NHS managers to be sacked in failing hospitals

Failing hospitals will be revealed in league tables and NHS managers sacked if they do not turn things around, the health secretary has told health leaders at a conference in Liverpool.

Wes Streeting is promising a “no-holds-barred, sweeping review” of NHS performance in England.

Hospitals can expect to be ranked on indicators such as care delivery and finances, so patients can see whether they are receiving a good service.

And “turnaround teams” will be sent into struggling trusts, while top performers will have more freedom over spending.

Meanwhile, senior leaders will be denied pay rises if key improvements are not made.

A new pay framework for chief executives will be published in April, which will “clamp down” on poor performance while rewarding success.

Streeting told the NHS Providers conference this morning there would be “no more turning a blind eye” to failure – something he has promised before, along with the idea of league tables.

“We will drive the health service to improve, so patients get more out of it for what taxpayers put in,” he said.

“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.”

Speaking to BBC Breakfast, Streeting said frontline staff were not to blame for poor NHS performance, but the NHS needs to be “better managed”.

He also promised to “incentivise and reward the best leaders to go into the most troubled trusts” to ensure poor-performing hospitals do not get stuck at the bottom of league tables.

These reforms focus on raising the “quality of leadership”.

“There are some outstanding leaders, but rotten apples are unacceptable and give the rest of the profession a bad name,” he said on the BBC R4 Today programme.

The Department of Health and Social Care says, currently, there is little incentive for trusts to run budget surpluses, from which they are unable to benefit – but that will now change.

Top performers will be given more capital and greater control over where to invest it – be that new equipment or technology or modernising their buildings.

The NHS Oversight Framework, which sets out how trusts and integrated care boards are best monitored, will be updated to ensure performance is properly scrutinised.

And at poorly performing trusts, government and NHS England “deep dives” will identify the most pressing issues and how they can be resolved.

NHS trusts could also be banned from using expensive agency staffing to cover certain rota gaps.

Some recruitment agencies have charged up to £2,000 for a single nursing shift -and last year, temporary workers cost the NHS in England £3bn, the government says.

NHS chief executive Amanda Pritchard welcomed the accountability, saying: “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.”

But Patients Association chief executive Rachel Power warned the new measures must bring positive change.

“We hope trusts who receive greater funding freedom will use this money wisely – to cut waiting times, make the waiting experience better for patients, and strengthen the ways they work with patients to improve services,” she said.

“These are the things that matter most to people using the NHS.”

Dr Adrian Boyle, president of the Royal College of Emergency Medicine, warned that the plans could risk demoralising staff and make recruitment and retention of staff in poorly performing areas “even harder”.

He said there was a real danger of “short-term target chasing” which would mean less effort being put into solving the really serious problems in the NHS.

Matthew Taylor, chief executive of the NHS Confederation, which represents NHS trusts, said health services were already subject to a lot of oversight and regulation – and the prospect of “more league tables” would concern health leaders.

“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,” he said.

“League tables in themselves do not lead to improvement.”

Mr Taylor said the “devil will be in the detail around what constitutes failure”, much of which could be beyond a health leader’s immediate control.

“We look forward to working with the government to make sure that any new measures don’t disincentivise managers from taking on roles in struggling organisations,” he said.

NHS Providers, which represents NHS trusts in England, said hospitals were already doing everything possible to boost productivity while delivering tough efficiency measures.

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