Health watchdog warned of ‘bigger challenges ahead’

A report has commended health watchdog Monitor for delivering ‘value for money’ but warns more changes are needed to cope with ‘bigger challenges ahead’.

In a recent report into Monitor’s work, the National Audit Office (NAO) commended the watchdog for delivering value for money and raising standards but warned of ‘bigger challenges ahead’. 

The NAO concluded that Monitor, with a core budget of £48m for 2012-13, has delivered value for money and proved its effectiveness with improving foundation trusts, especially those dealing with internal issues such as leadership or poor financial management. 

While the NAO admitted it was difficult to assess Monitor’s impact on foundation trusts, the trust staff in case studies took “faster or more effective action, or both, because of Monitor’s intervention than they would otherwise have done.” 

Monitor proved less successful when a “trust’s problems are down to underlying issues in the local health economy, such as where commissioners are also in financial difficulty” said the report, but auditors acknowledged the watchdog has recently tried to redress the balance by adapting its approach.

As the number of foundation trusts in deficit rises, Monitor’s workload is increasing, with the NAO auditor general Amyas Morse warning that “bigger challenges lie ahead for Monitor”.

“It needs to adapt how it works with other bodies to tackle underlying local weaknesses that increase the risk of individual trusts failing, either clinically or financially,” he said. The report urged Monitor to continue using its “informal powers of influence and persuasion to broker solutions”.

Speaking in response to the NAO report, Margaret Hodge, chair of the Commons public accounts committee, said she was “reassured” by the findings but stressed that Monitor needed to “ remain fit for purpose” in increasingly pressured times. She added her hope that the watchdog “quickly recruits the 113 posts that are currently vacant” to help manage the workload.