It’s been a turbulent week in Westminster, but the most significant news for me came on Thursday morning, when Colchester NHS Foundation Trust came out of special measures after four long years, in one of the most remarkable turnarounds the NHS has ever seen.
Four years ago, the hospital was placed into special measures amid concerns over high mortality rates and cancer services (see chart below), and problems proved so entrenched that Colchester remained in special measures longer than any other hospital in the country – repeatedly being rated as inadequate.
Just over a year ago, a new leadership team from a nearby hospital came on board, and the results have been dramatic (see chart above). Where 15 areas were rated as inadequate one year ago, today there are none – and three quarters of the 40 areas inspected are now graded as good. The graphs below give you a sense of the scale of the turnaround.
These aren’t just a few tick-boxes on a regulator’s spreadsheet. These changes represent a transformation in local health services for thousands of patients: better cancer care, safer maternity services, and a dramatic change in the quality of care people get in their final days and hours – with end of life care going from inadequate in every area to good in every area.
Lives saved, better results from surgery, and healthier prognoses: it is hard to over-emphasise the difference that these changes can make to local people.
I’ve now been Health Secretary for more than five years, and perhaps the most important lesson I’ve learnt in that time is that turning hospitals around is nothing to do with problems with staff, and all about the quality of leadership. The staff in a trust that goes into special measures are exactly the same as the staff when it’s come out of special measures. In other words, it’s nothing to do with the staff – it’s all about leadership. Everyone joins the NHS because they want to help people in the most vulnerable moments of their life, when people are sick or dying, so the question is whether you have the leadership that unlocks that basic thing that every single person in the NHS wants to do.
Introducing a program of Ofsted-Style ratings and special measures into the NHS was controversial at the time. People said that hospitals were too complex to merit a single rating. Others feared that ‘special measures’ status would cause hospitals to sink into a spiral of decline, making it impossible for them to recruit and retain staff. In fact, nearly 15 per cent of NHS trusts have now been through the special measures programme. 21 have already come out – having recruited hundreds of extra nurses and doctors between them. Seven have gone straight from an ‘inadequate’ rating to a ‘good’ rating. And one early study into the impact of the programme estimated that around 450 lives had been saved in less than a year.
This is the great Conservative insight into our public services. Not just that every parent or patient has the right to know how good local services are and the ability to choose the right one for them, but that true commitment to our NHS and education system is insisting on high standards for patients in every corner of the country – however tough and challenging that might be.