Less than 20% of Special Measures Trusts Have Made Satisfactory Improvements

Less than 20% of trusts that have been placed in special measures due to inadequate care have improved satisfactorily in order to be removed within 12 months.

In total, 27 trusts have been placed in special measures by the Care Quality Commission since 2013.

Yet only five have been able to exit this circumstance within a twelve- month period, and all of these were from the original eleven placed in the regime in 2013.

Regulators guidance from 2014 states that “it is intended that the usual period of time a trust remains in special measures will be a maximum of 12 months, although this may be extended in some circumstances”.

Extensions are not usually expected to exceed six months.

In fact, the average time required in order for trusts to exit special measures is almost double the one-year target; 20.5 months to be precise.

And ten trusts have spent over two years in special measures, with Colchester Hospital University Foundation Trust having already been in special measures for over 3.5 years.

Furthermore, two trusts that had previously been removed from special measures, United Lincolnshire and North Lincolnshire and Goole, have been readmitted after the Care Quality Commission found that the situation at the trust has deteriorated.

The CQC’s chief inspector of hospitals, Sir Mike Richards, indicated his belief that the Care Quality Commission process should be as stringent as possible, and that patient well-being was always the number one priority.

“We are clear that we will only recommend that NHS trusts should exit special measures when we find that sufficient and sustainable improvements have been made to the quality of care they provide, regardless of how long or short they may have been in the regime. While trusts are placed in special measures for a 12-month period to begin with, this can be extended if further support is needed. What is most important is that the right changes are made and fully embedded to benefit patients.”

Initial guidance on special managers indicated that the extra mitigation can be extended if regulators are concerned that measures taken by trusts are not delivering satisfactory improvements.

And an addendum has only been added to the special measures guide indicating that if sufficient improvement has not been made 18 months “urgent and intensified consideration of the provider’s short and long-term improvement plans, and trusts may have to remain in special measures while efforts to achieve long-term viability are undertaken”.


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