Underperforming NHS Trusts: Government Oversight

Jim Shannon Excerpts

Wednesday 14th October 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to serve under your chairship, Mr Stuart. I thank the hon. Member for Chelmsford (Marie Goldman) for raising this issue and giving us a chance to participate in this debate.

The new intensive recovery programme has identified several NHS trusts in England that are underperforming as a result of waiting lists, persistent financial difficulties and leadership instability. The trusts identified include North Cumbria, Mid and South Essex, Hull, North Lincolnshire and Goole, and East Kent. Performance across those trusts and beyond has raised serious questions about whether patients in England are receiving consistent access to cancer treatment.

I want to focus on cancer treatment in particular. The NHS has a long-standing target that 85% of patients should get treatment within 62 days of an urgent referral for suspected cancer. However, the performance at many trusts is substantially beneath that, and it is having serious consequences on patient outcomes. For example, in 2023, the death of a patient admitted to Mid and South Essex was linked to the trust’s failure to meet any of NHS England’s cancer waiting time targets. At that trust, only 47.7% of patients began treatment within 62 days, and by 2025 the number had further declined—in other words, it was getting worse.

At the County Durham and Darlington trust, which the hon. Member for Darlington (Lola McEvoy) referred to, the situation is similar. Significant failings were identified in breast cancer care, as she illustrated very well. A review of the care received by women between 2023 and 2025 found that 32 women had undergone unnecessary surgery, 20 had experienced a late diagnosis and a further 78 patients were found to have suffered moderate or severe harm. A review has been committed to, demonstrating that the true scale of the issue is likely much bigger than we know.

Analysis of NHS cancer waiting time performance found that nearly every English NHS trust missed cancer targets. In Northern Ireland, we have also experienced serious concerns regarding cancer care. For example, recently there has been a call for a public inquiry into urology services at the Southern Health and Social Care trust, where it was identified that cervical screening services had reported some results incorrectly. Patients were told their scan was clear, and then shortly afterwards told it was not. That is an absolute scandal, and it caused patients and families considerable distress. Northern Ireland’s waiting time statistics further illustrate the pressure on cancer services. Some 30% of patients began treatment within 62 days, and that percentage has been on a downward decline.

I know the Minister has no responsibility for Northern Ireland, but she has responsibility for the trusts here. I look to her to ensure the promotion of effective oversight and accountability in all our trusts. Underperformance is widespread and must be addressed. These failures are undermining public confidence in the health service. A suspected cancer diagnosis is already a distressing experience, and patient outcomes are not being helped by lack of clarity and reassurance.

[Graham Stuart (in the Chair)]

Last but not least from the Back Benches, I call Adam Dance.

--- Later in debate ---

[Helen Morgan]

I do agree, and I echo my hon. Friend’s call. The estate that people work in is part of the fundamental problem that we are trying to tackle across the NHS.

I hope all the Members here who have made excellent speeches highlighting shocking failures in their own trusts can take heart from the fact that it is possible to tackle the issues in underperforming trusts. In my time as the MP for North Shropshire, I have seen meaningful changes for my constituents. From 2018 to 2023, Shrewsbury and Telford hospital trust was obviously underperforming, with CQC inspections consistently rating it as inadequate. That included inadequate levels of safety and services—reflected in the horrifying stories received at the time in my inbox and those of the other Shropshire MPs, and on doorsteps—and a churn in the management team that led to constant uncertainty about what was going to happen there. The human consequence of those stories was devastating.

When I was first elected, the overwhelming issue was the abysmal ambulance waiting times, related to poor handover times, as the hon. Member for Stoke-on-Trent South (Dr Gardner) highlighted. I will never forget the letter I received from a headteacher: after a pupil dislocated his knee playing football, he and the teachers waited so long for an ambulance in the dark and cold on a winter night that he was at risk of developing hypothermia by the time the ambulance arrived. We heard countless devastating stories, including ones where the ambulance had taken so long to arrive that it was too late, and the outcome was fatal.

Following a targeted campaign, which included me joining the West Midlands ambulance service team for an eye-opening shift, wait times have significantly improved, and we see far fewer of these cases in our inboxes. But challenges remain, not least in corridor care in the accident and emergency department, which has at times been rated one of the worst in the country.

A constituent told me of the shocking experience of her aunt Cath during this period, who was admitted to Royal Shrewsbury hospital following a serious stroke. One night, Cath fell out of her hospital bed and broke her hip after staff had failed to put up the necessary guardrails. She spent nearly half an hour trying to attract the attention of staff on the ward with the alert bell, but they were so overworked that they did not respond, and in the end she was forced to dial 999 from the floor of the ward. She was left in the ridiculous position of explaining to the call centre staff that she was actually on the floor of a ward in Royal Shrewsbury hospital before the staff reached her. That cannot be right. We heard of many heartbreaking situations where cancer patients’ scans could not take place because waiting lists had meant that they were booked in the wrong order and of fatally long waits for diagnosis in some cases, with the trust failing to hit key targets across the board.

Finally, the 2022 Ockenden report shook my community with its devastating finding of over 200 preventable deaths of babies and unimaginable harm done to families. Campaigning and voicing justified anger, which everyone has done today, and working with Ministers on the failings can bring about change. That was essential in Shropshire, and though things are not perfect, it is encouraging to see the improvements that have been made so far. It has been a really difficult environment for staff to work in. I pay tribute to them and the new leadership team for all the hard work that they have put into turning this extremely difficult situation around. The trust’s CQC rating has recently been upgraded, although it still requires improvement, with emergency department waiting times and understaffing as key focuses. However, there is much to be pleased with. Reviews have noted a positive culture, and the trust has recently been shortlisted for several awards for its performance improvements.

We must celebrate the many trusts in the UK that provide high levels of care and innovation, and support those making significant improvements. For underperforming trusts, it is our duty to our patients and constituents to ensure that we campaign to bring them up to good standards, and I congratulate everyone here today on doing just that. However, if conditions for care are stretched and staff are expected to deliver the impossible with limited time and resources, it is patients who suffer. How can we transform patient safety? To start, we need to hold failing leaders to account, as I have discussed. Reports have pointed to a culture of unaccountability among NHS leaders, which has accompanied recent scandals and undermines public confidence. Failing trusts need to be held to account, and our amendments to the Health Bill would help do that by retaining the necessary structures for accountability.

First, we must retain the independent patient voice, Healthwatch, which was established in the wake of the Mid Staffordshire scandal. Although still in its infancy, HSSIB, the Health Services Safety Investigations Body, should also be retained because it promises to improve the patient safety environment. Our amendments would also introduce duties and a standardised framework for the reporting of suspected health system failings and medical malpractice by coroners, medical examiners and members of ICB and NHS trust boards.

Whistleblowing routes to the CQC, the Department of Health and Social Care, HSSIB and the police would be accompanied by statutory protections. We would also place a corresponding duty on senior leadership to escalate any concerns they have about safety or malpractice to the relevant boards. My colleagues in the other place will be re-tabling those amendments at the next stage of the Health Bill, and I urge the Government to accept them.

[Jim Shannon]

The hon. Lady referred to whistleblowing, as did the hon. Member for South Basildon and East Thurrock (James McMurdock) before her. Does she agree that there should be more encouragement for those who want to blow the whistle, but also protection for their jobs?

[Helen Morgan]

I fully agree, and that is why HSSIB has a role to play, because it provides a safe space for people to raise concerns without fearing for their jobs. The National Guardian’s Office, which is also being removed by the Health Bill, enables and encourages safe whistleblowing across the NHS, and it is important that we retain it.

The Thirlwall inquiry highlighted constant reorganisation as a problem as well. I received a notification in my inbox this week that Shropshire, Telford and Wrekin ICB had clustered with Staffordshire and Stoke-on-Trent ICB to get ready for a merger, but that it is all on hold now because it does not line up with local government reorganisation. It is really problematic for local health services when their management teams do not know whether they are coming or going from one month to the next. I urge the Minister to deal with that problem as well.

It is clear that urgent action is needed to turn around underperforming trusts for the safety of their patients, the welfare of their staff and the value delivered for the taxpayer. I hope the Government will look at the measures we have outlined and accept some of them in the Health Bill as it passes through the House of Lords, so that we can really affect people’s lives and put back their confidence that the NHS will be there for them when they need it most.