Indebted Mid Staffordshire hospital trust faces break-up

http://www.guardian.co.uk/society/2013/jan/17/mid-staffordshire-hospital-trust

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The hospital trust at the centre of the NHS's biggest care scandal in years looks likely to be broken up after a health service watchdog warned that patient safety could be put at risk because of its huge financial problems.

Mid Staffordshire NHS Foundation Trust faces the prospect of other nearby hospitals taking over some of its key services as a result of an inquiry into its clinical and financial viability by experts commissioned by the regulator, Monitor.

Between 400 and 1,200 patients are believed to have died between 2005 and 2008 after receiving poor care at Stafford hospital, which the trust runs.

The results of a public inquiry, headed by Robert Francis QC, into how failings in the NHS regulatory system failed to identify and prevent the scandal are due within weeks.

While Mid Staffs trust is providing safe care at the moment, it will not be able to do so on a sustainable basis in future, according to a contingency planning team, made up of experts from Ernst & Young and McKinsey & Company, and appointed by Monitor. The trust faces many challenges, including low patient numbers, large debts and persistent difficulty in recruiting doctors and nurses, the team's report warns.

The team says that, as one of the smallest hospital trusts in England, with relatively few patients using A&E, giving birth or receiving planned surgery at the two hospitals it runs – the other is in Cannock – Mid Staffs "will find it increasingly difficult to provide adequate professional experience for consultants and support them in the numbers recommended to maintain a high-quality service in the long term".

Mid Staffs received £20m from the Department of Health (DH) last year to help stay afloat. It would have to make £53m of savings in the next five years in order to break even. And, even if it did so, it would still need a further £73m from the DH, the experts said.

They are now looking at whether the trust can continue to operate both hospitals, and "assessing whether some services should be moved to existing or new providers in the area".

Monitor will submit a final report containing recommendations in March, which could lead it to make Mid Staffs the second trust, after the debt-plagued South London Healthcare Trust, to be put into the NHS's "unsustainable providers" regime.

Lyn Hill-Tout, the Mid Staffs chief executive, said its board accepted that the trust was not clinically or financially sustainable because, despite many improvements, it was unable to break even by 2015. Its financial situation mirrored that of many smaller district general hospitals across England, she added.

A DH spokeswoman said: "Despite improvements, Mid Staffordshire is still facing serious financial challenges. This puts at risk its work on improving services for patients. It is important that valued local services will last and are able to continue providing high-quality treatment and advice for patients."