Written - Performance Issues at Cardiff and Vale NHS Trust

As a result of my concerns about performance issues, I have today directed Cardiff & Vale NHS Trust to undertake two reviews into the performance of their organisation. These are an Assurance Review of the Trust`s processes, leadership and governance, and a Review of Waiting List Management within the Trust.

My officials identified concerns about management of the waiting lists in orthopaedics and cardiac earlier this year. They are also concerned about delivery of the planned level of orthopaedic activity, and whether sufficient activity has been commissioned to meet the waiting times targets of 22 weeks throughout the year and 14 weeks by March 2009.

At the end of May, the Trust reported 157 orthopaedic inpatient/day case breaches.

I have required the Trust and the LHBs to develop plans to tackle these issues immediately and to ensure that patients are treated in a timely manner. As well as delivering planned activity levels, the Trust will be seeking to treat extra patients. The LHBs are developing plans to treat patients at other hospitals. Achieving the waiting times targets could mean that about 1,000 extra patients must be treated between now and the end of March. The majority would need to be treated at other hospitals.

I have discussed these matters with the Trust Chair on three occasions, most recently on Monday 28 July.

I am very disappointed about performance in A&E. where the Trust has consistently been the worst performer against the 4 hour and the 8 hour targets. The Trust has received substantial support from my officials and the Delivery and Support Unit to tackle these performance issues, and yet problems remain.

I have decided that further external scrutiny of this organisation is necessary. The two reviews I am announcing today will provide advice to the Trust Board about the fitness for purpose of the organisation in general, and its waiting list management processes in particular.

I have set the Terms of Reference for the reviews, and specified membership. The reviews will report to the Trust Board, who will consider them in public session. The Trust Chair will inform me of the outcome of the Board’s discussions and the actions they intend to take.

I take these matters very seriously. Performance targets are there to ensure that the public receives a guaranteed minimum level of service. It is the responsibility of Trust Boards to ensure that their organisations have in place leadership, processes and governance arrangements which will deliver within these targets. It is particularly important that systems are transparent, so that patients know that they will be treated fairly.

The reviews I have directed Cardiff & Vale NHS Trust to undertake will tell us whether we can have confidence in arrangements within that organisation. I expect to receive the outcomes from the reviews in the autumn. In the meantime, my officials will continue to work with the Trust and the LHBs to secure treatment for patients and reduce the number of breaches of the waiting times targets by the NHS.

I attach a copy of a letter that I have today sent to the Chair of the Trust.