Failing hospitals: Is the glass half-full or half-empty?

Jug of water

Health Secretary Jeremy Hunt's glass was certainly half-full when he gave an update on Wednesday on how the special measures regime for failing hospitals has worked out.

A year to the day since the first 11 were placed in the failure regime, he said he was encouraged hospitals were on the "road to recovery".

Five of the 11 have come out of special measures or are in the process of doing so. But is that really a story of success?

After all, three of those - East Lancashire, Buckinghamshire and North Lincolnshire / Goole - are continuing to get support from the wider system and are being kept under a watchful eye by inspectors.

And if you look at Basildon and Thurrock Trust - one of the two that is fully out - the picture is still not straight-forward. It actually escaped special measures after an inspection in March led to it being given a good rating, with its maternity services becoming the first in the country to be rated as outstanding. That is just eight months after it was placed into the failure regime. A remarkable turnaround you may think? Not quite.

Early days

The trust was already well on the way to addressing the problems when the announcement was made last July. A new chief executive, Clare Panniker, had been in place since the autumn of the year before and extra staff, and new governance arrangements were being put in place.

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She told me special measures had helped the trust address the problems by giving people a "licence to talk" and giving greater transparency about the problems, but it is clear the improvement journey had already started by the time Mr Hunt stood up in the House of Commons last summer to list the trust's failings.

Of the remaining six trusts, we are yet to hear anything about two, while there are signs of improvement at three, but obviously not enough to warrant escaping special measures.

However, in the case of one - Medway Maritime Hospital in Kent - there seems to have been little improvement. It was given an inadequate rating less than a week ago, with inspectors noting there were still too few junior doctors and nurses on duty and raising serious concerns about the quality of surgery and A&E.

This is not to say that special measures has no role to play - it has been widely welcomed by those inside and outside the health service - but at this stage it seems too early to tell just how effective it is.

Since the first 11 trusts were put into special measures, another six have followed suit - and the Care Quality Commission still has 60% of England's hospitals to inspect. The process is barely half-way through, no wonder it is hard to tell whether the glass if half-full or half-empty.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 101.

    "even more
    dishonesty &

    Fear so. Whichever party or coalition accepts or takes power, what is left of the idea & structure of the NHS, the circulation of talent & trained skills to meet need as well as some insurance against worse in private practice, the arms-length dealing between public & private sectors ever more compromised, in NEITHER of supposed 'two tiers' the ideal.

  • rate this

    Comment number 100.

    79. imemomeme

    Those involved in PFI have a cup that overfloweth.


    Indeed. These PFI contracts are crippling the NHS and were largely the creation of the Caledonian half wit who liked them because he could keep so much more debt off balance sheet and pretend things were much better then they were.

    Return Labour next year and we will get even more of this dishonesty and incompetence.

  • rate this

    Comment number 99.

    Part of the trouble with much of the PFI is that we will have just about paid it off when we need a new hospital. Ours has been open about 3 years, cost around £290m to build and will be costing us between £40m and £90m a year for the next 30 years. Oh and it doesn't have enough dialysis equipment.

  • rate this

    Comment number 98.

    Oracle @96
    "fair enough?"

    No. Post-war leaders did what they could, nationalising without securing equal partnership, in the NHS not even securing normal management-employee relations, leaving hospital consultants free to spend a tenth of their time seeing a third of their patients 'privately', NHS to pay for their other activities, teaching, training and 'service management': vive la différence!

  • rate this

    Comment number 97.

    We seem to be in a position where the General Public have a choice.
    The choice is do we want affordable HEALTH CARE ..or a system that helps people make lots of money.
    Bit like buying a Train Fare or a commercial TV subscription.
    Or any other product>

  • rate this

    Comment number 96.

    92.alan "The NHS doesn't have to do everything itself."

    That sounds fair enough, but where is the line drawn? I am guessing that the Tories believe private can do all of it better and cheaper.Our everyday observations of private failure should tell us that it isn't always better.PFI has turned out to be a very expensive way of running the NHS and Osborne has just given the go ahead for 1 in B'ham

  • rate this

    Comment number 95.

    Hospitals in England are managed by acute trusts; there are 160 acute trusts in England. A year ago 11 hospitals (trusts?) were placed in the failure regime.

    Given that there appears in some political parties a inclination towards private health care, how is the state of private health care in the UK?

  • rate this

    Comment number 94.

    alan @92
    don't exist for
    those who work"

    Yet, as an economist, you will know that without agreed equal partnership in our nation as such, without security of belonging (equal participation in profit or loss & debt), we all are dependent on our income sources, on our contracts for employment or fee or dividend; our defences of relative value inevitably made part of an unseemly industry.

  • rate this

    Comment number 93.

    Yea sure the NHS fail on many levels but its really not hard to see why... its not the services themselves that fail but the increasing demand on them... The NHS is limted to how much it can work to demand and the government cuts, etc dont help matter - I for one am saying the NHS does well with what its got even if it doesnt live to the high standards people want it too.

  • rate this

    Comment number 92.

    anth smith@85
    The NHS doesn't have to do everything itself.
    If some jobs can be contracted out to a private contractor who do them more effectively and efficiently for less cost, then the patient and the taxpayer benefits.
    Some workers don't of course but hospitals don't exist for the benefit of people who work in them.

  • rate this

    Comment number 91.

    Random advice@82
    Depends on the definition of failing.
    I am sure that many patients treated in a "failing" hospital receive good care but obviously some don't.
    My daughter went to a "failing" school but still got into Oxford University.
    Most hospitals of course aren't "failing" - just like schools.

  • rate this

    Comment number 90.

    Someone mentioned the Dutch system - well many years ago, whilst pregnant I ended up in an Amsterdam hospital. There was only one other patient around. At first I thought 'if only this were the UK'. However, the length of time it took them to find the baby's heartbeat just showed that they needed more patients to practice on. Perhaps there is something to be said for busy waiting rooms!

  • rate this

    Comment number 89.

    AliBen @80

    In government & sweeping wards: "Who else to blame?"

    Except 'we' do not employ as we think. 'We' do not exist without equal partnership. We (in mass self-deception) work NOT 'to be our best' for the common good, to play our part, but above all 'for ourselves' to survive, gently to jostle or fiercely to trample, for the sake of family and pension, to get ahead of our fears.

  • rate this

    Comment number 88.

    @30. Steve
    "This is what happens when you let Jeremy Hunt MP run a major civil service department. PM missed a chance to sack another one of his useless mini-brain colleagues
    Mr Hunt could not organise a proverbial extended drinking session in a brewery."

    Jeremy Hunt has a brain!?!?! Could have fooled me....

  • rate this

    Comment number 87.

    Where NHS failings are met, especially repeated, they must be counted not just of individuals but of contexts, not just of Trusts but of governments. Living in, and colluding in, the perpetuation of rule by fear and greed, the fault to be drawn is not just in our leaders or parties, but in society as a whole, 'united' in wanting not civic equality, but merely 'more' - a little or a lot - for self.

  • rate this

    Comment number 86.

    Brave it can be, even 'by the dozen', for those who were not there, even with full panoply of witnesses & police evidence, testing by prosecution & defence advocates, judicial summing & guidance, to arrive at 'the truth' of even a single 'NHS incident', let alone 'the quality' of a Trust, or numbers of Trusts, or the whole NHS; unless to see context in fear, greed & corruption. Brave or foolhardy?

  • rate this

    Comment number 85.

    @80 aliben sawali
    You obviously do not work in the health service, do not have a clue.
    A vast no of people in NHS trusts work for private companies under contract..
    Cleaning is done by contracted people on minimum wage.
    Maintenance done by contractors.
    Nursing banks private.
    Private sector is bleeding NHS dry.
    There is V little public sector left even in what we call the NHS.

  • rate this

    Comment number 84.

    Americans spent 20% of their GDP on healthcare whereas the UK spends 9%.
    Yet we live longer, have a lower infant mortality rate and are much healthier.

  • rate this

    Comment number 83.

    Money is being poured into private contractors by overpaid managers and commissioners. The NHS spends funds on defence of poor service rather than commit funds to care. Its finished, too many snouts at the trough.

  • rate this

    Comment number 82.

    How can we have the best healthcare in the world at the same time as we have failing hospitals?

    It is as about as believable as a cost of living crisis in an obesity epidemic!


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