‘Fundamental failure’ sparks NHSE intervention at top 10 trust

 A “fundamental failure in quality governance” has led NHS England to take enforcement action against one of England’s largest trusts.

NHSE has decided to intervene at Northern Care Alliance Foundation Trust because it believes the provider is “unable to provide assurance” that it has a “clear and consistent quality governance structure across the whole organisation that will ensure no further patients may suffer harm”.

 A letter to the trust from NHSE North West regional director Louise Shepherd said: “There have been a series of escalating quality concerns over the previous 18 months, for which [the trust] has been unable to respond at the expected pace… The culmination of quality concerns and [the trust’s] response has resulted from a fundamental failure in quality governance.”

Greater Manchester Integrated Care Board placed the trust in a “rapid quality review process” in January over concerns that it has made insufficient progress to remedy care failings identified by two independent reviews into its spinal services.

The trust then commissioned the Good Governance Institute to undertake a review. It produced 43 recommendations and found NCA lacked a “clear and consistent quality governance structure to ensure patients would not suffer harm”.

In September, the Care Quality Commission issued a warning notice to the trust following an inspection of Salford’s surgical services. It said NCA had not ensured surgical wards had sufficient and suitably qualified staff, as well as effective risk-management systems.

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Source: HSJ, 23 June 2026