Monitor - Independant Regulator of NHS Foundation Trusts
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Learning and implications from Mid Staffordshire NHS Foundation Trust
Published on: 3 September 2009
Following the significant failings in quality of care at Mid Staffordshire NHS Foundation Trust, Monitor commissioned KPMG, our internal auditors, to produce a report considering how our methods and processes could be improved. The purpose of this review was not only to learn potential lessons, but also to share them with others in the healthcare system.
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The report makes fourteen recommendations, each of which we accept and against many of which we have already made good progress. There are two main themes:
- The need for better sharing of information across the healthcare system. Monitor has already taken action in this area. We have agreed arrangements with the Care Quality Commission (CQC) to ensure that we are informed about concerns that they might have about the quality of care delivered by applicants to be foundation trusts and that these concerns are resolved before a decision is taken to authorise the applicant. Arrangements have also been agreed to share information about under-performing foundation trusts and to coordinate any action. These agreements are part of the Memorandum of Understanding which Monitor and the CQC have now signed. This is available here.
- The need for Monitor to focus on developing an approach to assuring itself that appropriate clinical governance is in place in applicant or existing foundation trusts. By clinical governance we mean the combination of structures and arrangements in place at, and immediately below, the Board level to manage and monitor clinical performance, plan and manage continuous improvement, identify performance that may be below standard or out of line, investigate it and take management action.
Although the recommendations of the report are intended for Monitor, they have implications for how we work with our partners. We have shared and discussed the report with both the CQC and the Department of Health and we all agree that improved sharing of information and better coordination will help ensure that there are neither gaps in the system nor duplication.
Monitor’s management response to the internal audit findings can be found here.
