British Hospital Trust to Receive Enhanced Oversight

The UK National Health Service took over management of the Shrewsbury and Telford Hospital Trust on November 8. (Wikimedia Commons)

Britain’s National Health Service (NHS) imposed special measures on the Shrewsbury and Telford Hospital Trust (SaTH) on November 8 following a string of infant deaths and repeated warnings over patient safety, poor management, workforce issues, and problems in maternity care.

The NHS will no longer permit the trust, located in Shropshire in the West of England, to run itself. NHS Improvement, a body responsible for overseeing foundation trusts and NHS trusts, will impose the measures.

The decision comes following growing concern over the trust’s activities and its dealing with patients. Prior to the measures, the trust had already been reported to a watchdog agency over maternity and emergency services care at both its Royal Shrewsbury and The Princess Royal hospitals.

The primary reasons for the measures are an August independent review carried out by the Care Quality Commission (CQC) regarding more than 100 cases of infant deaths and patient safety complaints in both the maternity and emergency departments.

On November 6, the CQC levied a formal warning at the trust over understaffing in critical care departments and concerns with practices in other departments. Three days before, approximately 3,000 people participated in a protest over the trust’s plan to close the Accident and Emergency unit at The Princess Royal Hospital at nights. The trust cited staff shortages to justify its decision.

The move by NHS Improvement to impose measures itself represents the first time a trust has been subject to special measures without a formal recommendation from the CQC. Professor Ted Baker, chief inspector of hospitals at the CQC, said that “there is sufficient evidence that the trust will not be able to make all the necessary improvements in the quality of their services without external support,” thus justifying his decision to ask “NHS Improvement to put in place all necessary support without delay.”

Matt Hancock, secretary of state for health and social care, communicated with politicians to inform them of the special measures being put into place, noting, "In light of ongoing concerns about the trust's quality and performance and recent concerns raised by the Care Quality Commission, I believe that this is the right decision to take to ensure safe services for patients.”

The response from those in the trust points to a willingness to cooperate with the implemented measures. Regarding the decision, the trust’s chief executive, Simon Wright, said that, while special measures would cause "anxiety among our patients and staff," the trust "absolutely welcome[s] that extra support that comes with special measures and NHS Improvement's support for the trust's leadership to make the necessary improvements."