New managers for failing hospitals

Ratings included waiting times and cancelled operations

Four hospital trusts failing to meet government performance targets are to be taken over by more successful NHS executives.

They were among one dozen hospital trusts which got a "no star" rating in league tables published last year and have not done enough since then to improve the service they offer to patients.

All general hospitals were ranked according to how they performed in key areas.

After the star ratings were released, no-star hospitals were given three months to improve.

Management jobs at those not deemed to have made progress are now being "put out to tender" to other NHS managers.

The "franchises" will last three years.

The hospitals whose management is to be "franchised " are:

• Ashford and St Peter's NHS Trust
• Dartford and Gravesham NHS Trust
• Portsmouth Hospitals NHS Trust
• Barnet and Chase Farm NHS Trust, London

A fifth hospital, University Hospital of Coventry and Warwickshire NHS Trust - formerly Walsgrave Hospital NHS Trust - has been given a temporary stay of execution, while ministers await an inspection report due later this month.

Among the four, apart from at Barnet and Chase Farm, new chief executives are either in place or about to start work.

However, advertisements for suitable candidates will now be placed.

Those now in post will have to reapply for their roles - and could lose out if a management team is brought in from another hospital.

The chief executive of Barnet and Chase Farm resigned last week following a scandal involving a massive backlog of ultrasound scan requests.

'No star' hospitals

Ashford & St Peter's

Barnet & Chase Farm

Brighton Health Care

Dartford & Gravesham

E & N Hertfordshire - Stevenage

Medway - Gillingham

Oxford Radcliffe

Stoke Mandeville

Portsmouth

United Bristol

Epsom and St Helier

Walsgrave

Most of the poor performers were in the south of England.

It is expected that at four of the trusts managers from other hospital trusts will be offered the opportunity to come in and turn things around.

Health Secretary Alan Milburn had hinted that the private sector might be involved although this more radical and controversial option has been postponed.

He said: "In a minority of cases, despite the best efforts of staff, underperformance continues. Persistently poor organisational performance is neither good for NHS staff nor NHS patients.

"Bringing in the best NHS managers will help turn around poor performance. And in the future we will be able to draw on an even wider pool of management expertise."

No easy solution

However, Nigel Edwards, from the NHS Confederation, which represents health service managers, said that changing the management of "failing" hospitals was not necessarily a "magic bullet".

No management can function properly when faced with the Secretary of State's constant interference and obsessive target setting

Shadow Health Secretary Dr Liam Fox

He said that some of the worst-performing hospitals might have deeper problems which were preventing them meeting government targets.

He added: "In terms of the private sector, I'm not entirely clear where this pool of management talent is - that is prepared to work for the kind of salaries paid by the NHS to its managers.

"The zero star trusts have been scored against government criteria which do not necessarily mean that they are providing poor quality care for their patients."

Dave Prentis, from the health service union Unison, said: "There is no doubt that sharing these NHS managers will give a real boost to the hospitals and staff they are set to manage.

"The government should now let these managers get on with the job and prove their credentials before casting around in the private sector for other so-called experts from outside."

Shadow health secretary Dr Liam Fox said the government's policy is in "disarray".

He said: "No management can function properly when faced with the secretary of state's constant interference and obsessive target setting which is now seriously undermining the work of our hospitals."

Liberal Democrat spokesman Dr Evan Harris added: "Seeking to scapegoat hospitals with many beds blocked or who are short of nurses is the latest example of the government trying to shift the blame away from themselves."

The government is to begin compiling a register of experts with the qualifications and experience needed to run a struggling hospital.

They may come from private companies but ministers are also looking for talented entrepreneurs in the public sector such as local government, the universities and charities.