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NHS Performance 2001 Tuesday, 25 September, 2001, 11:00 GMT 12:00 UK
Star ratings handed to hospitals
nursing generic
This is the first set of hospital management rankings
Government star-ratings for every major hospital have been revealed - but a dozen are so bad they have got none.

The hospitals have been ranked on everything from waiting times and staff vacancy rates to patient satisfaction and ward cleanliness.

Those which are not making the grade are likely to have only a short "grace period" to improve before "hit squad" management teams are sent in to take over.

Among those given the "no-stars" rating are the trusts running the criticised Bristol Royal Infirmary, Walsgrave Hospital near Coventry and the John Radcliffe Hospital in Oxford.

This isn't about money, it's about management

Alan Milburn, Health Secretary
It is the first time that hospitals have been specifically ranked on management issues, as opposed to clinical performance such as death rates.

In all, 35 have been given the top, three-star rating, 12 the lowest no-star rating.

Health Secretary Alan Milburn said: "There has always been a convenient excuse for when there is a problem but these tables explode the myth once and for all."

Mr Milburn said there was too much variation in performance across the NHS. "This is not about money, it is about management."

He said the ratings showed some hospitals in poorer areas had actually performed better than others in more affluent areas.

Staff bonuses

Stephen Thornton, head of the NHS Confederation said: "Now we've done the measuring, we have to put in place measures to improve performance. It isn't just about managers, its about clinical staff, and a whole number of issues."

Managers at the top rated hospitals will be able to use their share of a 155m fund in any way they want.

The failing trusts
Ashford & St Peter's Hospitals NHS Trust
Barnet & Chase Farm Hospitals NHS Trust
Brighton Health Care NHS Trust
Dartford & Gravesham NHS Trust
E & N Hertfordshire NHS Trust
Medway NHS Trust
Oxford Radcliffe Hospital NHS Trust
Stoke Mandeville Hospital NHS Trust
Portsmouth Hospitals NHS Trust
United Bristol Healthcare NHS Trust
Walsgrave Hospitals NHS Trust (now University Hospitals of Coventry & Warwickshire NHS Trust)
Epsom and St Helier NHS Trust
Ministers would be happy for them simply to divide it up as staff bonuses, to reward hard work by teams at the hospitals.

The worst hospitals will be given just months to turn things around - or face intervention by troubleshooting "hit squads".

Managers from good hospitals would even be able to "bid" for the franchise to form the squads.

The underperforming trusts with no stars or just one will still get money to improve their services - but will have to account for every penny to managers at the NHS Modernisation Agency.

Hospitals with two stars will also get money, but have only limited autonomy over how they spend it.

Weaker hospitals are expected to also face more frequent inspections by the Commission for Health Improvement (CHI), while top hospitals will have to submit to inspections less often.

We must not fall into the trap of creating yet more hoops for managers to jump through

Dr Peter Hawker, BMA

Mr Milburn announced that top-performing trusts will be able to set up their own "trading arms" to make extra money for their trusts.

Money for laundering

For example, a trust would now be allowed to set up a laundry business to do all of its own washing and go on to sell that service to other hospitals.

Any money it makes could be ploughed back into the service.

Trusts could also set up companies to make money out of technologies developed by their researchers.

The Royal Marsden Hospital invented a kind of scanner called the PET - but made no profit when the invention was exported around the globe. In future, three-star hospitals would be permitted to do this.

The rankings were broadly welcomed by the British Medical Association, which said that the public had the right to know how good its hospitals were.

However, consultant's leader Dr Peter Hawker added: "We must not fall into the trap of creating yet more hoops for managers to jump through.

"In an over-stretched service, we need managers' energies focused on driving up quality, not on massaging the figures to please their masters higher up the command chain".

The BBC's Karen Allen
"Ministers see this as an important tool"
Steve Thornton, NHS Trust Confederation
"I do not think what has been published does actually shame hospitals"
Hospitals have been rated by the government

See also:

09 Mar 00 | Health
21 Jun 00 | Health
16 Jun 99 | Performance 99
28 Oct 99 | Health
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