Failing hospitals to be named and shamed in league tables

It will come under new Government plans Hospitals that are failing will be publicly identified in league tables, and NHS managers will be dismissed if they fail to improve patient care and manage finances, according to the Health Secretary. Wes Streeting will inform leaders at the NHS Providers conference in Liverpool that there "will be no more rewards for failure", as he outlines a series of measures designed to address poor performance. NHS England will conduct an unrestricted review of NHS performance across England, with the results being made public in regularly updated league tables.

NHS trusts can anticipate being ranked on various indicators such as finances, service delivery, patient access to care, and leadership competence. However, NHS leaders have criticised the move, claiming it could demoralise staff and accusing ministers of "falling for the appealing notion of a magic productivity tree which will make the NHS more efficient just by shaking the magic tree harder." Under government plans, consistently underperforming managers will be replaced and turnaround teams will be deployed to trusts that are running large financial deficits or providing substandard service to patients.



Meanwhile, the best performing NHS entities will be granted increased spending control to aid in the modernisation of their buildings, equipment, and technology. The Department of Health stated that currently, there is little incentive for trusts to maintain budget surpluses as NHS trusts cannot benefit from them, but this will now change, with top-performing trusts receiving more of this money. Mr Streeting said: "The Budget showed this Government prioritises the NHS, providing the investment needed to rebuild the health service.

Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients." Mr Streeting was adamant about accountability and added: "There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.

Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses. "With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks." NHS chief Amanda Pritchard welcomed the focus on leadership along with necessary support.

She said: "While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development. The extensive package of reforms, developed together with government, will empower all leaders working in the NHS and it will give them the tools they need to provide the best possible services for our patients." Mr Streeting has already announced that failing NHS managers will be denied pay rises if they do not improve patient care or get their finances in order.

A new pay framework for very senior managers will be published before April next year, with those who do well given financial rewards. The deputy chief executive of NHS Providers, Saffron Cordery, said the scale of the challenge facing NHS leaders was “huge” and they were “pulling out all the stops to boost productivity while delivering tough efficiency measures”. She added: “It’s vital we take decisive action to tackle the deep-rooted causes of pressures on the health services including the lack of resources for public health, prevention and social care, chronic workforce shortages, financial shortfalls and historic under-investment in the bricks and mortar of the NHS which underpin so many of the challenges we face today.

“Taking steps to resolve these root causes is critical before any plans to introduce league tables and threats to ‘sack failing managers’ are even put on the table. Trust leaders are highly accountable, subject to rigorous standards and stand ready to tackle the challenges ahead, as they have always been. League tables bring with them significant risk of unintended consequences.

” Matthew Taylor, chief executive of the NHS Confederation, said “the prospect of more ‘league tables’ will concern health leaders, as these can strip out important underlying information. He said: “NHS staff are doing their very best for patients under very challenging circumstances and we do not want them feeling like they are being named and shamed. “League tables in themselves do not lead to improvement.

Trusts struggling with consistent performance issues, some of which reflect contextual issues such as underlying population heath and staff shortages, need to be identified and supported in order to recover.” Nuffield Trust chief executive, Thea Stein, said: “We know from the special measures for quality regime that naming and shaming NHS trusts can make it harder to recruit staff, which doesn’t help patient care at all. “It’s unclear what new league tables will measure – a table based on general waiting times doesn’t add much if you need to know how good heart surgery is.

Many of the drivers of poor productivity are systemic, from the dire state of social care stranding people in hospital, to crumbling roofs and worsening population health. “They happen across England. Which trust is worst affected is often a matter of luck and history as much as leadership.

We need a system that encourages leaders to go to the most difficult and challenged trusts to improve patient care, not one that rewards them for choosing easier places to work. “Ministers have long warned the NHS against the naïve belief in the magic money tree. But they themselves are at risk of falling for the appealing notion of a magic productivity tree which will make the NHS more efficient just by shaking the magic tree harder, rather than by changing the drivers of efficiency.

“That can only lead to the NHS being forced back into asking for ‘more, more, more’, with patients ultimately paying the price.” Mr Streeting will also tell Wednesday’s conference how NHS trusts could be banned from using agencies to cover staffing gaps such as healthcare assistants and cleaners, in a bid to cut the £3 billion a year spent on agency workers. Those NHS staff who leave permanent jobs could also be stopped from coming back into the health service through expensive agencies.

Rachel Power, chief executive of the Patients’ Association, said: “The focus on tackling poor performance and rewarding excellence sends a clear message about raising standards across the NHS.”.