All 12 organisations below are in NHS “special measures” and have a long-standing chief executive.
NHS bosses earning up to £300,000 annually at England’s worst-performing hospital trusts could soon face dismissal under new plans to enhance healthcare performance.
Health Secretary Wes Streeting announced that NHS managers failing to meet standards in upcoming league tables will be removed. He emphasized a zero-tolerance stance on poor management, targeting “rotten apples” who earn substantial taxpayer-funded salaries.
Currently, NHS England ranks hospital trusts into four tiers based on key performance metrics. This oversight framework is expected to be used to create the public league tables. The Telegraph has identified 12 chief executives who have led underperforming trusts for over two years, now categorized in the lowest tier (formerly "special measures") and requiring intervention from NHS England.
This means they have “very serious, complex issues manifesting as critical quality and/or finance concerns that require intensive support”.
The criteria considers factors including performance against waiting time targets, A&E and cancer care, financial deficits, ratings by the Care Quality Commission (CQC) and any “catastrophic failings” in safety or leadership.
A further eight failing hospital and ambulance trusts have had a new chief executive appointed within the last two years.
All 12 organisations below are in NHS “special measures” and have a long-standing chief executive.
Tracey Fletcher was appointed chief executive of East Kent Hospitals University NHS Foundation Trust in April 2022 with the task of turning around the trust’s failing maternity services.
A review by Dr Bill Kirkup, published in October 2022, revealed 45 baby deaths had died unnecessarily with many more subject to avoidable harm.
But since then, things have only got worse, with the number of deaths rising. The CQC downgraded the trust’s maternity services in 2023 from “requires improvement” to “inadequate”.
Last month, it was confirmed that an external review was underway to investigate a 34 per cent increase in neonatal deaths at the Trust’s two hospitals: William Harvey Hospital in Ashford and the Queen Elizabeth The Queen Mother Hospital in Margate.
Meanwhile, Ms Fletcher took home £240,000 in 2023-24, according to the annual accounts.
Professor Clive Kay has been in charge of King’s College Hospital NHS Foundation Trust since 2019 and is the biggest earner on the list, taking home £305,000 per year.
It is understood King’s College is receiving “intensive support” because of its huge financial deficits.
The hospital’s chairman and financial chief both stepped down at the start of the year after its forecast deficit for 2023-24 rose from £45m to £90m.
The Trust’s pathology services provider, Synnovis, which provided bloodwork analysis, was hit by a cyber attack during the summer affecting tens of thousands of appointments.
The hospital was also forced to defend a wheelchair rental scheme, which is free for four hours but charges patients £2 an hour after that. It said it did not receive any money from service provider Wheelshare for hosting the service.
Another hospital with significant maternity failings is Nottingham University Hospitals NHS Trust (NUH), which has been run by chief executive Anthony May since September 2022.
Donna Ockenden, a senior midwife, is currently conducting the largest ever review into maternity care, talking to almost 2,000 families that have suffered stillbirths, neonatal deaths, injured babies and mothers and maternal deaths dating back to 2012.
Although the review began before Mr May’s appointment, Ms Ockenden revealed just two months ago her team were still hearing “extremely disappointing” reports of “racism, discrimination, unkindness, lack of civility from staff to women, including some women being shouted at by members of staff, poor bereavement care”.
Mr May has repeatedly apologised to families who have suffered at the hands of the Trust and ensured improvements are being made.
He was paid around £290,000 last year.
NUH also ranked second worst in October for its performance against the four-hour A&E target, with 50 per cent waiting longer.
It also had one of the worst financial forecasts last year, having planned for a £6.5 million deficit in the third quarter of the 2023-24 financial year – but ending up with an actual deficit of £63.8 million.
A lifelong NHS worker who trained as a nurse, Jayne Black was appointed chief executive in August 2022 and tasked with turning around Medway NHS Foundation Trust’s “inadequate” A&E department.
However, in June this year the CQC said the Trust still needed to urgently improve its A&E and revealed it had taken action against Medway Maritime Hospital in Gillingham following an inspection, but could not share details until “legally able”.
Last month, the Health Service Journal (HSJ) revealed a senior manager had left the Trust after making alleged racist and sexist remarks on a work video call.
The Trust also has one of the largest proportions of patients waiting more than 18 weeks for a hospital appointment in England, according to data published this week, with 49 per cent waiting longer than that target timeframe. A spokesman said this was because of capacity issues in the endoscopy department that were being addressed.
Ms Black earns £200,000 per year.
Liz Davenport has led Torbay and South Devon NHS Foundation Trust since October 2018 but is due to retire later this year, which will coincide with the trust’s two year anniversary of being in special measures.
She earned around £215,000 according to the Trust’s latest annual reports and the Trust has begun the process of finding a replacement.
The trust was downgraded over issues with waiting lists, emergency care and finances. Last year the CQC ordered improvements to keep patients safe.
In particular, its inspection found an overcrowded A&E unable to see children in crisis or patients with strokes within target times, as well as a 100-year-old outpatient department “no longer fit for purpose”.
Earlier this year the regulator also demanded improvements to maternity care to its inadequate monitoring of unborn babies, incomplete records and unsafe staffing levels.
A spokesman for Torbay and South Devon said: “Devon’s NHS is in national framework 4 and we are working as one system to deliver a plan that will deliver performance and financial stability.
“During the past year our performance has significantly improved, particularly for cancer and planned care. We have invested millions of pounds into our services to ensure people in Torbay and South Devon are seen and treated quicker.”
The trust has been run by Richard Mitchell since October 2021, with the chief executive earning £195,000 a year.
An inspection in June by the CQC found its services, including in A&E and maternity, required improvement, which were the same as after an inspection two years earlier, despite the regulator noting some improvements, for example safety in maternity care went from “inadequate” to “requires improvement”.
Last month the Trust declared a critical incident because of delays in treating patients in its emergency departments as it urged only those with life-threatening injuries to attend.
Its record on cancer care is also poor, with the latest data revealing that 43 per cent of patients had to wait more than 62 days to start cancer treatment after an urgent referral. The key target is for 85 per cent to begin treatment within two months.
Maggie MacIsaac was appointed chief executive of the Hampshire and Isle of Wight Integrated Care Board (ICB) in November 2021 and received £245,000 last year.
The board is one of 42 local NHS bodies around England in this case overseeing the operations of five hospital trusts and one ambulance trust in its area, all of which are in special measures.
A spokesman for the ICB, also speaking on behalf of those on its patch, said: “All NHS organisations in Hampshire and Isle of Wight requested to collectively enter the national Recovery Support Programme in 2023 which meant each was placed in segment 4 of the current NHS oversight framework. We took this decision due to the collective financial challenge we faced and recognised this could only be addressed by each organisation working together as a system.”
Among those hospital trusts receiving intensive support in Hampshire is University Hospital Southampton NHS Foundation Trust, led by David French since 2020, on a salary of £265,000.
The hospital trust is among the most challenged in England because of its financial deficits, forecasting a £66 million end-of-year overspend.
It has also been embroiled in controversy this week over a row with porters who are planning to strike in protest at being told they cannot take toilet breaks – a claim the Trust has refuted.
Another Hampshire hospital in the NHS’s lowest rung of tier four because of financial pressures and patient care is Portsmouth Hospitals, which has been run by Penny Emerit since March 2021.
She earns £245,000 per year.
The hospital trust ranks in the bottom five out of 118 trusts for A&E performance against the four-hour wait target.
Some 43 per cent had to wait more than four hours to be seen in October. The target is to be less than five per cent.
Alex Whitfield took the helm at Hampshire Hospitals in 2017 making her one of the longest serving chief executives in the NHS.
She was paid around £205,000 last year.
The hospital’s financial challenges were set to be alleviated somewhat as part of the Conservative’s 40 new hospitals programme, however that is currently being reviewed by the new Government.
Ron Shields is the chief executive of this newly created NHS Trust which was born out of a merger between Southern Health, which he led from 2020, and Solent Trust.
He was paid £200,000 per year in his previous role.
Southern Health struggled to shake the damage to its reputation as a mental health trust following the deaths of multiple patients between 2011 and 2015. An independent report published in 2021, led by Nigel Pascoe QC, found there were still “significant unresolved issues” six years after its leadership was heavily criticised in relation to major care failings.
Shropshire, Telford and Wrekin ICB has been in the NHS’ most challenged tier since its inception in 2022, with chief executive Simon Whitehouse in charge for the duration.
It has a track record of large financial deficits in relation to its size, including an expected overspend of more than £70 million for 2023-24.
It had planned for a deficit of £57 million, but was forced to increase this to £130 million earlier this year. The overspend is equivalent to about 14 per cent of its total funding, making it one of the largest deficits in the country by proportion.
The chief executive, who earns £190,000 per year, has also faced a number of official grievances and resignations from directors in recent months.
Six senior members of staff have left the ICB in the last year, including the chief nursing officer, chief medical officer, chief operating officer, deputy finance director, director of urgent and emergency care and head of digital.
An NHS spokesman said: “We have a robust recovery support programme in place for the most challenged trusts, including tailored improvement plans, dedicated advisers to provide support, and regular formal review meetings – with more work being done to attract talented leadership teams to struggling trusts.
“Improvement takes time – and long-term structural issues often affect the ability to turn around services. But where regulatory action is required, we enforce management changes in line with our statutory powers and responsibility to patients.”
East Kent Hospitals University NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, Nottingham University Hospitals NHS Trust, Medway NHS Foundation Trust, University Hospitals of Leicester NHS Trust, and Shropshire, Telford and Wrekin ICB were all approached for comment.
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