Guide to special measures

Special measures apply when NHS trusts and foundation trusts have serious problems and there are concerns that the existing leadership cannot make the necessary improvements without support. 

They consist of a set of interventions designed to remedy problems within a reasonable timeframe. Trusts may be placed in special measures as a result of serious failures in quality of care and/or serious financial problems.

This guidance, jointly produced by the Care Quality Commission (CQC) and NHS Improvement, describes how special measures work for quality reasons. It explains:

• why trusts are placed in special measures for quality reasons
  
• the process for entering special measures
  
• what will happen to trusts during special measures and how long special measures are intended to last
  
• the roles and responsibilities of key organisations involved
  
• when and how trusts will exit special measures, including the relationship between quality and financial performance
  
•  if and how a trust can re-enter special measures
  

Our guide describes how special measures work for financial reasons. It explains:

• why trusts are placed in special measures for financial reasons
  
• how NHS Improvement places a trust in special measures for financial reasons
  
• what happens to trusts in special measures for financial reasons
  
• removing trusts from special measures  
  

• Single Oversight Framework
  
• Well-led framework
  
• Use of Resources assessment framework
  
• Special measures for quality review