Barts Health NHS Trust, the largest NHS trust in the country, was recently placed into special measures following concerns about care at Whipps Cross Hospital. What does ‘special measures’ mean, and how does this impact a patient’s care?

What are Special Measures?

Hospitals across the country are monitored by three organisations:

  • Monitor;
  • The Care Quality Commission (‘CQC’); and
  • The NHS Trust Development Authority (‘NHS TDA’).

If, following an inspection, there are concerns that appropriate standards of care are not being provided by the hospital and patients might be at risk, then Monitor or the NHS TDA put the Trust in charge of the hospital into special measures.

There are a number of reasons why a Trust might be put into special measures. These could include:

  • Informed consent not being taken for treatment;
  • Patients not being provided with food and drink;
  • Patients being abused by members of staff;
  • High levels of infection;
  • Problems with the correct medication not being given or recorded;
  • Risk to patient welfare, due to poor standards of care;
  • Lack of staff to provide an appropriate standard of care; and
  • Communication problems affecting the standard of care.

By putting a Trust into special measures, Monitor or the NHS TDA will:

  • Prepare a plan to improve the standards of the hospital, and review progress, with an Improvement Director put in charge of managing the improvements;
  • Possibly partner the Trust with a high-performing Foundation Trust; and/or
  • Reduce the functions or services of the Trust to focus on improvements.

There is a target for improvements to be made within 12 months after a Trust has been put into special measures.

My NHS Trust has been put into Special Measures. What will happen to my care?

As a Trust includes a number of services, the hospital that you are receiving care at may not be the place where concerns were raised; your treating hospital may not be the reason that the Trust was put into special measures. Even if it is the same hospital, the department that is providing your care may not have caused the concern. However, you should discuss the position with the hospital and/or your GP and you should be given full details about how this will impact your care. If the Trust is partnered with a Foundation Trust, some of the services provided may change and this may impact your care. If you are concerned about this, you may wish to speak with the hospital and/or your GP to discuss transferring your treatment to another hospital if and where this is possible.

Does Special Measures mean that I’ve received negligent treatment?

Being placed in special measures means that the hospital has failed to meet the standards the NHS and CQC expect a hospital to meet. This does not necessarily mean that the staff at the hospital have acted negligently in providing your treatment, as that will depend upon whether the standards of care provided to you have fallen below a reasonable standard. However, this may be a reason for a Trust being placed into special measures. If there is concern about a particular doctor or other member of staff who treated you, the hospital should have informed you about this and provided you with details