latest health care news

09.07.13

Investigation into orthopaedic hospital over missed RTT targets

Monitor is investigating an orthopaedic foundation trust in Shropshire over its “persistent failure” to hit 18-week referral to treatment targets.

Despite recent improvement, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS FT has not managed to clear a backlog of patients as fast as planned.

The hospital, which carries out specialist bone and joint surgery, is a leading national centre for hip and knee replacements.

Monitor has now opened a formal investigation to see if the trust has breached the conditions of its licence.

Adam Cayley, regional director at Monitor, said: “The [trust] has a strong reputation and we have no evidence that the trust is providing poor quality of care to its patients.

“Its small size and the specialist nature of what it does mean that there are a range of issues that might cause it to have difficulty in meeting referral to treatment (RTT) targets. 

“However it has twice failed to fully implement a recovery plan and, despite some significant progress having been made, it is still failing to meet its target to reduce the number of patients waiting over 18 weeks.”

Monitor’s official notification of its decision to open the investigation, in the form of a letter to trust chairman Russell Hardy, says: “Monitor is concerned that the trust has failed to deliver sustainable compliance with all RTT targets for a sustained period of time and has failed to rectify the breaches in a timely manner:

  • Incomplete RTT target: failed for four consecutive quarters since it was introduced (Q1-Q4 2012/13) and expected to be failed in Q1 2013/14;
  • Admitted RTT target: failed for four consecutive quarters (Q3 2011/12-Q2 2012/13), subsequently failed in Q4 2012/13 and expected to be failed in Q1 2013/14; and
  • Non-admitted RTT target: failed for four consecutive quarters (Q3 2011/12-Q2 2012/13).

“As previously communicated to you, in light of the prolonged failure to achieve sustainable compliance with all RTT targets, and the trust's failure to deliver two previous recovery plans, we are concerned about the robustness of the trust's capacity and planning assumptions, and its waiting list management processes. Our concerns are further illustrated by the trust’s weekly performance data for May 2013, and June 2013, which show that whilst the backlog of patients waiting in excess of 18 weeks is reducing, the reduction is not in line with the planned recovery trajectory.”

Senior members of the trust board are now expected to attend a meeting at Monitor’s London offices to discuss the next steps.

The trust is one of five in England currently subject to a Monitor investigation over potential breaches of licence conditions.

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