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'Special measures' considered for trusts failing on A&E

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NHS Improvement is considering a new category of “special measures” for trusts with the worst performance on high profile access targets such as accident and emergency.

The regulator is expected to make a decision over the next fortnight as to whether to introduce the category for organisations which are seriously failing the target of seeing 95% of attendances within four hours.

“We are considering introducing special measures for operational performance”

NHS Improvement

It is not known what being placed in special measures would entail, but earlier this year five trusts were placed in a new “financial special measures” regime.

The news comes as the English NHS recorded the worst performance against the target since 2003, with 90.3% of people attending A&E being seen within four hours in quarter one of 2016-17. In quarter one of the last financial year performance was 94.1%.

A spokesman for NHS Improvement said: “It is clear that a small number of providers are not giving this the attention it deserves and their patients and staff are being let down as a result.

“In order to address the ongoing issues with A&E performance at this small number of providers, we are considering introducing special measures for operational performance,” he said.

“We need to see those consistently poor performers, those trusts not giving this the focus it requires, implementing the advice and support provided. They have to sort this out, urgently,” he told Nursing Times’ sister title Health Service Journal.

Analysis of the quarterly data from shows some trusts contributing disproportionately to the decline in national performance, including Princess Alexandra Hospital Trust in Essex and Nottingham University Hospitals Trust.

Hull and East Yorkshire Hospitals Trust had the biggest improvement from last year’s position.

However, of the 3.8 percentage point performance decline year-on-year, only 2.4% related to the 40 worst performing trusts.

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Readers' comments (1)

  • I worked for 8 years in A&E and loved it. Problems arose with changes in management and cost cutting excercises. Senior band 6 nurses were told to re-apply for their posts, everyone over the age of 35 were challenged as considered too old for the role. Many were told to look for other jobs within the trust. As a result the senior nurses did not re-apply, they all left one after another. Inexperienced nurses were recruited most straight from training.
    There was a severe skill mix shortage and morale is low. Management and ancillary staff has increased to disproportionate levels. Lets go back to the training of nurses on the job and not at universities. This could make up the shortfall and encourage more nurses in as they would be paid a decent wage whilst working and not end up with a terrifying amount of debt which is untennable with todays cost of living and increased housing costs.

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