Published on: 1st May 2012
Monitor has today instructed Gloucestershire Hospitals NHS Foundation Trust to take immediate action to improve A&E waiting times at the Trust.
Monitor is using its regulatory powers of intervention to require the Trust to develop and implement an effective plan to improve its emergency care pathway with the support of the NHS Intensive Support Team.
Monitor has decided to intervene to ensure that the Trust makes effective improvements to the delivery of emergency care and addresses all underlying issues that have caused the poor performance. It should be noted that the Care Quality Commission has no outstanding concerns about the outcomes of patient care at the Trust.
The Foundation Trust Regulator has also announced that it will be a joint addressee on an independent review of Board governance and effectiveness which the Trust is to commission immediately and will hold the Trust to account on delivering any actions it recommends. Pending this review, Monitor has asked the Trust to make improvements to its Board reporting processes so that all material performance failures and risks are promptly and appropriately reported to and managed by the Board.
The Trust, which was found in significant breach of its terms of authorisation in September 2009 primarily for persistent failures in meeting A&E targets and weak financial performance, has failed to meet A&E targets consistently during the last two and a half years. In the second half of 2011 it showed a considerable deterioration in its performance against the target.
Monitor has found that there are a number of reasons for the failures including poor systems to assess people arriving at A&E departments, poor coordination of inpatient care and the need to work more closely with primary and community services to address high demand for care. A recent review, carried out by the NHS Intensive Support Team, indicated that the Trust's plans would need to be improved significantly if they were to be successful in implementing the necessary long-term changes at the Trust.
Speaking after Monitor’s Board made its decision, Merav Dover, Compliance Director at Monitor, said:
"We have decided to take action to ensure that the Trust makes immediate improvements to the way it delivers emergency care services to patients. Long waits are unacceptable for patients and the Trust has failed to rectify this issue sustainably during the last two and a half years.
"Monitor needs to be assured that the Board is able to identify and address issues at the Trust quickly and we are concerned that they have not been able to do this. The Trust is to commission an independent review of Board governance and we will expect the Trust to address any weaknesses identified in the report.
"We will keep under close review the Trust’s progress in returning to compliance with the A&E target and will consider further action including intervening again if necessary."
Notes for editors