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Monitor to investigate the challenges facing smaller NHS hospitals

Monitor has announced that it is to examine the challenges that smaller district general hospitals face in delivering high quality, sustainable care to patients, and how they are responding.

The health sector regulator wants to hear from patients, providers, commissioners, health care professionals and any other parties with an interest in providing acute care as it looks at the challenges facing these providers.

For the purpose of this study, Monitor is primarily looking at non-specialist providers that operate at least one acute general hospital, with an annual income of £300 million or less, although it will be asking for help from all sizes of provider to draw comparisons.
Monitor is particularly seeking evidence on:

  • whether smaller non-specialist acute providers are facing particular difficulties in delivering high quality, sustainable services;
  • factors that may affect these providers’ ability to deliver high quality services to patients or to respond to issues;
  • the opportunities they have to address potential challenges and to demonstrate innovative, high quality service delivery.

Importantly, says the regulator, it is open to evidence that factors other than scale may pose challenges to providers.

There are just over 140 non-specialist Acute Trusts in England, which together receive a total income in the region of £50 billion per year for all their services. Around half of these Trusts have an income of less than £300m.

David Bennett, Chief Executive at Monitor, said: “We have an important job to do in making sure that the whole sector works in the best interests of patients and understanding the pressures on small hospitals is an important part of that job.
“Smaller acute providers are an integral part of the NHS and we want to know more about the pressures they face.”

Monitor is working with the NHS Trust Development Authority (TDA) on this research project, as well as other organisations across the health sector, and says the exercise is exploratory only, not a formal investigation nor a review of the quality of individual Trusts.