The worst hospitals are costing us millions. What happens to them?
Recently released figures from the NHS Litigation Authority have shown that hospitals at the centre of recent medical negligence scandals have cost the NHS almost £300 million in damages since 2009. In total 14 hospitals were investigated over their high death rates, and 9 of those have cost the health service more than £291 million in medical negligence claims. This figure far outweighs the amount of money the hospitals were paying into the NHS insurance scheme.
Last year the NHS paid out over £1.3 billion in compensation and legal fees for thousands of people affected by poor standards of care. The worst hospitals are put into special measures to address the concerns over the quality of care they provide to patients. We have taken a closer look at these measures to highlight exactly what will be happening in 11 underperforming trusts throughout the UK.
What happens to a trust in special measures?
Improvement plan
A trust will publish an improvement plan which lays out the measures taken by the trust to improve their services as well as detailing who is in responsible for specific actions with the trust. Plans must be updated on a regular basis because they are free for public viewing. This allows patients and the general public to see what progress is being made to improve their local NHS services.
Leadership review
If necessary, changes to trust management could be made to ensure that those in charge are capable of making the required improvements set out in the plan.
Suspension of freedoms
Foundation Trusts can have some of their freedoms suspended. This include the freedom to decide who sits on the executive board, the freedom to decide how to make improvements to services, and the freedom to decide how they spend their budget. The decision to suspend certain freedoms is made on a case-by-case basis.
Support and scrutiny
Trusts are given a significant range of support depending on their specific needs. Some trusts will receive help from high performing trusts in the form of partners, whilst others will get further support from commissions and access to local health science networks. Underperforming hospitals will also be placed under intense scrutiny with regular monitoring to ensure that planned improvement actions are actually taking place. Each trust is allocated an improvement director who keeps a close eye on all the progress being made.
The role of improvement directors
Improvement directors are embedded within trusts to scrutinise the daily progress being made in hospitals. They play an important role, acting on behalf of the NHS Trust Development Authority to provide advice and support to leadership, whilst challenging those in charge to take the necessary action to achieve improvement in patient care. They are also key figures in the establishment of strong and productive working relationships within the trust and with external stakeholders.
The future for failing hospitals
It is up to the chief inspector of hospitals to evaluate specific trusts before they can be declared free of special measures. With the number of medical negligence claims being made set to increase to around 12,000 by the end of 2014 there is still a lot of work that needs to be done to improve the situation. Hopefully, over the coming months and years, the chief inspector will be able to take several trusts out of special measures and rebuild public trust in the NHS as a whole.
JMW is a law firm specialising in claims for those who have suffered medical or clinical negligence.
