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Special measures for 11 trusts after mortality review

Eleven of the 14 trusts investigated in Sir Bruce Keogh’s review of death rates will be placed into special measures if they are not already, and all will have to implement improvement plans. “Not one of these trusts has been given a clean bill of health by my review teams,” he said.

The review looked into trusts with higher than expected mortality rates and found a pattern of factors which contributed to their clinical failures. These include professional and geographic isolation; a failure to act on data that showed cause for concern; an absence of a culture of openness; a lack of willingness to learn from mistakes; and ineffective governance and assurance processes.

Five trusts were already in special measures prior to the review, and the six newly announced trusts are Basildon & Thurrock University Hospitals; Burton Hospitals, Medway; Sherwood Forest Hospitals; Tameside Hospital; and North Lincolnshire and Goole Hospitals.

Three that will remain under supervision, but not special measures, are Colchester Hospital University NHS Foundation Trust; The Dudley Group NHS Foundation Trust; and Blackpool Teaching Hospitals NHS Foundation Trust. 

All 14 will be inspected again within the next year by the new Chief Inspector of Hospitals, Professor Sir Mike Richards. The NHS Trust Development Authority and Monitor will assess the quality of leadership and each trust will be partnered with a high-performing NHS organisation.

The Government will also legislate to make sure failed managers cannot get jobs elsewhere in the NHS. Sir Bruce called for demonstrable progress to reduce avoidable deaths, staffing levels and a skill mix to appropriately reflect the caseload and severity of illness of patients and for no hospital to be an island.

He said: “Higher mortality rates do not always point to deaths which could have been avoided but they do act as a ‘smoke alarm’ indicator that there could be issues with the quality of care. That’s why I was asked to carry out a ‘deep dive’ inspection of the care and treatment being provided by each of these trusts.

“Not one of these trusts has been given a clean bill of health by my review teams. These reviews have been highly rigorous and uncovered previously undisclosed problems. I felt it was crucial to provide a clear diagnosis, to write the prescription, and, most importantly, to identify what help these organisations might need to support their recovery or accelerate improvement.

“Mediocrity is simply not good enough and, based on the findings from this review I have set out an achievable ambition which will help these hospitals improve dramatically over the next two years.”

Health secretary Jeremy Hunt said: “Under the new rigorous inspection regime led by the Chief Inspector of Hospitals, if a hospital is not performing as it should, the public will be told. If a hospital is failing, it will be put into special measures with a limited time period to sort out its problems.

“We owe it to the three million people who use the NHS every week to tackle and confront mediocrity and inadequate leadership head on. I would like to sincerely thank Sir Bruce and his team for their extremely difficult and thorough work.”

David Bennett, chief executive of Monitor, commented: “The Keogh review has identified a number of serious issues at these foundation trusts, and we are taking appropriate action to ensure they are fixed as quickly as possible.

“These inspections will inform the future work of the new Chief Inspector of Hospitals, and we look forward to working closely with Prof Mike Richards and his new team at the Care Quality Commission to get prompt warning of emerging problems with patient care or hospital governance in future.”     

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