Special measures for more NHS A&Es says NHS England

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Marching to stop the closure of the A&E at Lewisham Hospital
Marching to stop the closure of the A&E at Lewisham Hospital

NHS Trusts performing poorly against the four-hour target could be placed in new ‘A&E special measures’ if their performance does not improve by June, reports the HSJ.

Trusts are to be put into one of four groups based on their emergency department performance under the new approach, the letter from NHS England said. Trusts in group one, the most challenged areas, face weekly meetings with system leaders before Easter to discuss ‘local system recovery and action plans’.

The letter, seen by HSJ, added: ‘If a struggling system fails to deliver improvement by June, consideration will be given as to whether they will be placed in A&E special measures to ensure patient safety.’

It continued, ‘The plans will be monitored weekly by NHS England and NHS Improvement regional directors, with systems meeting with Simon Stevens, Jim Mackey and Pauline Philip before Easter to discuss implementation plans.’

The four groups are:

• Group one: Systems with longstanding challenges and the highest level of intervention and support

• Group two: Systems with low levels of performance and a high volume of breaches that require regional intervention and support

• Group three: All systems not in groups one, two or four that will be monitored by the region via urgent and emergency care elements of their STPs

• Group four: High performing systems that are delivering consistently.

London trusts have been placed in the following groups

Group one: Lewisham and Greenwich Trust.

Group two: London North West Healthcare Trust; Barts Health Trust; Barking, Havering and Redbridge University Hospitals; Royal Free London Foundation Trust; North Middlesex University Hospital Trust; The Hillingdon Hospital FT.

Group three: Croydon Health Services Trust; Whittington Health Trust; Kingston Hospital FT; Imperial College Healthcare Trust; University College Hospitals FT; Guy’s and St Thomas’s FT; St George’s University Hospitals FT; Chelsea and Westminster Hospital FT.

Group four: Homerton University Hospital FT; Epsom and St Helier University Hospitals Trust.

Concerns have been raised that the measures will push hospitals to take risks to try and get their overall performance back on track.

HSJ revealed that from April, sustainability and transformation fund money would only be made available to trusts hitting their A&E targets. HSJ understands NHS England and NHS Improvement have now effectively dropped routine financial penalties for many trusts in relation to elective and cancer waits.

Providers have also been told to ensure every hospital has a front door ‘streaming model’ by October, to keep unwanted patients out, linked to an additional £100m capital funding announced in the spring budget.