Rescue plan for failing hospitals

Written By Unknown on Kamis, 19 September 2013 | 16.50

19 September 2013 Last updated at 05:12 ET By Nick Triggle Health correspondent, BBC News
Health Secretary Jeremy Hunt

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Health Secretary Jeremy Hunt: "People who have led our best all-round hospitals are the perfect people to help"

Managers from top-performing NHS hospitals are to be sent into failing ones in England to try to improve them.

Bonus payments will be available to trusts if standards are raised at failing sites, in a move that echoes the "super-heads" scheme for schools.

Health Secretary Jeremy Hunt said there were a "handful of inspirational leaders" who were "anxious to help".

Labour said what the hospitals needed was more nurses on the ground.

Eleven trusts were put in special measures in July following a review into trusts with high death rates. They are now being twinned with more successful hospitals.

'Anxious to help'

Mr Hunt said that management consultants had been favoured in the past, but they had only identified problems - rather than solving them.

He told BBC Radio 4's Today programme: "The problem is making actual changes on the ground.

"Generally, successful hospitals attract good people and we are looking to find a way to get these good people to other hospitals."

Though he acknowledged the risk of diverting successful managers from their own hospitals, he said that managers' posts would be back-filled.

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If you look at the Mid-Staff inquiry... there wasn't a lot of refreshing of the clinical staff there"

End Quote Dame Julie Moore University Hospitals Birmingham chief executive

He added: "These people are anxious to help us turn around these failing hospitals, they want to play their part."

Dame Julie Moore, chief executive of University Hospitals Birmingham, is one of the managers expected to take part. University Hospitals Birmingham has been partnered with two trusts: George Eliot and Burton hospitals.

She told the BBC: "I don't think we're talking about upping sticks and abandoning our home base."

Instead, the plan would be more focused on around sharing knowledge and expertise, she said.

Dame Julie added there was a "dying breed of smaller isolated hospitals" which did not have the infrastructure and flow of new staff that larger, more modern hospitals had.

She added: "If you look at the Mid-Staff inquiry... there wasn't a lot of refreshing of the clinical staff there.

They were relatively isolated - not only geographically but they didn't have the kind of constant flow through of new doctors, new nurses, new physios... and all the rest of it that keep ideas fresh, and keeps people reminded of what good looks like now - in this day and age - rather than what it looked like when they qualified."

'Huge potential'

The 11 trusts were placed in special measures after a review by NHS medical director Prof Sir Bruce Keogh. The review looked at the standard of care at the 14 trusts with the worst death rates, following the Stafford Hospital scandal.

The 11 trusts in special measures have been given the following partners:

  • North Cumbria University Hospitals NHS Trust (Cumberland Infirmary and West Cumberland) - to be partnered with Northumbria
  • Northern Lincolnshire and Goole Hospitals NHS Foundation Trust (Diana, Princess of Wales Hospital, Goole and District Hospital and Scunthorpe General) - partner trust to be confirmed
  • Tameside Hospital NHS Foundation Trust - to be partnered with University Hospital of South Manchester NHS Foundation Trust
  • United Lincolnshire Hospitals NHS Trust - being managed by Sheffield Teaching Hospitals NHS Trust
  • Basildon and Thurrock University Hospitals NHS Foundation Trust - to be partnered with the Royal Free London NHS Foundation Trust
  • Burton Hospitals NHS Foundation Trust - to be partnered with University Hospitals Birmingham NHS Foundation Trust
  • East Lancashire Hospitals NHS Trust - to be partnered with Newcastle-upon-Tyne Hospitals NHS Foundation Trust
  • George Eliot Hospital NHS Trust - to be partnered with University Hospitals Birmingham NHS Foundation Trust
  • Sherwood Forest Hospitals NHS Foundation Trust - being partnered with Barnsley Hospital NHS Foundation Trust (specifically on complaints)
  • Buckinghamshire Healthcare NHS Trust - to be partnered with Salford Royal NHS Foundation Trust
  • Medway NHS Foundation Trust - partner trust to be confirmed

Prof Chris Ham, chief executive of the King's Fund think tank, said: "Bringing in experienced NHS managers has huge potential as long as they are given enough time to bring about change and have enough resources, and, crucially, their own hospitals are able to have the right leadership while their focus is elsewhere."

He added that previous attempts to use the skills of managers at successful trusts had led to performance at those organisations being dragged down as hospitals were "much more complex than schools".

He said: "We've got to get the detail right - it's got to be a long-term objective.

"In principle if we get it right, it will level up standards, if we get it wrong it could level down standards."

'Management solution'

Shadow health minister Jamie Reed said: "This is a management solution, not a front-line solution.

"What Keogh revealed was that many of these trusts have lost staff in recent years and what they need is more nurses on the ground."

Mr Hunt agreed that understaffing was "one of the problems" in these hospitals. However, he insisted: "It's not just that, it's about leadership, culture, training... To get that right you need to have the right people leading the hospital."

Among the problems identified by Sir Bruce were:

  • patients being left on trolleys, unmonitored for excessive periods
  • poor maintenance in operating theatres, potentially putting patients in danger
  • patients often being moved repeatedly between wards without being told why
  • staff working for 12 days in a row without a break
  • backlogs in complaints

But Sir Bruce said while the failings were significant they had found nothing on the scale of the Stafford Hospital, where hundreds suffered neglect and abuse.


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