Colchester Hospital chairman removed from post

The chairman of a hospital foundation trust has been removed from his post over a series of failings, regulator Monitor announced today.

Richard Bourne was reappointed as chairman of Colchester Hospital University NHS Foundation Trust in September, after chairing it for four years.

But Monitor has used its regulatory powers to force him to step down over concerns about patient safety, leadership and waiting times.

A statement from Monitor said: "Regulatory action has been prompted by the trust's failure to comply with healthcare standards, its failure to exercise its functions effectively, efficiently and economically, and serious and wide-ranging concerns as to overall governance and leadership at the trust."

The news comes after Monitor intervened at another foundation trust, Basildon and Thurrock University Hospitals NHS Foundation Trust, after a damning report found poor hygiene and standards of care.

The foundation trust status is a supposed marker of excellence and allows NHS organisations greater financial freedom and control over their own affairs.

Sir Peter Dixon has been appointed interim chairman of the trust.

Monitor officials found the trust to be in "significant breach" of the terms relating to its foundation trust status.

The trust also had death rates higher than the national average, at 112 in 2008/09.

The national average is 100, meaning anything above this level is considered high.

The trust also failed to deliver on the Government's 18-week target, which promises patients they will be treated within 18 weeks of referral by their GP.

It failed to deliver the target over three consecutive quarters and also failed to sustain meeting the four-hour target for A&E.

Other targets affected include cancer waiting times, measures of patient satisfaction and board leadership and governance.

In a letter to Mr Bourne, Monitor said there had been "almost nine months of formal regulatory discussions and contact between Monitor and the trust during which considerable period all issues relating to the breaches of the specified terms of authorisation have been raised and debated in both meetings and correspondence".

Other concerns included that the trust's annual health check performance for quality of services had moved from excellent in 2007/08 to fair in 2008/09.

The Monitor statement said: "Although the trust has made some progress over the last six months to improve its performance against some healthcare targets, the rate of progress had been slower than expected and even where targets are now being achieved, such as in A&E waits, the trust recognised that performance was fragile.

"Having given full consideration to these issues, and the various options for regulatory action, Monitor decided a change in board leadership was most likely to assist in a rapid and sustained return to compliance with the terms of its authorisation."

Monitor's executive chairman, William Moyes, said: "We have taken this decision to ensure the trust has the board leadership capacity to address our concerns.

"Ultimately this is about making sure the trust is in a position to identify risks and challenges that affect patient services and then deliver an effective response."

A senior source at the trust said Mr Bourne was "surprised" by the action taken, given it had made significant progress on meeting Monitor's requirements.

He is currently seeking legal advice.

The trust experienced its highest number of A&E admissions in January and February, which led to a bed shortage and the need to cancel routine operations such as hip replacements.

However, according to the trust, many such issues have been resolved.

Earlier this month, Mr Bourne accused Monitor of being "grossly unfair" and "intimidatory".

In a confidential email to other foundation trusts, seen by the Health Service Journal (HSJ), Mr Bourne said Monitor's process "ignored large amounts of evidence of a favourable nature".

The email said: "In our view the entire process has been disproportionate and grossly unfair and we are likely to make a formal legal challenge.

"The approach also appears to be deliberately intimidatory and they (Monitor) have made threats of various kinds to take action against myself, other directors and governors."

The trust said the email had not been intended for publication.

A statement from the trust today said: "At its regular monthly board meeting on Wednesday, Monitor reconsidered in full the trust's position and concluded that we are in breach of our terms of authorisation.

"Consequently, having considered a range of options, Monitor's board decided to use its powers of intervention to remove Richard Bourne as chair with immediate effect.

"This decision was communicated to the trust by phone late yesterday afternoon and in a subsequent letter from Bill Moyes, executive chairman of Monitor.

"From Monday (November 30), Sir Peter Dixon, who is chair of University College London Hospitals NHS Foundation Trust (UCLH), will become interim chair. He will maintain his UCLH role."