Medway NHS trust faces new action
An NHS trust that has already been placed in special measures has been told it must take urgent action or face leadership changes.
Medway NHS Foundation Trust was put in special measures after the Keogh review this year found it had major failings.
Health regulator Monitor has now found problems are broader than first thought and has imposed new conditions on the trust's licence to ensure improvements.
Medway NHS said it recognised the urgency and was addressing the issues.
'A&E and maternity issues'
Paul Streat, Monitor's regional director, said: "We know that staff are working hard to improve the quality of the trust's services, but we need the organisation's leadership to do more to make sure that urgent change happens quickly.
"The new licence condition gives us the power to make changes at the top if the current leadership fails to deliver."
He said the trust had failed to address properly poor A&E performance.
Problems identified by the Care Quality Commission in midwifery and maternity services last month meant the trust continued to operate in breach of its licence, he added.
He also said an improvement director who was appointed to support the trust as part of the special measures regime had found that the trust had focused on tackling care quality issues but needed "a credible clinical strategy for the organisation as a whole".
Mark Devlin, chief executive of Medway NHS, said: "Our new leadership team has made some real and tangible progress in tackling issues raised by the Keogh review."
But he added: "I absolutely accept the need for a new comprehensive clinical strategy to sustainably transform services."
'More nurses and consultants'
He said top priorities for the new medical director, chief nurse and whole team were to ensure improvements and shape the new clinical strategy.
He added improvements already made included a fall in staff vacancies, more than 60 additional nurses and over 20 clinical consultants employed, lower staff sickness and lower staff turnover.
The first phase of redesigning the emergency department was under way, he added.
Fourteen trusts across England were investigated for high death rates this year after the public inquiry into the Stafford Hospital scandal.
The investigation, led by NHS England's medical director Prof Sir Bruce Keogh, led to 11 of those trusts being placed in special measures.
Medway was criticised for poor communication with patients, poor management of deteriorating patients, inappropriate referrals, delayed discharges and long waits in A&E.