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Monitor takes enforcement action to ensure continuity in regulatory regime

Monitor has confirmed the enforcement action it is taking over known or potential breaches of the new provider licence by 18 NHS foundation trusts.

The breaches under the new regulatory regime that came into force on 1 April  relate to a range of issues that had put the trusts in significant breach of their terms of authorisation under the old regime.

These issues include failure to deliver improvements in the quality of care, long waiting times (including A&E), poor financial performance or planning and failure to develop strategic plans.

In order to tackle these issues under the new regime, Monitor has a range of powers to ensure NHS foundation trusts take the required remedial action.

In this case, five NHS foundation trusts with a history of non-compliance or very severe issues have been ordered to put right the breaches. The NHS foundation trusts are: Bolton, University Hospitals of Morecambe Bay, Tameside Hospital, Sherwood Forest Hospitals, and Kettering General Hospital.

In addition the first three of these have given legally binding undertakings to remedy other potential breaches within an agreed timescale.

The 13 other NHS foundation trusts have also given formal legally binding undertakings that they will put right potential breaches as soon as possible. They are: Cambridge University Hospitals; Rotherham; Basildon and Thurrock University Hospitals; Burton Hospitals; Derby Hospitals; Heatherwood and Wexham Park Hospitals; Queen Elizabeth Hospital King’s Lynn; Medway; Milton Keynes Hospital; Peterborough and Stamford Hospitals; Royal National Hospital for Rheumatic Diseases; Southend University Hospital; and Stockport.

Furthermore, Kettering and Rotherham have had additional licence conditions imposed to ensure the trusts are being run in a way that delivers the changes needed.

Mid Staffordshire NHS Foundation Trust, which was also found to be in significant breach of its terms of authorisation under the old regime, is now under special administration and subject to separate regulatory scrutiny.

Managing Director of Provider Regulation Stephen Hay said Monitor decided on the appropriate action to take after reviewing representations from the individual trusts.

"It follows a period of engagement with trusts in which we reviewed their representations and then decided on the appropriate action to take.

"This is not new action, but the translation of known issues at these 18 NHS foundation trusts into the new regulatory regime laid down by parliament. We are taking enforcement action  in the context of our duty to protect and promote the interests of patients.

"Although the legal basis for our regulatory scrutiny has changed, Monitor continues to apply consistent and robust principles to ensure that foundation trusts are well led and able to provide good quality services for patients on a sustainable basis."

Notes to editors

  • For media enquiries please contact Emma Shepherd, Media Relations Officer, on 020 7340 2438 (
  • Monitor is the sector regulator of NHS-funded health care services. Under the Health and Social Care Act 2012 its main duty is to protect and promote the interests of patients
  • Information about Monitor's role can be found here
  • Monitor's Enforcement Guidance sets out the procedure we will follow when we become aware of a potential breach of the licence. When we decide to begin an investigation, we will notify the provider, set out what we are investigating, the key contacts at Monitor and the expected timetable. The provider will be given the opportunity to make representations Monitor's Enforcement Guidance press release can be found here
  • Follow us on Twitter - @MonitorUpdate
  • Link to the enforcement action taken can be found here

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