More failing hospitals 'likely to be found'

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

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More hospitals in England are likely to be put in special measures, the health secretary has said as he unveiled the rescue plan for failing trusts.

Jeremy Hunt said the new inspection regime, which began its roll-out this week, would identify more trusts that needed turning around.

His comments came as he set out what support was being given to the 11 trusts already put in special measures.

Managers from top NHS hospitals are to be sent in to lend support.

Andrew Gwynne: "This is not the whole solution. We need to support nurses, clinicians, and support staff"

Bonus payments - from a pot totalling £5.5m - will be available to the successful trusts if standards are raised at failing sites, in a move that echoes the "super-heads" scheme for schools.

Mr Hunt said there were a "handful of inspirational leaders... anxious to help".

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

Instead, the buddy scheme would last between three to five years, and although he acknowledged the risk of diverting successful managers from their own hospitals, he said that managers' posts would be back-filled.

'Biggest challenges'

But he admitted solving the problems would be difficult.

"Turning around our failing hospital is perhaps one of the biggest challenges we are facing today.

"It is entirely possible, even likely, other hospitals will have to go into special measures," he added.

Analysis

The 11 trusts in special measures have some common problems that with the help of the star performers in the system should be brought under control.

These include things such as staff shortages, poor IT systems and a lack of clear strategic thinking.

But for some - perhaps most of these trusts - the worry is that such changes will only take them so far.

You do not have to look far to see the major similarity between the failing trusts. They are mostly small, or at best, medium-sized district general hospitals.

Many argue that model is outdated and the future of care lies in larger, super centres - something the successful partner organisations could all claim to be.

The risk now is that the buddy scheme could once again delay attempts to radically overhaul the hospital network.

Dame Julie Moore, chief executive of University Hospitals Birmingham, is one of the managers taking part.

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, particularly over IT, she said.

She added her organisation would have no problem attracting good managers to help plug the gaps.

The 11 trusts were placed in special measures after a review by NHS medical director Prof Sir Bruce Keogh, which found evidence of patients being left unmonitored, backlogs in complaints and poor maintenance of operating theatres.

The review looked at the standard of care at the 14 trusts with the worst death rates, following the Stafford Hospital scandal.

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.

'Huge potential'

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 partnered with 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

Steve Jamieson told the BBC that the College of Royal Nursing welcomed the government's new initiative

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."

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."

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