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Weak NHS trusts 'target-driven'

04/02/2008

Some boards of NHS trusts are focusing on mergers and targets at the expense of other factors in their hospitals, the NHS watchdog warned today.

A report from the Healthcare Commission says there are common problems underlying poorly-performing trusts, including a heavy focus on targets; poor leadership; ineffective management; inadequate teamwork; and a lack of clarity about who is responsible for particular roles.

Some boards do not have systems in place to ensure they are routinely informed of key information such as rates of infection and measures of quality of care.

The Healthcare Commission's claims are based on a review of the 14 investigations it carried out between August 2004 and April 2007.

These 14 were the result of 200 referrals about serious breakdowns in healthcare in NHS trusts.

Releasing the report today, the Healthcare Commission called on all trusts to learn from the problems outlined and to focus on good leadership, effective management and systematic use of information.

Healthcare Commission chief executive Anna Walker said good leadership ensures staff are encouraged to speak about concerns, that risks are monitored and change is undertaken while maintaining the quality of patient care.

"Above all, it means boards putting systems in place to turn their vision of quality care into a reality on the wards," she added.

"There are trusts across the country that are succeeding at doing all of this while still managing change and meeting targets."

Commenting on the report, NHS Confederation chief executive Gill Morgan said: "This is a valuable report to help spread the lessons from serious failings. The messages are strong and clear but we should reassure the public the cases are relatively rare - of 200 referrals over a three year period, 14 resulted in a full investigation.

"The majority of boards ensure the good running of their trusts and we all want to work with the healthcare commission to ensure this good practice is spread."