Alberti report on Pennine Acute Hospitals NHS Trust

Date published: 01 November 2005

The report on Pennine Acute Hospitals NHS Trust has been published and it contains stinging criticsm

Sir George Alberti and the review team sent in by the Strategic Health Authority have spent the past three months researching and interviewing before putting the report together. Below is a summary of the recommendations:

The recommendations are presented under the relevant section headings.

We believe that all of these actions are of great importance.

Leadership and Management

1. The Trust must increase the focus on strategic change and reconfiguration. Each Division and department needs to develop its own vision for the future, working with local PCTs and with support and encouragement from the SHA.

2. Local PCTs should review the way in which they perform their role in relation to the strategic developments required and ensure that they are providing strong, supportive and cohesive force for change.

3. A strong leadership triumvirate of Chair, Chief Executive and Medical Director should lead the Trust into this next stage of development.

4. A Trust Medical Advisory committee should be established immediately to ensure that there is meaningful clinical input into all strategic decisions.

5. An external recruitment process should be followed to appoint a strong Medical Director.

6. The Chair and Non-Executive Directors should reflect on their role and influence in the Trust and should work with the SHA to enhance their role.

7. The CEO and all Directors should increase productive contact with staff from all areas in the Trust.

8. Directors and clinical leaders should give careful thought to the values that are important and the management styles that will enable those values to flourish.

9. Managers and clinical leaders must be able to demonstrate their ability to perform their roles; and a comprehensive programme of development should be made available to them where necessary.

Size and Structure

10. Each Division must review its current structures and ensure that management processes, structures and decision making to ensure that they are fit for purpose (i.e. to improve patient care in a clinically effective and cost efficient way). This should include a review of the CAT leads, ensuring that the right people are taking the role and are adequately resourced to fulfill their responsibilities.

11. Divisional leads must work with corporate Directors to ensure site management is established.

12. The Trust must appoint an excellent Director of Human Resources who will provide leadership to the department and will ensure that Human Resources is adequately resourced to take a full role in the
necessary Trust developments.

13. The Trust must work with the Trade Unions to speedily resolve outstanding issues.

14. The Medical Staffing Department should be reviewed urgently to ensure that the resources and processes are appropriate. This should include a review of the use of locums and agency staff.

15. Nursing staff levels should be carefully monitored by the Director of Nursing.

16. AHPs should be involved in discussions about their role in the health economy.

Service Delivery and Standards

17. A further in-depth examination of clinical governance processes should begin immediately, preferably by an external team. This is needed to provide assurance that clinical practices throughout the Trust are safe and effective.

18. As part of that review Divisions should examine whether they are using performance data, incidents and complaints optimally to ensure good performance and governance.

19. More training is needed throughout the Trust in dealing with and learning from complaints.

20. The annual Clinical Audit plan should be well published throughout the Trust.

21. Processes related to the access, booking and choice system and modernisation should be reviewed.

Communication and Involvement

22. Communication systems should be enhanced. An additional clinically focused briefing from the Medical Director/Nurse Director should become a regular event – together with a progress report on reconfiguration. The delivery of the team brief should be improved.

23. A review of email traffic should take place with a view to reducing the amount where possible.

24. Much better devolved decision making should be introduced. The increased involvement applies particularly to CAT leads and ward managers.

25. Communication and training and education should be recognised as key strands in moving the Trust forward. They should be given higher profiles and related budgets should be protected.

Within the one month of receipt of this report the Trust should produce an action plan that maps out actions, dates and responsibilities to take forward these recommendations.

That action plan should be agreed with the SHA. Progress should then be monitored by the Trust Board on a bi-monthly basis and by the SHA on a quarterly basis as a minimum.

No one of these recommendations would resolve the current issues in Pennine Hospitals Trust. We are looking for systematic change that will lead to other changes.

The full report can be read by clicking the link below (PDF format):

Pennine Acute Hospitals NHS Trust Final Report