Search the hub

An integrated care board chair is keeping her job despite complaints being upheld against her in a previous role, it has emerged. Danielle Oum left her position as Birmingham and Solihull Mental Health Foundation Trust chair last October. It later emerged that an independent investigation carried out the month before her departure, the results of which were leaked to HSJ, had upheld several complaints against her and found she did not always act with “honesty, truthfulness and clarity”. She was appointed to the ICB position in October 2021, four months before the complaints were made against her by an individual at the trust. But NHS England now says it has reviewed the matter and concluded that it “continue[s] to offer Danielle our full support in her role as chair of Coventry and Warwickshire ICB”. Following the independent investigation, which upheld 16 complaints against Ms Oum in total, NHSE carried out its own review of the issues. NHSE said its review involved a “rigorous fact-finding process” and it was grateful to those who raised “freedom to speak up” concerns. It said in a statement: “A thorough review has taken place at regional and national level, and the committee responsible for adjudicating these issues has delivered what we believe is a fair decision." Read full story (paywalled) Source: HSJ, 31 August 2023

The government is to investigate claims an ambulance service covered up details of the deaths of patients following mistakes by paramedics. It follows the Sunday Times report that North East Ambulance Service (NEAS) withheld information from coroners. Labour's shadow health secretary Wes Streeting described the alleged cover-up as "a national disgrace". Health minister Maria Caulfield said she was "horrified" and there would be a further investigation. The newspaper reported that concerns were raised about more than 90 cases and whistleblowers believed NEAS had prevented full disclosure to relatives of people who died in 2018 and 2019. Speaking in the House of Commons, Mr Streeting asked why the regulator - the Care Quality Commission (CQC) - had failed to take action. Ms Caulfield said that while both the NEAS and the CQC had both reviewed the allegations, further investigation was required. The minister said non-disclosure agreements have "no place in the NHS", adding: "Reputation management is never more important than patient safety." Read full story Source: BBC News, 23 May 2022

Junior doctors have been prevented from returning to scandal hit heart surgery unit previously criticised over “toxic” culture, The Independent has learned. A coroner defended cardiac surgery at St George’s University Hospital, criticising an NHS-commissioned review into 67 deaths that warned of poor care. However, The Independent has learned the unit received a critical report from Health Education England (HEE), the body responsible for healthcare training, just last year. The NHS authority was so concerned about culture problems and “inappropriate behaviour” within the unit that it took away the junior doctors working there. This is the third time HEE has intervened since 2018, when the unit was criticised in an independent review for having a “toxic” culture. In a statement, Professor Geeta Menon, postgraduate dean for South London at Health Education England, said: “HEE carried out a review of cardiac surgery at St George’s University Hospital in July 2021 and concluded that further improvements were required to create a suitable learning environment for doctors in training. "Unfounded’ NHS criticism and investigation caused unnecessary deaths at London heart surgery unit “We continue to work closely with the trust to implement our requirements and recommendations and will reassess their progress this summer. HEE is committed to ensuring high quality patient care and the best possible learning environment for postgraduate doctors at St George’s.” The Independent understands that a report issued in December, following the HEE visit, identified problems of “inappropriate behaviour”, poor team working from consultants and raised concerns the culture problems previously identified at the unit persisted. Read full story Source: The Independent, 14 May 2022

A trust chief who blew the whistle on her predecessor’s ‘aggressive’ behaviour and lack of interest in patient safety says it was the hardest thing she has had to do in her career. Janelle Holmes, who is now chief executive of Wirral University Teaching Hospital Foundation Trust, was among four Wirral University Teaching Hospital Foundation Trust senior executives who wrote to regulators in 2017 about the behaviour of the trust’s then CEO David Allison. They said he would react with “dismay and aggression” to concerns being raised about service quality, and staff were afraid to speak up as a result. The intervention led to Mr Allison’s departure and a subsequent independent investigation found “deep systemic cultural issues”. Mr Allison always denied his behaviour was inappropriate. In an interview with HSJ, Ms Holmes talked of the difficulties in taking those actions, and the subsequent efforts to overhaul the trust’s culture. She said: “From a personal integrity perspective, it was the right thing to do…and I [also] felt I had a personal responsibility to make it right afterwards. “But yes, it was the most difficult thing I’ve ever had to do.” She said: “I remember watching Sir David Dalton (the ex-Salford CEO) probably more than 10 years ago… say ‘we are harming patients’.. it was like ’you can’t say that’. “But actually [there was a] complete sea change and [it became] an organisation where [speaking out] was the right thing to do. That’s the only way you can ensure you’re delivering good quality high standard services. If you’re acknowledging mistakes happen, you’re learning from them, you’re correcting things… I think that then starts to shape how our clinicians and staff feel. Read full story (paywalled) Source: HSJ, 12 May 2022

The culture at a long-troubled ambulance trust is ‘worsening, not improving’, its staff have told a health watchdog. Concerns about culture and patient safety at East of England Ambulance Service Trust (EEAST) were raised to inspectors at the Care Quality Commission (CQC) during an inspection of the trust last month, according to public documents. In a feedback letter to the trust following the inspection, the CQC said staffing at EEAST’s control room was below planned levels, and the inspectors were “not assured that staffing levels met the demands within the service and this may impact on patient safety when managing the high volume of calls”. The trust, which is in the equivalent of special measures and currently rated “requires improvement” by the CQC, has had long-standing cultural problems and last year signed a legal agreement with the Equality and Human Rights Commission on how it would protect staff from sexual harassment. According to the feedback letter, staff described a “worsening, not improving, culture” and said the workforce was “tired” and not receiving mandatory training, one-to-ones with managers or appraisals. The letter, published in the trust’s latest board papers, also reported inspectors raising concerns about potential risks to patients over the management of the trust’s call stack and a lack of consistency over “standard operating procedures”. Additionally, some staff in the control room on an accelerated training programme were unable to undertake full patient assessments and had to call for assistance from others. Read full story (paywalled) Source: HSJ, 11 May 2022

Sir Robert Francis has announced he is to step down as chair of Healthwatch England 20 months early, claiming funding cuts mean the patient watchdog could soon struggle “to fulfil its vital role”. The prominent QC has also announced he will quit his position as a non-executive director of the Care Quality Commission on November 15 2022. In a letter to Mr Javid, Sir Robert said it had been an “honour and a privilege” to serve on the CQC’s board and a “great pleasure” to support Healthwatch England. He added: “I believe [Healthwatch England] has proved its worth to your department and the system more generally and is now in an ideal position to help you take forward your agenda for improving the patient’s voice. “However, if I have one regret about my time as chair[man], it is that we have been unable as yet to find a way of reversing the alarming decline in the resources available to Healthwatch – I am afraid there is a growing risk the network will be unable to fulfil its vital role unless urgent attention is paid to this issue.” Sir Robert has chaired a number of independent inquiries involving the NHS, most notably the inquiry into poor care and high mortality rates at Stafford Hospital – which was published in February 2013. Last June, Sir Robert was appointed by the government to undertake an independent study into a framework for compensation for victims of the infected blood scandal. Read full story (paywalled) Source: HSJ, 3 May 2022

An NHS mental health trust that has been the worst performing in England has been warned it must improve after failing another inspection. Norfolk and Suffolk NHS Foundation Trust (NSFT) has been rated "inadequate" in the latest Care Quality Commission (CQC) report. The CQC said it had served the trust with a warning notice that it had to act on to improve patient care. The trust has been rated "inadequate" on three previous occasions by the health watchdog, as well as being the only one currently within the NHS's improvement regime for not meeting standards. Following the latest inspection, its overall rating was downgraded from "requires improvement" - and three out of five measures assessed by the CQC, for safety, leadership and effectiveness, met its lowest grading. The report said two wards were immediately closed to new patients following a CQC visit in November, after the trust was threatened with enforcement action if urgent measures were not taken. Significant staffing problems, including an annual nurse vacancy rate of more than 17%, were also highlighted. Staff at an adult long stay ward did not complete regular checks on patients supposed to happen every 30 to 60 minutes, which meant they were unaware if somebody needed help for periods of up to seven hours. Inspectors also said there had been a severe deterioration on the trust's inpatient ward for children and young people - the Dragonfly Unit in Carlton Colville, Suffolk. They found it was reliant on agency workers and lacked a permanent doctor. Read full story Source: BBC News, 27 April 2022

NHS management and leadership are overly ‘task focused’, according to briefings by the senior military leader who has carried out a major review of health and care for the government. General Sir Gordon Messenger has nearly completed the work, which had been due to be published shortly before Easter but was delayed by the government, and has briefed several senior leaders on several of his main observations. According to several senior figures, he has said NHS management and leadership are heavily “task focused” — a management term referring to an approach devoted to completing certain tasks or meeting certain short-term objectives; in contrast to an approach which focuses on people, relationships or skills. HSJ has spoken to several senior sources who have been briefed on Sir Gordon’s findings so far. One said the former military figure had observed that “NHS leadership is… very focused on getting things done, and not focused enough on how things get done – which I think is very fair if you think particularly what the last 10, 15 years have been like”. Another finding, according to those briefed, is the need for better support for NHS leaders running the most difficult local organisations, including providing what has been described as “support packages”. Read full story Source: HSJ, 26 April 2022

The chief executive of a mental health trust grappling with care quality failures has described his anger at ‘disrespectful’ staff who have ‘now had to leave the organisation’. In a message to staff, seen by HSJ, Brent Kilmurray, chief executive of Tees Esk and Wear Valleys Foundation Trust, said a number of staff had “stepped away from our values”. HSJ has heard reports of 12 staff members within the trust’s forensic secure inpatient services being suspended in recent weeks, and some dismissed, after being caught sleeping on shifts and using electronic devices while meant to be observing patients. The reports are unconfirmed, but appear to be referenced in a message sent by Brent Kilmurray on 14 March, which said: “I’m sorry to say, there’s been a handful of people who have stepped away from our values and in doing so have now had to leave the organisation." Mr Kilmurray said the staff were in a “minority” and that when the trust investigated these matters “we have found far more excellent caring practice”. He added the trust is working with service leaders “to ensure that they understand their accountabilities for ensuring that services are safe”. Read full story (paywalled) Source: HSJ, 14 April 2022

Criticism of NHS managers over the treatment of whistleblowers has been reignited by Donna Ockenden’s damning review of maternity services at Shrewsbury and Telford Hospital Trust. Her findings come seven years after the “Freedom to speak up?” report from Sir Robert Francis QC, which found that NHS staff feared repercussions if they blew the whistle on poor practice. He recommended reforms to change the culture and support whistleblowers. The Public Interest Disclosure Act 1998 makes it unlawful to subject workers to negative treatment or dismiss them because they have raised a whistleblowing concern, known as a “protected disclosure”. But critics say little has changed since the Francis review. According to Protect, a whistleblowing charity, 64% of those contacting it for advice said that they had been victimised, dismissed or forced to resign. Shazia Khan, founding partner at Cole Khan Solicitors, says that instead of being afforded protection, whistleblowers are “targeted as a form of retaliation by trust senior management and disciplined on trumped up charges to shut them down”. Those seeking to vindicate their rights before an employment tribunal, Khan adds, will often be “priced out of justice” by well-resourced NHS trust lawyers who at public expense “deploy a menu of tactics” to defend cases. When Peter Duffy, a consultant urologist at University Hospitals of Morecambe Bay Foundation NHS Trust, reported on allegedly unsafe practices by colleagues in 2016, he was demoted, falsely accused of financial irregularities, and threatened with a six-figure adverse costs order by Capsticks, the hospital’s law firm. “All my witnesses dropped out after the medical hierarchy told them that the department might be dissolved if the case went badly,” Duffy says, which meant there was no one to rebut the trust’s evidence. Read full story (paywalled) Source: The Times, 7 April 2022

Several large teaching hospitals are among those which saw the steepest declines in the proportion of staff who would recommend the care of their organisation, according to the NHS staff survey results. Norfolk and Norwich University Hospitals Foundation Trust, University Hospitals Birmingham, Liverpool University Hospitals FT and Nottingham University Hospitals Trust saw declines of 12 percentage points or more in 2021 — for the proportion of staff saying they would be happy for a friend or relative to be treated at their organisation. This was double the average drop in the acute sector. In a message to staff, Sue Musson, chair of Liverpool University Hospitals Trust, said about her trust’s overall results: “On behalf of the trust board, I want to apologise to everyone that the experience of working at the trust is so deeply unsatisfactory for so many colleagues. “It would be wrong to suggest that there are quick fixes to these issues. The promise I can give you today is a genuine commitment to listen and learn; we particularly need to understand what would make the difference for colleagues across the trust, recognising that there may well be different answers in different parts of the organisation. “We will seek to learn from the trusts that have demonstrated the best staff experience scores and to implement best practices at pace. We will also be seeking support and input from national and staff side colleagues.” Read full story (paywalled) Source: HSJ, 11 April 2022

Health leaders ‘pay lip service’ to engaging with patients and "do not look like or live the lives of the people they are making decisions about", an NHS England director has said. Olivia Butterworth, NHSE’s deputy director of people and communities, told a public event hosted by the New Local think tank there is a “whole load of work” going on around reforming patient-reported outcome measures. But she said that “none” of this work “starts with conversations with people about what do they value and what they want to measure.” Asked whether NHS England’s top leadership is “paying lip service” to patient engagement, Ms Butterworth said: “I think often everybody pays lip service to it. We all use the right words. But whether it’s local government, whether it’s the NHS we know the words to use, but do we really live that in our actions in the way that we really like to change things? “Or do we just blame the system for being too complex and it is the system that won’t let us, without recognising that we are the system, we make the system, we run the system, the system is people.” Elsewhere in the session, Ms Butterworth said that “our decision makers do not look like or live the lives of the people they are making decisions about.” She added that health services need to “join up around people” and that integrated care systems and partnerships offer the opportunity to “cut the crap of the organisational boundaries that stopped us doing things”. Read full story (paywalled) Source: HSJ, 8 April 2022

Doctors at an acute trust believe their clinical leaders have failed to tackle the ‘big personalities’ accused of being aggressive bullies, a review has found. The probe at University Hospitals of North Midlands Trust was prompted by a survey carried out last year by the British Associations of Physicians of Indian Origin, after concerns were raised by its members. The review was undertaken by Birmingham-based equalities charity Brap, and Roger Kline, a research fellow at Middlesex University Business School. It found the trust was not an outlier in statistical measures of bullying and harassment, but suggested the situation was still worse than leaders would wish. They said: “The most common reason people cited for bullying/harassment they experienced was the personality, attitude, and disposition of their managers and colleagues… it is felt senior clinical leaders have, in the past, failed to tackle these ‘big personalities’. “It is worth noting feedback from interviews suggesting many doctors feel they have endured poor behaviour – talking over people during meetings, criticising work in public, aggressive questioning – for years, and have simply become inured to it. The reviewers found that as a consequence, certain people within the organisation were perceived to be “bullet proof”, and added: “We would suggest the trust needs a big, long-term plan to ‘rehumanise’ the organisation. “The trust’s existing culture has permitted, and continues to permit infringements in behaviour… While this is not condoned by senior leaders in the trust, the lack of a plan to proactively tackle a legacy of overlooking poor behaviours has allowed them to persist.” Read full story (paywalled) Source: HSJ, 6 April 2022

Press release: 7 April 2022 Today the charity Patient Safety Learning has published a new report, ‘Mind the implementation gap: The persistence of avoidable harm in the NHS'. The report is an evidence-based summary of the failures over decades to translate learning into action and safety improvement. It highlights that avoidable unsafe care kills and harms thousands of people each year in the UK and costs the NHS billions of pounds for additional treatment, support, and compensatory costs. The report highlights how we fail to learn lessons from incidents of unsafe care and are not taking the action needed to prevent harm recurring. The report focuses on six sources of patient safety insights and recommendations, ranging from inquiry reports into patient safety scandals, such as the recent Ockenden report into maternal and neonatal harm at Shrewsbury and Telford Hospital, to the findings of Coroner’s Prevention of Future Deaths reports. It calls on the Government, parliamentarians, and NHS leaders to take action to address the underlying causes of avoidable harm in healthcare and proposes recommendations in each policy area. Patient Safety Learning is calling for system-wide action in healthcare to transform our approach to learning and safety improvement. Helen Hughes, Chief Executive of Patient Safety Learning, said: “Today’s report highlights the all too frequent examples of where healthcare organisations fail to learn lessons from incidents of unsafe care and not taking the action needed to prevent future harm. Time and time again there is a lack of action and coordination in responding to recommendations, an absence of systems to share learning and a lack of commitment to evaluate and monitor the effectiveness of safety recommendations.” “This is a shocking conclusion that is an affront to all those patients and families who have been assured that ‘lessons have been learned’ and ‘action will be taken to prevent future avoidable harm to others’. The healthcare system needs to understand and address the barriers for implementing recommendations, not just continually repeat them. Hope is not a strategy.” This report has been published as part of the Safety for All Campaign, which calls for improvements in, and between, patient and healthcare worker safety to prevent safety incidents and deliver better outcomes for all. The campaign is supported by Patient Safety Learning and the Safer Healthcare and Biosafety Network. Notes to editors: Patient Safety Learning is a charity and independent voice for improving patient safety. We harness the knowledge, insights, enthusiasm and commitment of health and social care organisations, professionals and patients for system-wide change and the reduction of avoidable harm. Safer Healthcare and Biosafety Network an independent forum focused on improving healthcare worker and patient safety and has been in existence more than 20 years. It is made up of clinicians, professional associations, trades unions and employers, manufacturers and government agencies with the shared objective to improve occupational health and safety and patient safety in healthcare. COVID-19 pandemic has provided a stark reminder of the vital role healthcare professionals play in providing care to those in our society who need it most and this was recognized in the WHO Patient Safety Day in September 2020: only when healthcare workers are safe can patients be safe. In 2020, the Network launched a campaign called ‘Safety for All’ to improve practice in, and between, patient and healthcare worker safety to prevent safety incidents and deliver better outcomes for all.

When Debbie Greenaway was told by doctors that she should try to deliver her twin babies naturally, she was nervous. But the doctor was adamant, she recalls. “He said: ‘We’ve got the lowest caesarean rates in the country and we are proud of it and we plan to keep it that way'." For Greenaway, labour was seemingly endless. She was given repeated doses of syntocinon, a drug used to bring on contractions. By the second day, the midwife was worried for one of the babies, whom the couple had named John. “She was getting really concerned that they couldn’t find John’s heartbeat.” Her husband remembers “the midwife shaking her head”. “She said a number of times that we should be having a caesarean.” By the time doctors finally decided to perform an emergency C-section, it was too late. Starved of oxygen, baby John had suffered a catastrophic brain injury. When he was delivered at 3am, he had no pulse. Efforts to resuscitate him failed. Their son’s death was part of what is now recognised as the largest maternity scandal in NHS history. The five-year investigation will reveal that the experiences of 1,500 families at Shrewsbury and Telford Hospital Trust between 2000 and 2019 were examined. At least 12 mothers died while giving birth, and some families lost more than one child in separate incidents, the report is expected to show. The expert midwife Donna Ockenden and a team of more than 90 midwives and doctors will deliver a damning verdict on the Shrewsbury trust, its culture and leadership — and failure to learn from mistakes or listen to families. At its heart is how a toxic obsession with “normal birth” — fuelled by targets and pressure from the NHS to reduce caesarean rates — became so pervasive that life-or-death decisions on the maternity ward became dangerously distorted for nearly two decades. Read full story (paywalled) Source: The Times, 26 March 2022

GP practices are set to face new targets for responding to patient complaints under standards being piloted by the health ombudsman. All ‘straightforward’ complaints should be dealt with within six months and 95% within three, while 80% of ‘complex’ complaints should be completed within six months and half within three, under the proposals. The new Parliamentary and Health Service Ombudsman (PHSO) complaint standards are currently being piloted in every sector of the NHS – including one GP practice – and were due to be implemented across the NHS this year. However, a PHSO spokesperson told Pulse that due to delays caused by the pandemic, the full rollout is now planned for the beginning of next year, with the ombudsman to implement the standards from April 2023. The proposed complaints standards said staff should ensure they ‘consistently meet expected timescales for acknowledging a complaint’ and ‘respond to complaints at the earliest opportunity’, providing ‘regular updates throughout’. They should also give ‘clear timeframes’ for how long investigating the complaint will take and ‘agree timescales with everyone involved’, including the complainant. An accompanying draft model complaint handling procedure said that complaints will be acknowledged within three working days either verbally or in writing. Read full story Source: Pulse, 24 March 2022

An ‘outstanding’ London trust has come under fire for asking staff to communicate ‘only in English’ when around other people. A document published under the ‘trust values’ section of Homerton University Hospital Foundation Trust’s website, says: “I will only communicate in English in the presence of others.” The document has been widely shared on social media in the last 24 hours, with many criticising the trust for its wording. The document itself is dated 2014, but was reposted by the trust in 2019, and remained on its website as of midday today. NHS England’s director of equality – medical workforce, Partha Kar, who is also NHSE’s diabetes lead, questioned the document on Twitter. He also said: “I am not aware of any NHS England ‘diktat’ suggesting we must all only speak in English to uphold NHS values.” It follows a separate notice being posted on Twitter yesterday signed simply by “Matron”, by a doctor who claimed her friend saw it at her “hospital placement”. It seemingly threatened staff with “disciplinary action” if they spoke any other language other than English. It reads: “English is the only language to be spoken in the ward area – this includes the kitchen. Disciplinary action will be taken against staff who do not comply, including agency and bank.” The documents have prompted a backlash on Twitter, with many criticising them and raising concerns about racism and inclusivity of staff. NHSE’s chief nursing officer, Ruth May, has publicly queried where the document is from. Read full story (paywalled) Source: HSJ, 16 March 2022

NHS England is trying to force a prestigious cancer trust to publicly apologise to a group of whistleblowers, after being ‘shocked’ by the way it responded to a review into their concerns. As HSJ reported in January, an external review into The Christie Foundation Trust supported multiple concerns which had been raised by staff about a major research project with pharma giant Roche. The review had also noted how 20 current and former employees, some of whom were “long-standing, loyal, senior staff”, had described bullying behaviours and felt they had suffered detriment because they spoke out. In response to the review, trust chair Christine Outram and chief executive Roger Spencer issued a bullish report listing numerous “inaccuracies” and characterised the concerns as being limited to a “small number of staff who are dissatisfied or aggrieved”. It did not thank the staff for raising the issues, nor apologise for the experiences they had. However, HSJ has now learned that NHSE is trying to ensure the trust issues a public apology. At a meeting with some of the whistleblowers on 11 February, David Levy, medical director for NHSE North West, said he was “shocked” and “frankly a bit angry” at the trust’s response, saying it reflected badly on the organisation, HSJ understands. Read full story (paywalled) Source: HSJ, 9 March 2022

The government has launched a review of leadership in health and social care. The review will be led by former Vice Chief of the Defence Staff General Sir Gordon Messenger, and will report back to Secretary of State for Health and Social Care Sajid Javid, in early 2022. The Health and Social Care Leadership Review will look to improve processes and strengthen the leadership of health and social care in England. Working with the health and care systems, retired General Sir Gordon Messenger will have a team from DHSC and the NHS to support him led by Dame Linda Pollard, chair of Leeds Teaching Hospital. The review comes as the government invests a record £36 billion to put health and social care on a sustainable financial footing and deliver the biggest catch-up programme in NHS history. Any recommendations made as the review progresses will be considered carefully and could be rapidly implemented to make every penny of taxpayer’s money count. Secretary of State for Health and Social Care, Sajid Javid, said: "I am determined to make sure the NHS and social care delivers for the people of this country for years to come and leadership is so important to that mission. We are committed to providing the resources health and social care needs but that must come with change for the better. This review will shine a light on the outstanding leaders in health and social care to drive efficiency and innovation. It will help make sure individuals and families get the care and treatment they need, wherever they are in the country, as we build back better." Read full story Source: Department of Health and Social Care, 2 October 2021

NHS England wants lessons learned by a trust overhauling its culture after a high-profile bullying scandal to be shared systemwide because similar problems have been evident at other trusts, the hospital’s boss has said. West Suffolk Foundation Trust interim chief executive Craig Black said the trust was getting national level “support” to help with a cultural overhaul after a scathing independent review published in December concluded the trust’s hunt for a whistleblower had been “intimidating… flawed, and not fit for purpose”. Mr Black said he thought NHSE would be “looking to learn from what we are doing” because senior managers viewed concerns raised in the West Suffolk review as having ”resonance with a number of organisations in the NHS at the moment”. As well as the specific “witch hunt” case, the review raises wider issues about how trusts respond to whistleblowing and other concerns about care and patient safety. West Suffolk’s executive director of workforce and communications Jeremy Over told the meeting the cultural change required was “organisational development which will take time, significant time”. The report, West Suffolk Review – organisational development plan, sets out nine broad themes of work, linked to the trust’s core functions, “that capture the priority areas for organisational and cultural development at WSFT in light of the learnings from the report”. The document sets out how the trust’s governance, freedom to speak up, HR, staff voice, patient safety and other parts of its corporate infrastructure failed and contributed to a scandal. Read full story (paywalled) Source: HSJ, 1 March 2022

The NHS needs its best leaders to be prepared to take on “the biggest challenges” despite the risk of criticism, the Care Quality Commission’s chief inspector has said. At its monthly meeting, the CQC board was discussing how three previously ‘inadequate’-rated trusts – United Hospitals Lincolnshire Trust, Isle of Wight Trust and The Queen Elizabeth’s Hospital Kings Lynn FT – have all recently moved out of ‘special measures’, following improved reports from inspectors. In response, Professor Ted Baker said that at each of the trusts a “new approach to leadership had changed the culture”, and despite still being under “particular pressure” they were able to drive forward “major improvements”. He was “grateful” for the three leaders at the trusts for taking on the leadership challenge. Professor Baker said: “One of my concerns is leaders are not attracted to these posts, as they feel they are posts where they can be easily criticised. The best NHS leaders need to take on the biggest challenges.” Read full story (paywalled) Source: HSJ, 23 February 2022

The NHS should not be given greater control of social care because it is ‘hierarchical, centralised and not person-centred’, according to a government-commissioned review which is repeatedly scathing about the health service. The review was ordered by then health and social care secretary Matt Hancock in June 2020. Cross-bench peer, writer and former Number 10 adviser Baroness Camilla Cavendish was asked “to make recommendations for social care reform and integration with health in the wake of the Covid-19 pandemic, which could fit alongside the funding reforms planned by the department in the context of the NHS long-term plan.” In her final report, Baroness Cavendish wrote that “one answer” to the problems facing the sector “would be to let the NHS take over social care. On paper, this would join up the care continuum.” However, she rejected the idea because of the NHS’ “hierarchical” and “centralised” nature. Baroness Cavendish also suggested the NHS’ role should be limited because it is “still struggling to join up primary and secondary care”. In contrast to the NHS, she claimed: “Social care is more innovative, more responsive and human.” She added: “The culture of the NHS is still largely one of ‘doing to’ patients, and the NHS has much to learn from social care about how to be responsive and human facing.” Referencing “recent attempts to import the successful [Buurtzorg] model of self-managing teams into the NHS”, the cross-bench peer said these “have foundered, because the NHS culture cannot seem to cope with giving staff the autonomy required”. Read full story (paywalled) Source: HSJ, 23 February 2022

The leadership of a specialist trust in Liverpool is set to be taken over by the chief executive of the city’s main acute provider. A message to staff seen by HSJ said James Sumner, who leads Liverpool University Hospitals Foundation Trust, will also become interim CEO of Liverpool Women’s FT at the end of the year when Kathryn Thomson steps down. Ms Thomson announced her retirement in May. There have been long-standing ambitions to move Liverpool Women’s standalone hospital to the new Royal Liverpool Hospital site in the city centre, run by LUHFT, with a possible merger of the organisations. The relocation remains the ambition, although the trusts are focusing on service integration in the short term. The message to staff, sent this afternoon by chair Robert Clarke, said: “We have been clear for some time about our preferred future direction of travel for the trust, namely a closer collaboration with the large acute provider of services in the city as we believe this will support the long term clinical and financial sustainability of services for the benefit of women, babies and others who access our services. “Liverpool Women’s has secured agreement with NHS Cheshire & Merseyside on our ambition to move to a shared CEO model…This is a positive step in providing ongoing stability for Liverpool Women’s.” Read full story (paywalled) Source: HSJ, 30 August 2023

Whistleblowers who first revealed a toxic environment at one of England's largest NHS trusts say they do not believe crucial changes will be made. In a letter, they said families who suffered due to management failings at University Hospitals Birmingham (UHB) "have every reason to feel let down". Investigations have been examining UHB after staff told the BBC a climate of fear put patients at risk. The letter was written by three doctors to the Labour MP For Birmingham Edgbaston, Preet Gill, who is heading a cross-party reference group on the trust. In their letter, the consultants raise concerns about the appointment from within the trust of new chief executive Jonathan Brotherton and feel the management team remains largely unchanged. "More than six months have elapsed since we spoke to you of the need to repay the debt owed to those UHB staff, patients and their families who have suffered as a result of the board's serious failings," they wrote. "They now have every reason to feel let down." Read full story Source: BBC News, 29 August 2023

Amanda Pritchard has said it is time to ‘look again’ at whether NHS England should be given formal powers to disbar managers for ‘serious misconduct’. In an email to regional leaders and some national bodies yesterday, seen by HSJ, the chief executive officer of NHS England said the murder trial of neonatal nurse Lucy Letby has brought the issue of professional regulation for managers back into focus. She has planned an urgent meeting next week to discuss the options. Ms Pritchard said she wanted the meeting to explore; the feasibility of NHSE being given the powers and resources to act as a regulator; who this could apply to and how it could operate; and how a dedicated regulatory body for NHS leaders might fulfil the role. She stressed any new powers would need to be determined by the government, but said the NHS “should contribute proactively and fully, and with an open mind, to this decision-making process”. Read full story (paywalled) Source: HSJ, 25 August 2023