kent Primary Care Trust
Wiltshire Primary Care Trust
Interesting list! Why are some ‘poor’ Trusts given Foundation status? And either some ‘centers of excellence’ are far from excellent, or the ‘rating system’ is not showing a proper reflection of the standard of care.
Retired Orthopaedic Surgeon