First wave of NHS trusts registered under new system for monitoring standards

19 March 2010

• Tougher new regulatory system underway
• 66 trusts registered in first of three weekly announcements
• All trusts to be registered by 1 April

The Care Quality Commission (CQC) today (Friday) announces plans to give 66 NHS trusts a licence to provide services under a new, tougher system for regulating standards in the NHS.

For two of these trusts, registration will be conditional on further action being taken to address concerns about the safety and quality of care.

CQC says further urgent improvements are needed at Mid Staffordshire NHS Foundation Trust and Milton Keynes Hospital NHS Foundation Trust. It has set out the action required with strict deadlines for improvements to be made.

The regulator will register the remaining 64 trusts without conditions. But, the regulator stresses that no trust can be complacent and all must ensure that standards are maintained at all times. A full list of trusts in today’s announcement is below.

From 1 April, 378 NHS trusts in England will have to be registered with CQC by law to provide care. To be registered, trusts must show they meet new essential standards of quality and safety, which the regulator will constantly monitor.

The new standards cover important issues for patients such as treating people with respect, involving them in decisions about care, keeping clinical areas clean, and ensuring services are safe.

Where it finds trusts are not meeting standards, the regulator has stronger enforcement powers than ever before. This can start with a warning notice and escalate to fines, prosecution, restrictions on activities or in extreme cases, closure.

Cynthia Bower, CQC chief executive, says: “It is absolutely the responsibility of trust boards to ensure that standards are in place. These are the standards that every patient should be able to expect when they receive NHS care and they are now legally enforceable. This is a tough new system and we have stronger enforcement powers than ever before to make sure services improve.

“This initial registration process is just the start of the new system. For a number of trusts registration will be conditional on them taking immediate action to improve. Others have identified specific areas they say they are addressing. We will be keeping a very close eye on them to make sure they do. Safety is our number one concern here.

“The real work begins on 1 April when we will begin continuously monitoring standards. We are moving to a system where we will be looking at whether trusts are meeting the standards today and tomorrow, rather than in the past. We hope to identify and tackle problems earlier. We will carry out more inspections and we will look at the care people experience rather than just systems and processes. We will do more to listen and respond to the views of patients. If at any stage we believe a trust needs to take further action to protect patients, we will ensure this happens using our enforcement powers where necessary.”

To decide where to target regulatory activity, CQC will draw together intelligence and information about NHS care from a range of sources, creating quality-and-risk profiles for every trust in the country.

The regulator is also promising to take more account of the views of the public, gathering systematically the views of local patient groups and ensuring that patients have greater involvement in inspections.

Under the new system, trusts will be judged on the outcomes and experiences of patients, not just whether there are systems and processes in place.

Numbers of inspections at NHS trusts are set to rise significantly, with up to 2,000 reviews of compliance a year, the majority involving a visit. Inspections will involve observation of care, tracking of case studies and talking to patients and staff.

CQC says it will be proportionate, targeting resources at areas of concern and minimising inspection where organisations perform well. As a minimum, it will review every two years all trusts’ performance against the 16 standards that relate most closely to quality and safety.

The regulator will prioritise regulatory action at those trusts with conditions on their registration. Trusts must meet deadlines for improvements or risk enforcement action.

However, CQC stresses that trusts may still need to make improvements where conditions have not been imposed.

For example, there are standards where the regulator has evidence of non-compliance but the trust concerned has provided a credible action plan. There are other instances where CQC is following up on information provided by the public.

CQC says that it will be constantly monitoring and adding to the picture of performance of an organisation, taking action as appropriate.

In October this year, the new registration system will be extended to cover independent healthcare and adult social care providers, which are currently registered with CQC under a different system. For the first time, all these organisations will have to comply with a common set of essential standards.

From April 2011, the registration system is set to cover dentists and private ambulances. From April 2012, it is set to include primary medical care services such as GPs and private midwives.

List of trusts in first announcement with conditions

• Mid Staffordshire NHS Foundation Trust
• Milton Keynes Hospital NHS Foundation Trust

List of trusts in first announcement without conditions

• 5 Boroughs Partnership NHS Foundation Trust
• Aintree University Hospitals NHS Foundation Trust
• Airedale NHS Trust
• Ashton, Leigh and Wigan Primary Care Trust
• Barnet and Chase Farm Hospitals NHS Trust
• Barnet Primary Care Trust
• Barnet, Enfield and Haringey Mental Health NHS Trust
• Barnsley Hospital NHS Foundation Trust
• Barnsley Primary Care Trust
• Basingstoke and North Hampshire NHS Foundation Trust
• Berkshire Healthcare NHS Foundation Trust
• Berkshire West Primary Care Trust
• Blackburn with Darwen Primary Care Trust
• Blackpool Primary Care Trust
• Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust
• Bolton Primary Care Trust
• Bradford and Airedale Teaching Primary Care Trust
• Bradford District Care Trust
• Bradford Teaching Hospitals NHS Foundation Trust
• Brighton and Sussex University Hospitals NHS Trust
• Buckinghamshire Hospitals NHS Trust
• Buckinghamshire Primary Care Trust
• Burton Hospitals NHS Foundation Trust
• Bury Primary Care Trust
• Calderstones Partnership NHS Foundation Trust
• Camden and Islington NHS Foundation Trust
• Camden Primary Care Trust
• Central Lancashire Primary Care Trust
• Cheshire and Wirral Partnership NHS Foundation Trust
• City and Hackney Teaching Primary Care Trust
• Clatterbridge Centre for Oncology NHS Foundation Trust
• Countess of Chester Hospital NHS Foundation Trust
• Croydon Primary Care Trust
• Cumbria Teaching Primary Care Trust
• Dartford and Gravesham NHS Trust
• Derbyshire County Primary Care Trust
• Ealing Hospital NHS Trust
• East Kent Hospitals University NHS Foundation Trust
• Eastern and Coastal Kent Primary Care Trust
• Haringey Teaching Primary Care Trust
• Hounslow Primary Care Trust
• Isle of Wight NHS Primary Care Trust
• Kingston Primary Care Trust
• Knowsley Primary Care Trust
• Leeds Primary Care Trust
• Maidstone and Tunbridge Wells NHS Trust
• Mid Yorkshire Hospitals NHS Trust
• North Cumbria University Hospitals NHS Trust
• Nuffield Orthopaedic Centre NHS Trust
• Portsmouth City Teaching Primary Care Trust
• Portsmouth Hospitals NHS Trust
• Royal Bolton Hospital NHS Foundation Trust
• Royal Cornwall Hospitals NHS Trust
• Royal Liverpool and Broadgreen University Hospitals NHS Trust
• Sheffield Primary Care Trust
• Sheffield Teaching Hospitals NHS Foundation Trust
• Southampton City Primary Care Trust
• Southampton University Hospitals NHS Trus
• Southport and Ormskirk Hospital NHS Trust
• The Dudley Group of Hospitals NHS Foundation Trust
• The Royal Marsden NHS Foundation Trust
• The Walton Centre NHS Foundation Trust
• West Sussex Primary Care Trust
• Western Cheshire Primary Care Trust

Notes to editors