Health

'Life's too short': NHS trust boss's excoriating resignation letter


An NHS trust boss has quit her post, blaming underfunding of the service, the hospital inspection regime and pressures of the job, and concluding: “Life is just too short.”

Siobhan McArdle announced her resignation as chief executive of the South Tees Hospitals Foundation Trust in a plain-spoken letter to staff on Monday. McArdle, who has been the trust’s boss for four years, also took aim at NHS demands for unrealistic “productivity and efficiency savings”.

In her letter, she said: “After much debate with my family and friends over the last 12 months, I have now decided that the personal cost of being a CEO in the NHS is just too high and life is just too short.”

McArdle, a former management consultant, will leave the trust on 30 September. She had survived longer in the top job than she expected, given her “reputation for straight speaking” and NHS bosses’ typically short tenures, she said in the email.

She made clear that, after her trust delivered £140m in efficiency savings over the last five years, it could not tighten its belt any more. She was quitting “following the latest round of [financial] forecasting and re-forecasting and what I consider to be too great a challenge with regard to the delivery of further productivity and efficiency savings at [the] trust”.

South Tees trust runs the James Cook hospital in Middlesbrough, Friarage hospital in Northallerton, and community hospitals in north Yorkshire and the Tees Valley. The trust is heavily indebted because of the NHS cash squeeze, not because it is badly run, she said. The local health economy is “underfunded and unsustainable” in her view.

“South Tees is financially unsustainable without a much needed long-term financial recovery plan [that addresses] the shortcomings of our PFI contract but also deals with the burden of long-term debt that has built up over many years and resolves the urgent need for capital investment.”

The departing chief executive, who has a salary of £290,000-£295,000 a year, also took a swipe at the Care Quality Commission, which in July criticised the trust’s quality of care and leadership following an inspection. The watchdog said it “requires improvement” in the safety and effectiveness of its care and also in its leadership.

McArdle retorted: “Although there is always room for improvement in an organisation of its size, South Tees is not an organisation that requires improvement.”

The CQC also found that trust staff felt that senior managers “were not visible, contactable or approachable” and that morale was variable.

Like many other NHS trusts, South Tees is not meeting national targets for treating A&E patients within four hours, those awaiting planned care inside 18 weeks and cancer patients within a variety of timescales.

“We want to thank Siobhan for the tremendous contribution she has made to the trust,” trust chair Alan Downey said.

NHS Providers, which represents trusts, gave its support to McArdle. Saffron Cordery, its chief executive, said: “The concerns expressed here are not unusual. In recent years trust leaders have become accustomed to demands for productivity improvements and savings that are increasingly unachievable.

“We have concerns that NHS regulators do not appear to understand the pressures trusts face or take full account of them. Trusts … need a more collaborative culture from regulators to help them manage these pressures, and to support them to deliver the high quality of care for patients that we all wish to see.”



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