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Eleven NHS trusts under special measures

Eleven NHS hospital trusts in England are to be put under special measures for “fundamental breaches of care”, the health secretary Jeremy Hunt has said.

Among 14 investigated for high death rates, 11 had sufficient problems for special measures which would “tackle and confront mediocrity and inadequate leadership head on”.

The other three trusts investigated were also told to make improvements following the review. But the health secretary said investigators had confidence the leadership at those trusts was capable of making the changes needed.

As part of the process of special measures for the other 11, teams of external experts will be sent into the organisations to work with the senior management team.

The trusts are Basildon and Thurrock University Hospitals NHS Foundation Trust; Buckinghamshire Healthcare NHS Trust; Burton Hospitals NHS Foundation Trust; East Lancashire Hospitals NHS Trust; George Eliot Hospital NHS Trust; Medway NHS Foundation Trust; North Cumbria University Hospitals NHS Trust; Northern Lincolnshire and Goole Hospitals NHS Foundation Trust; Sherwood Forest Hospitals NHS Foundation Trust; Tameside Hospital NHS Foundation Trust; and, United Lincolnshire Hospitals NHS Trust.

Among the problems identified were patients being left on trolleys, unmonitored for excessive periods and then being talked down to by consultants; patients often being moved repeatedly between wards without being told why; staff working for 12 days in a row without a break; low levels of clinical cover – especially out of hours.

The investigation into the 14 trusts was launched earlier this year following the public inquiry into the Stafford Hospital scandal, which said the public had been betrayed by a system which put “corporate self-interest” ahead of patients.

The trusts were identified as they had the highest death rates in 2010-11 and 2011-12.

The probe has been led by NHS England’s medical director Prof Sir Bruce Keogh and focused on whether the figures indicated sustained failings in the quality of care and treatment at the trusts.

Sir Bruce said: “Not one of these trusts has been given a clean bill of health by my review teams. These reviews have been highly rigorous and uncovered previously undisclosed problems.

“I felt it was crucial to provide a clear diagnosis, to write the prescription, and, most importantly, to identify what help these organisations might need to support their recovery or accelerate improvement.

“Mediocrity is simply not good enough and, based on the findings from this review I have set out an achievable ambition which will help these hospitals improve dramatically over the next two years.”

Nine foundation trusts were chosen for the review on the basis of higher than average mortality rates. Five of those trusts were already in special measures imposed by the regulator Monitor for breaches of the FT licence. Three of the FTs didn’t warrant special measures.

Basildon and Thurrock University Hospitals is already in special measures, and has a new leadership team that is addressing the issues raised by the Keogh review. Monitor believes the improvements requested by the Keogh team can be delivered through existing measures and so no further enforcement action is proposed here.

Medway, Burton, Sherwood and Tameside are also already in special measures but Monitor judged that further intervention is needed in each case. These trusts are being asked to accept binding undertakings that they will deliver the Keogh action plan by a set date.

David Bennett, chief executive of Monitor, said: “The Keogh review has identified a number of serious issues at these foundation trusts, and we are taking appropriate action to ensure they are fixed as quickly as possible.

“These inspections will inform the future work of the new Chief Inspector of Hospitals, and we look forward to working closely with Prof Mike Richards and his new team at the Care Quality Commission to get prompt warning of emerging problems with patient care or hospital governance in future.”

Sir Richard Thompson, president of the Royal College of Physicians, commented: “It is clear that parts of the system must change to better meet patients’ needs. The NHS is struggling to cope with increasing pressures on acute services, patients with increasingly complex needs, and a breakdown of out-of-hours care.

“Patients deserve high quality care that meets all of their needs. To achieve this, both the system and patient care pathways must be designed around patients’ needs. Current services no longer meet the needs of patients; we are trying to fit around outdated systems. Patients’ demands have changed and so our hospital services must change.”

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