By Vivienne Russell
16 October 2009
Improved financial management in the NHS has left it well placed to tackle looming economic challenges, the new care watchdog has said in its first major assessment of the health service’s performance.
The Care Quality Commission this week published performance ratings for all 392 NHS trusts in England for 2008/09. These painted a broad picture of improvement in financial management and service quality.
On financial management, performance edged ahead of service quality with 26% of trusts judged ‘excellent’, 45% ‘good’, 26% ‘fair’ and 3% ‘weak’.
The commission said the ‘clear trend of improvement’ in financial management put the NHS in a ‘strong position to protect and improve services in a cold financial climate’.
Foundation trusts performed more strongly on financial management than their non-foundation counterparts. Only two non-foundation trusts were rated ‘excellent’: Royal Liverpool & Broadgreen University Hospitals NHS Trust and St Helens & Knowsley Teaching Hospitals NHS Trust.
Financial management was rated ‘weak’ at nine acute and specialist trusts. For seven of these, this was the fourth consecutive year of low ratings.
Barking, Havering & Redbridge Hospitals NHS Trust was the only trust to be rated ‘weak’ on both financial management and quality. Last year, six trusts were found to be ‘double-weak’.
A trust spokeswoman said: ‘We are extremely disappointed that we have been given a weak rating for quality of services. It is clear that we need to work to improve many areas.
‘This rating is historical and relates to targets in the previous financial year – 2008/09. Since that time, major improvements have been made in key areas.’
The cancer specialist Royal Marsden NHS Foundation Trust was the top performer, having been rated ‘double-excellent’ in each of the past four years. Chief executive Cally Palmer said the judgement ‘offers our patients reassurance that they are receiving the best possible care’.
On quality, the commission rated 15% of trusts ‘excellent’, 47% ‘good’, 33% ‘fair’ and 5% ‘weak’. The CQC paid tribute to the NHS’s ‘fantastic achievement’ in reducing waiting times for operations and in accident & emergency and in slashing hospital-acquired infection rates.
But the CQC also drew attention to organisations that had underperformed for too long. A total of 27 trusts have never been rated higher than ‘fair’ for either quality or financial management in any of the past four years.
There was also a slip in the performance of acute and specialist trusts, with fewer trusts rated ‘excellent’ and more falling into the ‘fair’ category. The CQC said the reasons behind this were complex, but one factor was more intense inspection of some crucial areas, such as safeguarding children and hygiene standards.
This is the last year that NHS performance will be presented in this way. From next year, all NHS trusts will have to register with the CQC to have a licence to provide services. Any dip in standards could see trusts losing that licence.
CQC chief executive Cynthia Bower said: ‘It is clear that some trusts are struggling and that some issues are proving tough nuts to crack. My biggest concern is those trusts that are “weak” and persistently “weak” or “fair”. They must do better for their patients.
‘I want to ring the alarm bell in the boardrooms of these organisations. Next year, all trusts must register with us to legally function. It is clear that many have significant work to do and a short time in which to do it.’
CQC chair Barbara Young added that the forthcoming registration regime would be a ‘shock to the [NHS’s] system’ and would represent a shift from a ‘once-a-year assessment’ to a ‘24-7 assessment’, which will be legally enforceable. ‘If trusts fail to meet standards they will be legally in default,’ she said.
Plans have been developed for each of the ‘weak’ trusts. Health minister Mike O’Brien said: ‘For the small number of trusts whose performance is weak, we expect immediate action to be taken to remedy this quickly. Earlier this year we introduced a tough new performance regime and we will not hesitate to trigger this.’
16 October 2009
Improved financial management in the NHS has left it well placed to tackle looming economic challenges, the new care watchdog has said in its first major assessment of the health service’s performance.
The Care Quality Commission this week published performance ratings for all 392 NHS trusts in England for 2008/09. These painted a broad picture of improvement in financial management and service quality.
On financial management, performance edged ahead of service quality with 26% of trusts judged ‘excellent’, 45% ‘good’, 26% ‘fair’ and 3% ‘weak’.
The commission said the ‘clear trend of improvement’ in financial management put the NHS in a ‘strong position to protect and improve services in a cold financial climate’.
Foundation trusts performed more strongly on financial management than their non-foundation counterparts. Only two non-foundation trusts were rated ‘excellent’: Royal Liverpool & Broadgreen University Hospitals NHS Trust and St Helens & Knowsley Teaching Hospitals NHS Trust.
Financial management was rated ‘weak’ at nine acute and specialist trusts. For seven of these, this was the fourth consecutive year of low ratings.
Barking, Havering & Redbridge Hospitals NHS Trust was the only trust to be rated ‘weak’ on both financial management and quality. Last year, six trusts were found to be ‘double-weak’.
A trust spokeswoman said: ‘We are extremely disappointed that we have been given a weak rating for quality of services. It is clear that we need to work to improve many areas.
‘This rating is historical and relates to targets in the previous financial year – 2008/09. Since that time, major improvements have been made in key areas.’
The cancer specialist Royal Marsden NHS Foundation Trust was the top performer, having been rated ‘double-excellent’ in each of the past four years. Chief executive Cally Palmer said the judgement ‘offers our patients reassurance that they are receiving the best possible care’.
On quality, the commission rated 15% of trusts ‘excellent’, 47% ‘good’, 33% ‘fair’ and 5% ‘weak’. The CQC paid tribute to the NHS’s ‘fantastic achievement’ in reducing waiting times for operations and in accident & emergency and in slashing hospital-acquired infection rates.
But the CQC also drew attention to organisations that had underperformed for too long. A total of 27 trusts have never been rated higher than ‘fair’ for either quality or financial management in any of the past four years.
There was also a slip in the performance of acute and specialist trusts, with fewer trusts rated ‘excellent’ and more falling into the ‘fair’ category. The CQC said the reasons behind this were complex, but one factor was more intense inspection of some crucial areas, such as safeguarding children and hygiene standards.
This is the last year that NHS performance will be presented in this way. From next year, all NHS trusts will have to register with the CQC to have a licence to provide services. Any dip in standards could see trusts losing that licence.
CQC chief executive Cynthia Bower said: ‘It is clear that some trusts are struggling and that some issues are proving tough nuts to crack. My biggest concern is those trusts that are “weak” and persistently “weak” or “fair”. They must do better for their patients.
‘I want to ring the alarm bell in the boardrooms of these organisations. Next year, all trusts must register with us to legally function. It is clear that many have significant work to do and a short time in which to do it.’
CQC chair Barbara Young added that the forthcoming registration regime would be a ‘shock to the [NHS’s] system’ and would represent a shift from a ‘once-a-year assessment’ to a ‘24-7 assessment’, which will be legally enforceable. ‘If trusts fail to meet standards they will be legally in default,’ she said.
Plans have been developed for each of the ‘weak’ trusts. Health minister Mike O’Brien said: ‘For the small number of trusts whose performance is weak, we expect immediate action to be taken to remedy this quickly. Earlier this year we introduced a tough new performance regime and we will not hesitate to trigger this.’
