22/09/2015 15:08 BST | Updated 22/09/2015 15:59 BST

Addenbrooke's Hospital Should Leave Us 'Very, Very Anxious About State Of NHS', Nuffield Trust Says

A world-class hospital that is failing despite its top-rated care for patients reflects problems that should make us "very, very anxious" about the NHS' future, an expert has said.

Addenbrooke's Hospital was placed on special measures to deal with staff shortages, delays to outpatient treatment and "disconnected" governance that meant messages from doctors were not getting through, highlighted in a report that, paradoxically, rated it "outstanding" for the quality of its care.

The Care Quality Commission said the hospital was "extremely caring and extremely skilled" but its senior managers had "lost their grip on some of the basics", while the hospital had a spending deficit of £1.2million a week.

The Nuffield Trust, which analyses how policy can improve health and social care, said Addenbrooke's reflected the position hospitals were being put in, where they must both simultaneously boost staff numbers and not increase costs, while surviving the twin threat of increasing expectations and demand of Britain's ageing population.

The National Health Action party said the hospital's "sudden and dramatic demise... couldn't be a starker warning of the impact of this government's reckless policies on the NHS".

But Nuffield chief executive Nigel Edwards said it was a "bit too tricky" to blame Jeremy Hunt's reforms for the growing problem but said some of them, such as cuts to the social care budget, had contributed.


He said the problems facing the NHS was worsened by the lack of a "fundamental rethink" of how it should work to address these issues, adding this made it hard for senior management of hospitals to know what to focus on.

"We're seeing a lot of hospitals running into this type of trouble... Demand is growing but money is flat. Expectations are rising but the money is flat. There's a significant shortage of staff so the staff we've got are costing a lot more because they're coming through agencies," he told The Huffington Post UK.

"The expectation that you don't compromise on quality or on money means there's nowhere to hide. There was a shortage of people who want to run these organisations. People are not applying to do this.

"We face a growing and very concerning problem in which, you then add into that battles that people are having with the medical profession over seven-day working and the junior-doctors' contract, leads one to be very, very anxious about the current state of the NHS."

While the NHS has "not had cuts per se", he said, the budget increases have only kept rise with inflation, meaning they have not received a real-terms budget increase to deal with the issues facing them. "[The NHS] been asked to do an awful lot more with the same amount of money," he said.

Mr Edwards highlighted two specific policies that were having an effect, the cuts to the social care budget, which prolonged peoples' stay in hospital, and the requirement that the NHS increase the number of staff per patient.

He said: "Social care has been cut... which has meant, one's ability to discharge patients home, if you can treat more patients, if you can get them out the other end. But if you can't discharge them... then that's a problem. So there is some element of this which is due to government policy."

Speaking of the requirement to boost the staff/patient ratio, he said: "People have been recruiting agency staff and staff from overseas. Trying to fill the gap that means the money goes out of control... The implication of that, you've got problems. You're short of staff already and you're short of money, it's quite hard to square that circle."

The hospital trust's chief executive Keith McNeil stood down suddenly last week, saying it "faced a number of very serious challenges".

Dr McNeil was appointed to the job in 2013 after an international headhunt but his departure was not unprecedented.

Mr Edwards said: "There's been a number of chief executives removed or retired. Hospitals find it increasingly hard to meet the requirements that are placed on them.

"No one's really arguing these are the wrong requirements I just think the question to what extent is it actually realistic for people to be able to hit all of these without there being more fundamental rethinking of how the system works and what we're asking people to do."

He added: "You can blame the government, I think that's too easy... This is a collection of things. Hospitals and other providers are going to increasingly run into trouble. We don't have a terribly credibly answer for what to do about that."