News

Failing Cambridge trust put in special measures after CQC and Monitor investigations

The deficit-ridden Cambridge University Hospitals NHS FT, whose chief executive and chief finance officer resigned last week, has been placed in special measures following a CQC inspection.

Monitor will also take enforcement action following an investigation into its poor finances and governance arrangements.

The trust, which runs Addenbrooke’s Hospital and The Rosie, is predicting a black hole of £64m this year as a result of overspending £1.2m a week.

CQC’s investigation concluded that it lacks adequate financial control, failed to deliver crucial savings and has not submitted a credible plan to address its soaring deficit.

It also underestimated the challenges posed by implementing the new £200m electronic patient record system, eHospital, which led to “significant cost increases” in healthcare provision. The regulator had already launched an investigation into the trust in July amid concerns that the failures tied to the new IT system could “indicate wider issues with how the trust is being run”. NHE had a special report on eHospital earlier this year.

Alongside this, the CQC gave the trust a rating of ‘inadequate’ based on concerns about staffing levels, delays in outpatient treatment and governance failings.

A series of steps will be enforced to bring the trust back above the water, including developing and implementing a new recovery plan to address the massive funding gap. The trust must also finalise and deliver a plan to improve its quality of care.

Its governance body will be shaken up by a thorough review into how the trust is managed, with recommendations for its executive leadership to be strengthened. If directed by Monitor, the trust will work with an improvement director appointed by and accountable to the regulator, as well as partner with a high-performing ‘buddy trust’.

The regulator also imposed a new condition on the trust’s licence to enable further action, such as replacing members of the trust’s leadership team if improvements are not observed quickly.

Stephen Hay, Monitor’s managing director, said the trust’s failings were "disappointing".

He added: "It’s reassuring that the trust has already started to address some of the issues raised by the CQC and our investigation. But much more needs to be done and the trust’s leadership needs to act quickly to resolve these issues.

"Putting the truth into special measures will ensure it gets the extra help and support it needs and we will closely monitor the trust’s progress in making the improvements that its patients expect to see."

Chair of the trust, Jane Ramsey, issued an apology to patients for their "lack of effective systems and processes".

She added: "We take this, and being placed in 'special measures' by our regulator Monitor, very seriously. Part of Monitor’s enforcement action means we have a number of clearly defined quality, financial and governance failings to rectify as soon as possible. We will take rapid action to address these concerns and maintain our record of safety and high-quality care.

"The care our staff provide has been rated as 'outstanding' and we are very proud of them, and we continue to have a strong track record on safety, clinical excellence and introducing ground-breaking treatments. However, the CQC’s inspection highlighted concerns with the protocols and processes that underpin the way we work. This has led to problems such as long waits for outpatient appointments and irregular checks on medical equipment.

"We are determined to put this right as quickly as possible, to make sure our processes are robust and transparent, so every step of a patient’s journey can be effectively monitored from the ward to the board."

The trust’s chief executive, Dr Keith McNeil, stepped down last week ahead of the CQC’s report. He said it was a matter of public record that the trust faces “very serious challenges” and a growing deficit, owing this to why he felt it was time to move on. Paul James, the chief finance officer since 2014, followed him out.

A day before his resignation, the BBC reported that the trust had already started implementing controversial cost-cutting measures, such as removing ice from patients’ water jugs. According to a spokesman, the ice jugs were slashed in an attempt to save almost £40,000 per year – despite the benefits to some patients who need it to swallow tablets.

(Top image c. Chris Radburn)