Morecambe Bay NHS Trust must make 'urgent improvements', CQC warns
A hospital trust has been told it must make "urgent improvements" after whistleblowers raised concerns over the safety and leadership of its services.
The Care Quality Commission (CQC) says its report into the University Hospitals of Morecambe Bay NHS Foundation Trust made for "disappointing reading".
Live report from Correspondent Rob Smith:
Ann Ford, the watchdog's Deputy Chief Inspector of Hospitals in the North, said there had been a "significant downturn in the quality of services" at the trust, with patients not getting the care they deserved.
The damning report follows an unannounced inspection of the urgent and emergency care services, surgery, and maternity services in April and May at Westmorland General Hospital in Kendal, Royal Lancaster Infirmary and Furness General Hospital.
It was carried out after a number of concerns and whistleblowing information regarding the safety, quality and leadership of the services were raised to the CQC.
All three hospitals have now been rated as requiring improvement, downgrading both Furness and Westmorland from their previous ratings of good.
The report comes just days after NHS England placed the Trust into special measures after it said there were 'very serious and complex issues that require intensive support'.
Furness General Hospital (FGH) also saw its maternity rating drop from good to inadequate.
Ms Ford said past improvements, "have not been sustained and the service has deteriorated, affecting patients and staff".
Major care failures were linked to at least 12 deaths of mothers and babies at FGH between 2004 and 2012 in what became known as the Morecambe Bay scandal.
What did the CQC find?
The CQC judges each Trust based on five criteria - whether services are safe, effective, responsive, caring and well-led.
Morecambe Bay NHS Foundation Trust - overall
Overall rating - requires improvement
'Safe', 'effective', 'responsive' - require improvement
'Caring' - good
'Well-led' - inadequate
Furness General Hospital
Overall rating - moves from good to requires improvement
'Safe' and 'well-led' - moves to requires improvement
The maternity rating - drops from good to inadequate
Royal Lancaster Infirmary
Overall rating - remains requires improvement.
'Safe' and 'responsive' - remains requires improvement
'Caring' - remains good
'Effective' and 'well-led' move down from good to requires improvement.
Urgent and emergency services - 'well-led' also moved down from requires improvement to inadequate.
Westmorland General Hospital
Overall rating - moves from good to requires improvement.
'Effective' and 'caring' - remains good,
'Responsive' - remaining requires improvement.
'Safe' and 'well-led' - moves down from good to requires improvement.
Urgent and emergency services - improved and is now rated good overall.
During the inspection, the CQC also became aware of concerns about the stroke services at both the Royal Lancaster Infirmary and the FGH.
It later imposed conditions on the trust and said inspectors were not assured all patients had received care and treatment in a timely way, exposing them to a risk of harm.
Inspectors noted that, overall, risks were not always identified correctly with appropriate mitigations put in place, and not all senior leaders demonstrated the necessary experience or knowledge to lead effectively.
The CQC said the culture within the trust was varied, with inspectors saying: "There were some services where the culture was poor and had remained so for some time."
The rating of the trust for being well-led went down to inadequate, as inspectors found that risks, issues and poor performance were not always acted on by leaders "in an effective or timely manner", including within stroke services, maternity and urgent and emergency care.
The CQC said the trust did not always collect reliable data, analyse and use it to make improvements, and it had concerns about the management of incidents and learning from them.
It said: "Incidents were not consistently identified and reported on. Not all incidents were dealt with appropriately or quickly enough and there was limited thematic learning across the organisation.
"We saw examples of incidents that should have been reported and had not been recognised or reported as such."
The CQC also said the trust had a "significant challenge" in managing the size of the financial deficit and how it was affecting operational performance and the quality of the trust.
Ms Ford said while the trust had previously shown a capability of making improvements, for example in its surgical services, it is "very disappointing" that the progress "has not been replicated throughout the trust".
Ms Ford added: "The improvements which were demonstrated at previous inspections of Furness General Hospital's maternity department have not been sustained and the service has deteriorated, affecting patients and staff."
She praised the "excellent work carried out by staff within the trust who, on the whole are providing care, treating patients with compassion sometimes under difficult circumstances".
But she said it was clear the trust is in need of support, which would come through the national recovery support programme, through NHS England and NHS Improvement.
Ms Ford added: "This will give the trust the resources to embed the improvements they need to make.
"In the meantime, we will continue to monitor the trust closely and return to check on any improvements which have been made."
Aaron Cummins, Chief Executive of the trust, said: "Our staff have worked incredibly hard throughout the pandemic and we are pleased the CQC recognised some of the improvements the trust has made since its last inspection, but clearly there is still work to be done and we know our colleagues, patients and local populations deserve better.
"The safety of our patients and staff is our absolute priority and we have already started making improvements to address the concerns raised, including creating dedicated stroke beds in our hospitals, appointing more colleagues in emergency care and launching new electronic patient record systems in maternity.
"We will continue to work with our teams to make further changes to ensure we are delivering the safest and best care for our patients and their families."