Lansley talks tough on failing hospitals
pharmafile | October 27, 2011 | News story | Medical Communications | Andrew Lansley, NHS reforms
The health secretary Andrew Lansley says he will intervene to remove management boards of hospitals which can’t clear debts or are putting patient safety at risk.
The hard line message was delivered in a speech to a meeting organised by think tank Reform, and is intended to prevent a repeat of the scandal at Stafford General Hospital, part of the Mid Staffs NHS Foundation Trust.
An estimated 400 patients died unnecessarily between 2005 and 2008 because of neglect and poor clinical standards, and a final report by the independent inquiry is expected by early 2012.
Lansley said: “Where things are going wrong and patients are being repeatedly put at risk, we will not stand by. We will not wait on a repeat of a scandal like Stafford General.”
The 2009 Health Act, passed by the former Labour administration gives the government authority to remove a foundation trust deemed to be an ‘unsustainable provider’ but the powers have not yet been used.
Lansley added: “I will not flinch from using it if NHS trusts are clearly failing patients or failing financially. So my message today is this – wherever there are pockets of poor performance, we will root it out, where there are institutions that are letting patients down or are financially unsustainable, we will expose them.”
Fears that other hospitals and care institutions were endangering patients were confirmed earlier this month when regulator the Care Quality Commission made 100 unannounced visits to hospitals.
The CQC focused on dignity and nutrition standards, and found concerns in 55 cases, describing its findings as ‘alarming’.
The care watchdog will now make a further 700 unannounced inspections in hospitals, learning disability services care homes to identify and drive out poor care, and has the power to order closure of services if they are deemed unacceptable.
Patient safety and reform
The efforts to reinforce safety coincide with the coalition government’s massive reform of the NHS in England. The Health and Social Care Bill doesn’t focus on patient safety, but Lansley says its greater emphasis on patient involvement, clinical leadership and transparency about performance will all support safety.
However there are many critics who fear the scale of the reforms – coinciding with a drive to save £20 billion over four years – will destabilise many parts of the NHS.
Financial problems
Lansley also unveiled plans to give one-off loans to foundation trusts which are struggling financially – but only if they are judged to be unfairly burdened with historic problems, and doing all they can to clear the debt themselves.
The health secretary said the new loan system would end a culture of bails outs of failing hospitals.
“No more sticking plaster solutions, no more back room solutions,” he promised.
The majority of NHS trusts are now foundation trusts – a total of 137 – but a further 116 have yet to gain the status, in most cases because of poor financial performance.
Lansley says the Department of Health wants to work with the remaining trusts to help them become foundation trusts, but has now threatened to remove management teams who fail to meet agreed deadlines.
“Sometimes the problems rest with the hospital management team, unable or unwilling to take the difficult decisions to turn things around. I am afraid for them I have a warning,” he said.
“If your hospitals are not there by the time you say, you are not getting there at all. The Secretary of State has the power to remove and replace management teams that fail to deliver, and I will not hesitate to use that power if needed.”
This signals a shift in tone regarding the health secretary’s level of intervention in the NHS. Lansley had originally insisted that he would remove himself from the running of the health service, but many – including coalition partners the Lib Dems – have pushed for reassurances that the minister would remain accountable for NHS performance.
The Health and Social Care Bill is now expected to be amended in the Lords to reinforce the health secretary’s responsibility, with Lansley’s talk of intervention backing this up further.
The government is also publishing today for the first time, summary hospital level mortality data indicators to help make poor performance more visible.
The data will be broken down by hospital trust, and will cover all beds in all settings, and will track patients up to 30 days after discharge.
Andrew McConaghie
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