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Mid Staffs: report finds trust clinically and financially unsustainable

A challenged foundation trust is providing safe care today but will not be able to do so on a sustainable basis in the future, according to an independent investigation for the health sector regulator.

The findings were published in an interim report from a team of experts tasked by Monitor with examining whether Mid Staffordshire NHS Foundation Trust in its current form is able to provide services to local patients in the long term.

The team reported that the trust is not clinically sustainable in its present form and cannot break even without compromising future clinical services.

Whilst significant improvements have been made to the way the trust is run and there are no immediate concerns about the care patients are receiving, the experts in the contingency planning team advised Monitor that this will not be sustainable.

The report says that Mid Staffs is one of the smallest trusts in the country with relatively low levels of patients attending accident and emergency, and requiring non-elective surgery and maternity services. This means the 2 hospitals at Stafford and Cannock Chase 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.

The report also said that, without continuing cash support, the trust is unable to pay its debts as they fall due and would be deemed insolvent. The Department of Health gave the trust £20 million last year. The investigation found that to break even, the trust would need to make £53 million of savings in 5 years (equating to 7% of its annual budget every year) and still require a £73 million subsidy from the Department over the period.

The experts are now considering how services should be provided in a way which meets the needs of patients in the Mid Staffordshire area and is also sustainable. This will include assessing whether some services should be moved to existing or new providers in the area and who these providers might be. It will reflect the views of commissioners from Stafford and Cannock as to which services it is essential to maintain locally.

Once Monitor has received recommendations in a final report, the regulator will decide what action to take and whether to put the trust into special administration.

Prof Hugo Mascie-Taylor, Clinical Adviser to the contingency planning team, said:

In the past the trust struggled to maintain high quality clinical services at the same time as reaching its financial targets and even now it is struggling to achieve recommended levels of staffing. If the Department removed its financial subsidy it is clear that clinical services would suffer.

Stephen Hay, Managing Director for Provider Regulation at Monitor, said:

The team of independent experts have consulted widely in examining whether Mid Staffordshire is sustainable in its current form. Now we have the team’s conclusions, it is important that they move forward quickly to find a way to safeguard services for patients in this area.

Mid Staffs: sustainability assessment