The term ‘special measures’ is used when hospitals are deemed to have serious problems with the quality of care they provide or their financial performance and require intervention by an external team to make the necessary improvements, as the existing leadership are unable to do so.
Special measures was a concept brought in by the Keogh review in February 2013, by Professor Sir Bruce Keogh, the Medical Director of NHS in England. At the time he picked out fourteen particular hospitals with outliers in terms of mortality rate.
Although mortality was the defining factor for inquiry, the actual review was based upon the quality of care and treatment in each hospital. This was evaluated in six key areas; patient experience, workforce, safety, leadership and governance, clinical and operational effectiveness, and of course mortality.
NHS blunders and medical negligence are more common than most people think and it’s important to know whether you may have been a victim of poor care at one of these hospitals.
In total there have been 28 trusts placed in special measures, many of which have seen significant improvements sufficient enough to be removed from the list. There are currently 11 in special measures as at May 2018, including:
Date Placed in special measures: February 2018.
The Trust was also placed into special measures for care quality concerns in December 2013.
This hospital trust was placed in special measures after their financial position was discovered to have rapidly ‘deteriorated’, necessitating a £15m bail-out loan from NHS Improvement. The extent of the trusts financial losses is currently under investigation. The hospital was originally placed in special measures in 2013 because of concerns over patient safety especially in A&E, due to an over-reliance on locum doctors and a lack of consultants and mid-grade medical staff.
Date Placed in special measures: September 2015
Reason: Financial and Quality
Hastings’s Conquest Hospital and Eastbourne District General Hospital were both rated ‘inadequate’ by the Care Quality Commission (CQC). In January 2017, further inspection by CQC showed improvements, but ongoing problems in A&E due to poor staffing levels, poor record keeping, and not meeting patient waiting and treatment targets, persisted. A previous concern of bullying “appeared to have been tackled”, according to the CQC. The Trust say they are now focused on the recruitment of more permanent clinicians and reducing patient waiting times.
Date Placed in special measures: January 2016
Walsall Healthcare NHS Trust was originally assessed by CQC in September 2015 due to problems in maternity and A&E services. There was also evidence of bullying by senior management, and low staff morale. In December 2017, a follow-up inspection by CQC showed considerable improvements, with services then rated good and outstanding. Despite the improvements, the Trust remains in special measures while improvements are continuing, including delivery of the ongoing A&E action plan which was drawn up in September 2015, patient consent in gynaecology, and the sharing of lessons learned following incidents and complaints.
Date Placed in special measures: December 2015
Worcestershire Acute Hospitals NHS Trust inspectors were put in special measures in 2015 after CQC inspectors raised concerns about safety in its A&E, children’s care, and maternity and gynaecology services. Two years later, in January 2017, the trust hit the headlines again after two patients died after experiencing long delays in receiving care. One of these patients suffered an aneurysm while waiting on a trolley located in a corridor, and later died as a result; the other died patient due to cardiac arrest. While in special measures, the Trust has also been publicly exposed for not assessing 10,000 x-rays, leading to serious concerns that illnesses may have gone undiagnosed.
The other hospital Trusts in special measures are:
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