Published on: 28 June 2012
The purpose of this response to the Morecambe Bay review is to document and accept the lessons learned and KPMG's two resulting recommendations, setting them in the context of Monitor’s overall approach to assessing applicants for foundation trust status and ongoing improvements to our assessment process.
As the Independent Regulator of NHS Foundation Trusts, Monitor's statutory role includes assessing NHS trusts that apply for foundation trust status and authorising those that satisfy the required standards.
Monitor authorised University Hospitals Morecambe Bay as a Foundation Trust on 1 October 2010. In October 2011, Monitor's Board found the Trust to be in significant breach of conditions 2, 5(1), 6(1) and 6(2) of its terms of authorisation, with the quality of care in maternity services and overall governance being the main causes for concern. Given the brief span between authorisation and breach and the nature of the concerns, Monitor's Board decided to review the case to see what lessons could be learned.
Monitor's Board commissioned KPMG, its internal auditors, to review events at Morecambe Bay between the start of the assessment process, March 2009, and 31st December 2011, and recommend any changes to Monitor’s assessment process it deemed necessary.
Overall, KPMG found that Monitor had conducted its assessment of Morecambe Bay correctly but there were nevertheless underlying issues concerning the quality of services at Morecambe Bay that the assessment process at that time did not uncover. Since that assessment, Monitor has been implementing a number of changes to the assessment process aimed at strengthening our capacity to test quality governance without overburdening applicant trusts.