Health trust to get outside help after it goes into special measures

Prof Sir Mike Richards
Prof Sir Mike Richards

An improvement director will be appointed at the health trust that runs the Royal Lancaster Infirmary after it was placed into special measures.

University Hospitals of Morecambe Bay NHS Trust (UHMBT) has been rated as inadequate following an inspection by the Care Quality Commission (CQC) in February.

Inspectors acknowledged that care in some services, such as maternity and A&E, had improved, but in other areas care had still not been addressed effectively.

Overall, inspectors concluded that the quality of care provided by the RLI and Furness General Hospital both required improvement, while the Westmorland General Hospital overall was providing a good service.

Health watchdog Monitor accepted the CQC recommendation that the trust be placed in special measures on Wednesday.

Jackie Daniel, chief executive of UHMBT said the trust was disappointed, but would use the report as a “springboard” to drive improvement.

Chief Inspector of Hospitals, Prof Sir Mike Richards, said: “There is a long history of concern with the quality of service provided by University Hospitals of Morecambe bay NHS Foundation Trust – so it is disappointing to report that a number of the issues that have been identified in the past remain unresolved.

“I do not believe that the trust is likely to resolve its challenges without external support. This is why I am recommending that the trust is placed in to special measures. I am looking to Monitor and the other organisations responsible for healthcare in the area to work together to support improvement.

“Despite the reorganisation of the trust’s clinical services - we have found a lack of clarity about the trust’s plans for the future that has left the staff feeling disengaged and remote from the executive team.

“I note that last year the trust made some progress in recruiting more staff - but the overall recruitment of nurses and doctors remains a fundamental concern, with too much reliance on temporary staff in a number of wards and departments.

“While many patients we met told us of good and compassionate care from committed and professional staff, it was clear that in medicine staff shortages meant care was not always provided at a good standard.

Jackie Daniel added: “The reports reflect the fact that we are part-way through a process of significant improvement which is still going to take a number of years to complete. It isn’t an overnight job to change the culture of a large complex organisation but through the hard work and commitment of our staff, governors and partners, our hospitals are now much safer, with improved standards of care in a number of areas from two years ago when we started to turn them around.”

Following its report, The Care Quality Commission has identified seven areas where University Hospitals of Morecambe Bay Trust (UHMBT) must improve:

n Staffing levels and skill mix in all clinical areas must be appropriate for the level of care provided.

n The trust must continue to actively recruit medical and specialist staff in areas where there are identified shortfalls.

n Nurses’ records on the medical wards must improve.

n All staff must be aware of their responsibilities to both report incidents and implement remedial action and learning as a result.

n The trust must ensure that appropriate action is taken in response to local audits where poor practice is identified.

n Accurate and timely performance information must be used to monitor and improve performance in all clinical areas.

n Performance information must be consistently and systematically collected and collated in order to support service improvement.

MP for Lancaster and Fleetwood Eric Ollerenshaw said: “It does seem like another week and yet another inspection report.

“Certainly my concern is the impact of all this on the morale of the hard working staff who are delivering a good service with clear evidence, even in these reports, of real improvements in A&E and Maternity services.

“Clearly things have to continue to improve across all parts of trust and this must be from the top down.

“The news that the trust will be going into special measures may cause alarm – however I do hope that the appointment of an improvement director to support the trust will assist them with the work that still needs to be done.

As I have always argued, the trust does deserve extra support to deal with its almost unique set of geographical problems and I will continue to argue for this.”