Shrewsbury and Telford Hospital NHS Trust (SaTH) is reported currently to have more civil enforcement actions imposed on its registration and more potential criminal cases being investigated, than any other NHS trust in England.
The measures regarding SaTH have been outlined in a letter from NHS England’s chief operating officer, Amanda Pritchard, to Professor Ted Baker, the Care Quality Commission’s (CQC) chief inspector of hospitals.
She says the trust, which runs Royal Shrewsbury Hospital and Princess Royal Hospital in Telford, faces "complex and substantial" challenges.
Ms Pritchard wrote: "In order to achieve the improvements that we expect at pace, SaTH needs the strong support of the surrounding system and also needs a further and strengthened package of support including more senior on-site support.
"We have agreed to hold a board to system meeting where Baroness Dido Harding and I will meet system leaders from Shropshire, Telford and Wrekin Sustainability and Transformation Partnership (STP) together with executives from SaTH and colleagues from NHS England and Improvement.
"The purpose of this meeting is to consider the approach the trust is taking to addressing the challenges identified and to review the wrap-around support that is being put in place and what other support may be required for success."
The package is expected to include senior dedicated support to the medical director; a dedicated maternity programme lead, with the specific remit of supporting the Ockenden review, and quality governance support to strengthen 'ward to board' governance processes and the embedding of learning from serious incidents.
It comes after Professor Baker wrote to Ms Pritchard with escalating concerns about patient safety at SaTH.
In the letter sent earlier this month, he said the "depth and breadth of concerns continue, with limited areas of improvement being demonstrated" and the CQC does not have confidence in the current leaderships capacity to address these concerns at sufficient pace without considerable additional senior on-site support.
Professor Baker wrote that SaTH currently has more civil enforcement actions imposed on its registration and more potential criminal cases being investigated, than any other NHS trust in England.
He added that considering making a recommendation for ‘trust special administration’ could not be ruled out if other interventions cannot be agreed.
That measure was previously used on the scandal-hit Mid Staffordshire NHS Foundation Trust, where an inquiry found hundreds of patients had suffered poor care, and led to the trust being dissolved.
SaTH is already in special measures after a highly critical CQC report and has been the subject of a number of warnings after follow-up inspections.
It is also the focus of an inquiry into failures in maternity care which is now dealing with more than 1,800 cases, and has led to the police investigating to see if criminal action should be taken.
Hospital bosses said the trust continues to work with NHS England and Improvement regarding the support that it needs.