A year to turn round failing King’s Mill Hospital

Sherwood Forest Hospital�"s new Chief Executive, Peter Herring
Sherwood Forest Hospital�"s new Chief Executive, Peter Herring

The new boss of King’s Mill Hospital has given himself a year to turn around its fortunes.

Peter Herring – drafted in as interim chief executive of Sherwood Forest Hospitals Trust – believes he can make big improvements to its failing hospitals.

‘I can make an improvement in the time I am here.’

He faces the daunting task of sorting out a range of problems, which have seen the trust placed in special measures – including a £33 million annual debt which has left it on the edge of a financial precipice.

Mr Herring has been at the helm of the failing trust for four weeks and expects to be in position for 12 months or more.

He said he has a 27-page masterplan to be able to leave the trust in good enough shape to have a ‘stable leadership’ in the future.

However, he admits it will take more than a year to turn round the trust which has had at least six leaders over the last 10 years.

Mr Herring is taking up the reins just months after an inspection from the Care Quality Commission revealed too many patients were still dying at King’s Mill.

The report said the hospital was in a worse state now than it was when first placed in special measures two years ago.

Mr Herring said: “I was asked to pick up this role and I am pleased to do so.

“I can’t in that time resolve every problem the hospital has, but I believe I can make a big improvement in the time I am here.

“My role is to take as rapid improvements as possible during that 12 months to hand over the hospitals in as good a shape as we can so the trust can have a stable leadership in the future.”

He was one of a number of senior executives brought into the trust by Monitor, the Government regulator for health services, to strengthen the current leadership team.

The CQC revealed the trust, which also runs Ashfield Health Village in Kirkby, Mansfield Community Hospital and Newark Hospital, had failed to improve in all but one of the 18 targets set in 2013.

Leadership at the trust was inadequate with the chief executive position occupied by at least six different people since 2010.

Mr Herring, who has 22 years experience as a chief executive officer, most recently at Shrewsbury and Telford Hospitals NHS Trust, said he has a 27 page plan of attack focusing on the issues raised in the last CQC report, including mortality rates, treatment of sepsis, problems with openness, ineffective learning from incidents and leadership.

He said the trust had already improved urgent issues such as mortality rates, treatment of sepsis and casualty problems, which led to a “Black Alert” – a warning to the healthcare community that a hospital is facing greater demand for services than it can handle – 12 months ago.

However, the hospital’s dire financial situation with an annual deficit of £30 million – including £10 million private finance initiative repayments – would take longer to address.

Mr Herring said: “Mortality rates was one of the big issues raised by the CQC.

“For the last four months they have been below the national average of 100 and we’re now below 90.”

“We did not have good procedures in place for identifying sepsis early enough and subsequent treatment.

“We now have a thing called a sepsis bundle, a set of procedures medical and clinical staff should follow which has good application rates in admission areas. where most of these things are identified.

“Now sepsis mortality rates have been consistently below 90 for the past three months where the national average is 100. We are going in the right direction.”

“Our stroke service used to have the lowest grading of a D.

“Recently it has been audited and we are now an A. It is about focusing on the clinical pathway and making sure it is as slick and streamlined as possible seeing the patient as early as possible after admission.”

Last January’s “Black Alert” saw King’s Mill under the spotlight for failing to meet performance targets, with people kept waiting for more than four hours in its accident and emergency department.

The situation was created by a perfect storm with an increased number of people arriving at the department and a bottleneck created by a lack of available beds for A&E patients.

Mr Herring said: “A&E performance is now among the best in the country. It is above 95 per cent for the year to date.

“There will be days when it will be bad, particularly when there is a flu epidemic and we can be overwhelmed in a short period of time.

“We have done a lot of work on patient flow movement of through the hospital from point they are assessed admitted and discharged we want to make sure people are in the right place and the right time.”

More than £320 million was spent on new facilities at King’s Mill Hospital through the PFI in November 2005.

The trust has a £30 million a year deficit, a third of which was down to PFI repayments – meaning the trust is repaying nearly £1 million a month.

However, he admitted he was unsure about the chance of renegotiating it.

Mr Herring said: “Clearly the PFI debt is an issue for us.

“There’s a question mark at a national level – something will need to be done . Locally I have no idea what the possibilities or opportunities are around that.

“But we have to focus on the underlying debt – general efficiencies and productivity we need to improve on.

“One of the national problems we share is the reliance on agency and temporary staff and we are actively trying to recruit to our vacancies to minimise those costs.”

And he has promised an “open and transparent culture” to improve communication across the trust.

Mr Herring said: “Myself and the senior leadership team need to be more visible and talking to people face to face, rather than relying on written communication – listening to staff about what they think their problems are.

“As far as myself and the board of directors are concerned we want to have an open and transparent culture, where people can safely raise issues without being shouted at.

“The important thing is to create a successful organisation which has high quality services with the most affordable costs. In 12 months I won’t have achieved all of that but we will make considerable progress.”