21.10.16
Over half of acute trusts ‘could be breaching their licence’
Over half of acute trusts are or could be in breach of licence, NHS Improvement (NHSI) has revealed as it published its shadow ranking of NHS providers’ support needs.
The categorisations, due to be formally introduced next month, rank trusts in one of four segments based on the level of improvement support they need under the new single oversight framework (SOF).
The table shows that 60 out of the 137 acute trusts were in segment 3, where they are set to receive mandated support for concerns about actual or suspected breaches of their licence. A further 20 were listed in segment 4, where they will have to go into special measures.
Ben Dyson, executive director of strategy at NHS Improvement, said: “All providers want to perform well and improve for their patients.
“Our ambition is to make sure they are able to access the right support at the right time to drive continuous improvements. We also want to provide more space and autonomy for those NHS providers performing well and promote greater peer-to-peer support across the provider sector.”
The SOF is based on five themes: quality of care; finance and use of resources; operational performance; leadership and improvement capability; and strategic change.
Amber Davenport, head of policy at NHS Providers, said the figures exposed “the enormous pressure the acute sector is facing”.
“While the new SOF marks a significant shift from NHS Improvement as it places much greater emphasis on improvement and support,” she added, “it is difficult to separate the segmentation from the difficult context in which providers are operating. This is one of increasingly challenged finances, a social care system that has now reached a tipping point and rapidly rising demand.
“We welcome the way NHS Improvement engaged with the sector during the shadow segmentation process and look forward to working with them to monitor the impact for trusts in each of the four segments. In particular the extent to which those providers in segments 1 and 2 enjoy autonomy and how trusts can move between segments. We will also work with NHSI to help shape the remaining areas of the SOF that still need developing around strategic change and leadership.”

Overall, there were 22 NHS providers in segment 4, and 74 in segment 3. Furthermore, 106 are in segment 2, where they will be offered ‘targeted support’ because of concerns about one or more of the themes. The 35 in segment 1, with no needs identified, will be encouraged to share best practice with other trusts.
In addition, two specialist trusts, six mental health trusts, three community trusts and three ambulance trusts were in segment 3. None of these types of trust were in segment 4, apart from the London and South East Coast ambulance trusts.
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