CEO of major Midlands NHS trust quits after pressure from health regulator

Dr Mark Newbold stands down, blaming Monitor for contributing to a “blame-based culture”

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The chief executive of one of the largest NHS trusts in England has dramatically quit his job blaming the health regulator Monitor for “undermining leaders” and contributing to a “blame-based culture” for driving him away.

Dr Mark Newbold, head of The Heart of England NHS Foundation Trust (HEFT), announced his resignation on his blog after the health regulator threatened to sack him if improvements were not made to a range of hospital services.

A damning report from Monitor had criticised the Trust’s leadership, which it said had led to longer waiting times and concern over mortality figures. More than 5,500 patients had to wait more than the four-hour target at three of the Trust’s hospitals in Birmingham and Solihull, according to latest figures.

Monitor published a press release last month on the Government’s website that said it was “taking action to improve services and strengthen the leadership of HEFT, so that patients receive better care”.

It had introduced a Section 111 order, which allows the regulator to take actions at board level if and when it is considered appropriate.

Monitor said HEFT, whose hospitals cover communities in Birmingham and south Staffordshire, had “failed to reduce long waiting times for A&E, routine operations and cancer care patients, together with additional concerns regarding mortality rates”.

The regulator said: “The range and seriousness of these issues demonstrate a clear failure in leadership and the trust’s organisational systems”.

Adam Cayley, regional director at Monitor, said: “We will continue to monitor the trust rigorously and take further regulatory action if we consider it necessary.”

Dr Newbold responded to Monitor in his latest weekly "CEO Diary”, and admitted his Trust “has some performance challenges”, but countered that “such language [used by Monitor] is undermining to leaders”.

He said: “I wondered if this was the intention. I do not question the action taken, but by utilising a critical style of communication, which implies the leadership might only do the right thing if forced to do so, we risk framing the inability to achieve targets as a behavioural issue.”

Dr Newbold attended an awards evening for staff shortly after reading Monitor’s release. He said: “We heard from many patients and staff about some exceptional work that individuals and teams have delivered throughout the year. I toured the theatre afterwards, speaking to staff as they waited for their photos to be taken. They were proud, as they should be, and pleased to be appreciated. We had heard numerous instances of great care, delivered with compassion, by staff who regularly go the extra mile.

“As I drove home, I wondered how we could have two such differing perspectives on a single organisation? Our NHS is full of individuals at all levels who are kind, compassionate and supportive, yet the broader culture remains harsh and blame-based.”

Dr Newbold questioned whether a more understanding and supportive approach would achieve quicker improvements for patients. He said the support he has received on social media since his resignation announcement “confirms my belief that the NHS is full of compassionate and supportive people”.

In his resignation letter, Dr Newbold, who has led the trust since 2010, admitted failings with “overcrowding”.

He said: “Overcrowding is the singular problem that HEFT has, and I regret that I have not managed to solve this on a sustained basis. It is responsible either directly or indirectly for most of the main missed targets, and indeed our mortality rates and poor staff morale. If I had managed to solve the overcrowding, I do not think I would be writing this letter.

“I feel it is time for me to step down. I am proud that we have brought about many changes. I am particularly pleased with the progress we have made on openness and a transparent way of operating.”

The Heart of England NHS Foundation Trust confirmed it accepted Dr Newbold’s resignation. It said in a statement: “Dr Newbold believes that the time is now right for him to pass the baton on to allow the Trust to continue on its positive journey with fresh impetus. The Trust Board will be in a position to announce new arrangements in the near future.”

Monitor declined to comment. Dr Newbold was unavailable for further comment writing on his blog that he would “leave any further reflection for future posts”.

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