Monitor response to Professor Sir George Alberti’s report on Mid Staffordshire NHS Foundation Trust

Published on: 30th April 2009

The Healthcare Commission report into Mid Staffordshire NHS Foundation Trust identified completely unacceptable failings in care. In commissioning this report jointly with the Secretary of State for Health, Monitor’s aim was to ensure a thorough assessment of the current state of services at the Trust and to provide assurance both on the progress made to date and on what else needs to be done to deliver the quality of care that patients in Staffordshire should expect.

Professor Sir George Alberti, one of the most experienced and respected clinicians in the country, has produced a robust piece of work which recognises that significant progress has been made at the Trust, although there is still work to do. He sets out clear and specific recommendations for what needs to happen next to deliver improved patient care.

Monitor, along with the Department of Health and the Trust have agreed these recommendations. The Trust is now required to deliver an action plan to urgently address:

  • All Professor Alberti’s recommendations;
  • Any concerns identified by the Healthcare Commission’s report  which have not already been addressed; and
  • Any recommendations relating to the Trust from Dr Colin-Thomé’s review of commissioning arrangements, also published today.

Monitor, Professor Alberti, and the Care Quality Commission (CQC) will review this plan to ensure that it addresses all issues identified and that the timing of the proposed actions reflects the seriousness of the concerns. 

As the independent regulator of NHS foundation trusts, we are very clear that this Trust will not be allowed to slip backwards. Monitor has already used its formal powers of intervention once at Mid Staffordshire NHS Foundation Trust to appoint an Interim Chair and direct the appointment of an Interim Chief Executive. If the Trust fails to deliver the planned actions to address the issues identified within agreed timescales, Monitor will take whatever further regulatory action is necessary to deliver improved patient care.

Monitor will ensure that the plan is made public in May, so that patients and families can see exactly what progress has been made and what is planned for the future.

Monitor will then hold the Trust to account at each step towards delivery of the improvements required, meeting with the Trust Board on at least a monthly basis and keeping speed and effectiveness of implementation under constant review. Professor Alberti will continue to work with Monitor as an independent advisor on the Trust’s progress.

Monitor and the CQC have agreed that they will meet with the Trust and with commissioners in June.  Following this, in September (six months after the publication of the Healthcare Commission’s report) the CQC will undertake a detailed review of progress against the action plan and in particular whether all the concerns in the Healthcare Commission’s report are being addressed. Again, where the action plan is not being delivered, or individual actions are not addressing in full the principal concerns, we will consider further action.

To ensure that, going forward, appropriate leadership is in place at the Trust to deliver improved patient care, and to embed a culture of openness and learning, Monitor is working with the Trust’s governors and Board, to identify permanent appointments at Board level to lead the organisation.

Dr Colin-Thomé’s report identifies that parts of the healthcare and regulatory system need to work more closely together to ensure that cases like Mid Staffordshire NHS Foundation Trust can never happen again. In the past year, dialogue between Monitor and the Healthcare Commission (the CQC since 1 April) and with commissioners  has been increased and formalised in order to identity risks related to quality of care at an earlier stage.

One of the key lessons from the events at Mid Staffordshire NHS Foundation Trust is the importance of Boards who are genuinely focussed on improving quality of care and are held to account for that quality by their members and elected Governors. Two areas where Monitor is seeking to increase transparency and accountability of FT Boards are:

  • We have required all FTs to produce a quality report for 2008-09, setting out their performance over the last year and their priorities for quality improvement; and
  • We are consulting on guidance to support FT Governors in understanding and using their statutory powers to hold Boards to account on behalf of their local communities.

ENDS

Notes to editors:

  1. For enquires please contact Anna Jefferson on 020 7340 2442 or Rebecca Gray on 020 7340 2440
  2. Professor Sir Alberti’s report on Mid Staffordshire NHS Foundation Trust can be found here.  Dr Colin-Thomé s report will be published on the Department of Health website. 
  3. Details of regulatory action taken by Monitor to date at Mid Staffordshire NHS Foundation Trust can be found here.
  4. Monitor authorises and regulates NHS foundation trusts, ensuring they are well-managed and financially viable. 
  5. Monitor was established in January 2004. It is independent of government and accountable to Parliament. Monitor’s functions and powers are set out in the National Health Service Act 2006