A TROUBLESHOOTER brought in to help turn around a hospital trust’s fortunes will not provide much-needed stability because she is not staying long enough, a union has warned.

Gillian Fairfield is due to start as chief executive of Brighton and Sussex University Hospitals NHS Trust at the start of April.

However her contract is only due to last for up to 12 months and she is on secondment from her £187,500 a year job as head of Pennines Acute Hospitals NHS Trust.

There is an option for her contract to be extended but unions say the constant change of leadership at the top makes it difficult for the trust to get much needed continuity.

The news follows the departure of Maggie Oldham from East Sussex Healthcare NHS Trust, who was brought in by the Trust Development Agency (TDA) as an improvement director last year but left after only four months.

The TDA, the national regulator for trusts, would not reveal how much Ms Oldham was paid and insisted the placement was always meant to be temporary.

Among the challenges is the fact that the Brighton and Sussex University Hospitals NHS Trust's accident and emergency services received an inadequate rating last year from the Care Quality Commission.

Gary Palmer from the GMB union said trusts like Brighton had a lot of challenges and it needed strong leadership and someone who would show a long term commitment.

He said: "Having short term bosses parachuted in cannot be good for the trust and this constant changing is not helping matters.”

Dr Fairfield is taking over from interim chief executive Amanda Fadero, who only began the job at the start of this year.

It had been expected among staff she would stay in post until a permanent chief executive could be found to replace Matthew Kershaw, who left at Christmas.

However the TDA recommended Dr Fairfield for the role and the Brighton trust board has agreed.

Mr Palmer said: “This trust has a lot of work to get itself on track and there is also its major £485 million redevelopment to consider as well.

“What it needs is a leader who is going to stay for the duration.

“We seem to have this situation now where we have continuous recycling of chief executives who travel up and down the country working at different trusts and only staying for a short period of time.

“That cannot bode well for the NHS and this trust needs something a bit more than that.”

Patricia Marquis, regional director for the Royal College of Nursing, said: “Stability is vital in providing sustained improvement and frequent management changes will always make this more difficult.

“As a temporary chief executive, the big challenge for Dr Fairfield will be to lay the foundations for lasting improvements in culture and performance.

“In the recent NHS Staff Survey only 26 per cent of staff at the trust reported good communication between senior management and staff, and improving this must be a priority.

“Senior management must start supporting and listening to frontline staff if they want to improve patient care.”

A TDA spokesman said: “Gillian Fairfield is a chief executive with experience of delivering improvements at pace in trusts with a challenging set of quality and financial issues.

“We support her appointment and strongly believe that she will be able to put in place rapid improvements for patients during the next crucial period at the trust.”

The trust has a number of challenges to face over the coming months, including a crucial upcoming inspection by the Care Quality Commission.

Last week it was placed on its highest level of alert as it struggled to cope with high numbers of patients and a shortage of beds.

It is also predicting an overspend of more than £37m by the end of March.

Mrs Fairfield will work full-time in Sussex and her salary will be paid for by the Brighton trust.

Any arrangements over the cost of her transfer and accommodation expenses have yet to be confirmed.

HOSPITALS’ BOSS FACES LOBBY FOR ACTION AND LONG-TERM SOLUTIONS

WHEN Gillian Fairfield arrives at Brighton and Sussex University Hospitals at the beginning of next month, she will be thrown right into the deep end.

The trust is facing an inspection from the Care Quality Commission (CQC) at the start of April, focused mainly on its accident and emergency services, which received an inadequate rating last year.

It is also forecasting a deficit of about £37 million and has recently been struggling with long waits in its accident and emergency departments and delays in seeing patients who have been referred for treatment by their GP.

The trust, which runs the Royal Sussex County Hospital in Brighton and Princess Royal Hospital in Haywards Heath, is not alone in its problems, but its change of leadership at the top is a little more unusual.

When former chief executive Matthew Kershaw, who had been in charge for three years, left at Christmas, his deputy Amanda Fadero stepped up as interim chief executive.

However she had only been in post for less than two months when it was revealed Dr Fairfield would be taking over in April on a year-long contract.

The news sparked surprise from some at the trust, who had believed Ms Fadero would stay in post until a permanent replacement for Mr Kershaw could be found.

The news has also surprised unions, who believe the constant changing at the top is leading to instability and uncertainty for staff.

It remains unclear about who insisted on Dr Fairfield’s appointment. The Brighton trust board approved the move but it is believed it may have done so following a recommendation from the national NHS regulator, the Trust Development Authority (TDA), to do so.

No specific reason has yet been given as to why Dr Fairfield was brought in, although the TDA says it is normal practice for people in leadership positions to be replaced on an interim basis pending permanent arrangements being made.

The Argus recently reported how the director the TDA appointed last year to oversee improvements at East Sussex Healthcare NHS Trust, which has been placed in special measures, left after just four months.

The TDA insisted that the appointment of Maggie Oldham had always been temporary and would not reveal how much the director had been paid while working at the trust.

The latest developments at Brighton have thrown up the question about how much changes in management can affect the continuity and stability for health trusts.

It may be fine if someone comes in for a few months and makes some changes but if they then leave, how long will those changes and improvements continue? It is an issue that is concerning unions, who say long-term commitment would be better rather than a merry-go-round of chief executives moving around different parts of the country.

Sometimes a change of leadership at the top and a fresh pair of eyes looking at an organisation is a good thing, but should it be a short- term solution? 

Gary Palmer at the GMB union in Brighton believes longevity is key, and Patricia Marquis, regional director for the Royal College of Nursing agrees.

She said: “Stability is vital in providing sustained improvement and frequent management changes will always make this more difficult. 

Unison regional organiser Caroline Fife also believes the changeovers are not ideal.

She said: “The turnover rate of senior management at Brighton and Sussex Universities Hospitals has been higher than neighbouring trusts. We hope Gillian Fairfield is able to become familiar with the trust as quickly as possible to deal with the challenges it faces.” 

The NHS across Sussex and around the country is experiencing its most challenging time to date, with many trusts facing deficits while still having to make savings and deal with capacity problems, often caused by a shortage of available beds and services in the community.

Whether appointing a troubleshooter to take over just for just one year, (even with an option of extending that contract) is the way to go about it, remains to be seen.

Paul Evans, director of the NHS Support Federation, based in Brighton, said: “Leadership is important but in some ways this new chief executive would have to be a magician in the current situation. 

“Huge underfunding and poor planning over a number years leaves the NHS under-staffed. 

“Cuts in social care are driving more patients through the doors of A&E. It’s not just hospitals but GPs, ambulance crews and community health services are all under pressure.” 

Corridors are full with patients because NHS services don’t connect properly with the community and there is not enough money in either sector due to persistent cuts and underfunding.

Mr Evans said there were five things the new chief executive should do.

He said they should connect with community services to open up beds, invest in a new A&E department, fill vacant posts and be the voice for NHS staff struggling on a day to day basis without proper resources.

The fifth was to help plan according to need, alongside GPs and community health services and not just achieve a healthier balance sheet.