The blueprint to transform Epsom and St Helier NHS Trust from its beleaguered state into a world-beating health care provider within 12 months finally went public last week.

The 39-point action plan is a promise to turn round the trust in the light of the scathing criticisms levelled at the body by watchdog the Commission for Health Improvement (CHI).

But the massive agenda brings with it a massive cost, and with Epsom and St Helier already facing a potential overspend of £5.4 million and no new national funding on the cards, the programme could make a bad financial situation decidedly worse.

Though responsibility for delivering on each point of the plan has been placed in the hands of a trust director, chief executive John de Braux said the buck stopped with him.

The trust will publish an annual report measuring its progress against the plan and also comprising staff and patient feedback, the first of which will see the light of day next August.

Innovations include a patients and carers forum, to be established by December, to put the views of service users at the centre of health care.

Contracts with the trust's cleaners could be revised in accordance with tighter cleanliness standards, while four directors will be appointed as whistle blowing champions' to make staff more prepared to report problems.

On the mammoth problem of nursing numbers, a senior nurse will be appointed with specific responsibility for recruitment, while the trust will also continue looking to abroad to boost its ranks.

But on the plus side, the trust's renal unit, which CHI singled out for praise, is set to provide a model of good practice for others to follow.

It has taken almost two months for the trust to produce its definitive response to CHI's scathing report, with initial drafts revised and re-revised by managers, to satisfy the requirements of the commission and the London NHS Executive.

In its introduction, the plan spells out the trust's financial conundrum, saying: "Although, not yet quantified, the resource implications of this plan are significant. It will be incumbent upon the trust board to work with our partners in the local health economy to ensure the success of this action plan."

But though the plan was warmly welcomed by Sue Gallagher, chief executive of the trust's biggest source of funding, Merton Sutton and Wandsworth (MSW) health authority, it has promised no new money.

She said: "The health authority was involved in its preparation and will support the trust with implementation."

But according to a trust Unison representative: "The Government is setting the trust up to fail. They cannot achieve what's in the plan without further funding, but, of course, the health authorities are saying there is no more.

He added: "We fully support what the board is trying to do."

Sutton and Cheam MP Paul Burstow said: "The trust has finally been forced to recognise that urgent action had to be taken, and this is a unique opportunity for Epsom and St Helier to reinstall the faith of all those connected to it."

Chief officer of Merton and Sutton Community Health Council (CHC) Nigel Spalding said: "We welcome the statement on how the trust is going to address the serious problems identified by CHI.

"The CHC will be working closely with the trust to ensure that the interests of patients are given the highest priority throughout."

Mr de Braux has the rest of his year-long term in office to deliver on the plan, or else the NHS could parachute in managers from high performing trusts to take over.

But he vowed: "Over the next 12 months, we will implement the actions in this plan.

"As chief executive, I will take personal responsibility for overseeing that this plan is put into place."

October 26, 2001 13:00