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Hospital found to be in breach of terms of authorisation after four serious surgical errors

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8048 (Published 26 November 2012) Cite this as: BMJ 2012;345:e8048
  1. Gareth Iacobucci
  1. 1BMJ

One of the country’s leading teaching hospitals has been found to be in “significant breach” of its terms of authorisation by the regulator of NHS foundation trusts, Monitor.

Cambridge University Hospitals NHS Foundation Trust, which incorporates Addenbrooke’s Hospital, has been served with regulatory action because of its “successive failure” to meet NHS targets, including those on waiting times for cancer treatment and emergency department performance.

Monitor said that the concerns were compounded by numerous instances of “preventable patient safety incidents” and “poor financial performance.”

Four so called “never events” were reported between 7 September and 7 October 2011, one relating to surgery done on the wrong person, one relating to surgery on the wrong part of the body, and two relating to instruments left inside patients.

For the third consecutive quarter (the first of 2012-13) the trust missed its target for 85% of patients urgently referred by a GP for suspected cancer to be seen within 62 days, achieving only 78.1%. This meant that it had breached this target in seven of the eight quarters to that point.

In the same quarter it failed to meet the target for 90% of patients admitted for treatment to be treated within 18 weeks of their initial referral for the second time in a row, achieving 85.9%.

The trust also missed its target to see 95% of emergency department patients within a four hour time limit for two quarters in a row, achieving 92.5% in the first quarter of 2012-13.

As a result, Monitor has instructed the trust to commission a board governance and effectiveness review and to appoint an “experienced turnaround expert” at board level to deal with the deficiencies.

The regulator, which will set the scope and timescale of the review, pledged to keep the trust under close scrutiny, and the board is required to provide a monthly update report on its performance.

Monitor said that it may decide to use its regulatory powers and take further action if improvements have not been seen in the agreed timescales.

Stephen Hay, managing director of provider regulation at Monitor, said, “This is not the first time we have called the trust in to explain itself. We are disappointed that the board has not resolved these issues.

“We note the trust has a new chair and will shortly appoint a new chief executive. We expect them to demonstrate they are getting the trust back on track as quickly as possible.”

Diane Abbott, Labour’s shadow minister for public health, said, “It’s right that Monitor takes action, because patient safety must be the priority. I’m concerned that we’re seeing the beginnings of a national patient care crisis here.

“The NHS has been thrown into chaos, the government has become sidetracked by an expensive ideological reorganisation, and they have boasted about increasing NHS spending when in fact they have cut it in real terms.”

Jane Ramsey, the chairwoman of Cambridge University Hospitals, said, “We take Monitor’s concerns very seriously, and we are determined to reverse the situation as soon as possible. My top priority, as the new chairman, will be to get to grips with these performance issues with my team, and we will be setting up a taskforce to swiftly get back on track. We will be focussing on turning this trust around, so once more we can be justifiably proud of our record as one of the leading trusts in the country.

“We are working to improve our performance on meeting targets every month, but we know we could do better. We are treating more people than ever before, and our health outcomes are amongst the best in the country. I am committed to retaining this achievement but also to meeting the standards that are required.”

Notes

Cite this as: BMJ 2012;345:e8048