Failing hospitals will be named and shamed in league tables and NHS managers sacked if they cannot improve patient care and take control of finances, the health secretary will say on Wednesday.
Wes Streeting will tell leaders at the NHS Providers conference in Liverpool there “will be no more rewards for failure” as he sets out a package of measures aimed at tackling poor performance.
NHS England will carry out a “no holds barred” review of NHS performance across England with the results made public in league tables which are regularly updated.
NHS leaders and experts have warned the health secretary’s announcements – such as “naming and shaming” NHS leaders, will have unintended consequences and risk getting the health system into a mess.
The move comes after former Labour health secretary Alan Milburn was appointed as a non-executive director for the Department for Health and Social Care. During Mr Milburn’s time as health secretary league tables were also brought into the NHS.
Under the new policies announced by Wes Streeting, NHS trusts can expect to be ranked on a range of indicators such as finances, delivery of services, patient access to care and the competency of leadership.
Under the plans, persistently failing managers will also be replaced and turnaround teams sent into trusts that are running big financial deficits or offering patients a poor service.
Meanwhile, the best NHS performers will be given greater spending control to help modernise their buildings, equipment and technology.
Responding to the announcement NHS Providers deputy chief executive Saffron Cordery warned: “Taking steps to resolve these root causes is critical before any plans to introduce league tables and threats to ‘sack failing managers’ are even put on the table.
“Trust leaders are highly accountable, subject to rigorous standards and stand ready to tackle the challenges ahead, as they have always been. League tables bring with them a significant risk of unintended consequences.”
Thea Stien, chief executive for think tank the Nuffield Trust, warned: “There is a danger the actions announced by the secretary of state will worsen some of the patterns that got us into this mess. We know from the special measures for quality regime that “naming and shaming” NHS trusts can make it harder to recruit staff, which doesn’t help patient care at all. It’s unclear what new league tables will measure – a table based on general waiting times doesn’t add much if you need to know how good heart surgery is.
“Ministers have long warned the NHS against the naive belief in the magic money tree. But they themselves are at risk of falling for the appealing notion of a magic productivity tree which will make the NHS more efficient just by shaking the magic tree harder, rather than by changing the drivers of efficiency.”
Meanwhile, the Royal College of Nursing’s executive director for England, Patricia Marquis, said: “We should not be tolerating poor management but scapegoating trust leaders for underinvestment and systemic failures is not the solution. NHS staff must not be pitted against one another.”
The Department of Health said there is currently little incentive for trusts to run budget surpluses as NHS trusts are unable to benefit from them, but that will now change, with top-performing trusts given more of this cash.
Mr Streeting said: “The Budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service.
“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.
“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.”
NHS chief executive Amanda Pritchard said: “While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.”
Mr Streeting has already announced that failing NHS managers will be denied pay rises if they do not improve patient care or get their finances in order.
A new pay framework for very senior managers will be published before April next year, with those who do well given financial rewards.
It comes after a review of the NHS by Lord Darzi earlier this year found the “only criteria” by which trust chief executive pay is set is the turnover of the organisation.
Mr Streeting will also tell the conference how NHS trusts could be banned from using agencies to cover staffing gaps such as healthcare assistants and cleaners, in a bid to cut the £3bn a year spent on agency workers.
Those NHS staff who leave permanent jobs could also be stopped from coming back into the health service through expensive agencies.
