Damning state of care found at ‘safe’ NHS trust

Chronic shortage of doctors, nurses and porters – and patients fainting from pain

A damning report into care at two hospitals has revealed security guards caring for patients, old and broken equipment, and patients fainting from pain in A&E because of seven hour waits – in an NHS trust authorized by regulators as safe less than two years earlier.

University Hospitals of Morecambe Bay NHS Foundation Trust, which serves 365,000 people in South Cumbria and North Lancashire, was given a clean bill of health by two regulators in 2010, despite a spate of serious problems being recorded dating back at least two years.

The Care Quality Commission (CQC) launched a full investigation into the trust in January after a series of damning inquiries and reports into widespread failings in maternity, A&E and medical wards came to light. This included the “bloody mindedness” of one father whose baby son died at the trust in 2008, which led to a damning coroner’s report into the maternity services.

The report should make uncomfortable reading for the CQC itself, Monitor and the department of health as it echoes many of the clinical and regulatory failings at Mid Staffordshire hospital where hundreds of people needlessly died. It makes clear that serious problems extend across the hospital departments. 

Investigators found chronic shortages of nurses, doctors and even porters with as many as one in four A&E staff were agency or casual employees. Nurses regularly asked security guards to step-in and carry out duties such as observing vulnerable patients at risk of falling.

Emergency patients encountered A&E waits of seven hours, with ambulances backed up and patients left in corridors unattended - problems which date back to at least 2009.  One man said he told A&E staff that he “wanted to die” after being left in pain for hours without relief. In another case a suicidal patient was left to wander outside alone despite a previous incident led to serious consequences. 

Some patients and relatives said staff laughed, taunting or were rude to them. Bullying and aggressive exchanges took place between staff leading to culture of “shared helplessness” and complete disconnect between clinicians and managers. Seven whistleblowers came forward to CQC – apparently too scared of recriminations to report concerns to their managers.

Bed shortages, poor community services and old fashioned ways of recording who was admitted where, meant too many patients ended up languishing in inappropriate wards. One man waited five days for a doctor to tell him he had suffered a fractured spine.

Old, broken, out of date and ‘not fit for purpose’ equipment meant operations were cancelled, blood pressures not taken, and patients had to sleep on “condemned mattresses”. In one case, there was no resuscitation equipment for a very sick child.

Last night, local MP John Woodcock said: “The regulators are in the dock again over what has happened and time it has taken to properly establish the problems and put in place a programme for recovery.”

“He added: “We would not be here today if wasn’t for the bloody mindedness of one father who was determined to get to the truth.”

Peter Walsh from the charity Action against Medical Accidents said: “This is depressingly familiar to what we’ve seen at Mid Staffordshire. There have now been so many serious failings by various bodies, that there is a pressing need for a full independent inquiry to look at role of regulators, commissioners, and the trust.”

Despite a spate of deaths in the maternity unit in 2008/09, and a host of other care problems stemming from chronic staff shortages, broken relationships between clinicians and managers, and no clear strategy, the CQC registered the trust in April 2010 (noting only minor staffing concerns) and gave the maternity unit a clean bill of health shortly afterwards. It issued a series of warnings and enforcement actions in 2011.

Monitor authorized foundation trust status in October 2010 but was forced to intervene a year later after it became apparent the trust was in serious breach of standards, including thousands of out-patient appointments being lost on the system.  Consultants KPMG carried out a “learning lessons” report on behalf of Monitor and recently concluded that the multiple, serious problems must have been going on when the trust was approved.

The CQC insists that it took appropriate, robust action based on the information they had and what they saw, and the trust had not made the promised improvements in response to their earlier warning. “Had the trust provided us with important information earlier, we could have escalated our actions earlier… As we learned more and became more concerned, we took increasingly robust action, culminating in this full-scale investigation.”

But one senior CQC official, who asked to remain anonymous, said the regulator must take a hard, honest look at why it failed to pick up such serious concerns earlier when others did. The official told The Independent that many questions about the regulator’s performance remained unanswered and they feared similar mistakes could happen again. 

The trust’s new chair, Sir David Henshaw, last night apologised to patients and said immediate and long-term action to improve safety and quality for patients were underway.   

The CQC said improvements were being made under new leadership and that it would formally review progress after six months.

Arts and Entertainment
Attenborough with the primates
tvWhy BBC producers didn't want to broadcast Sir David Attenborough's famed Rwandan encounter
News
people
News
Campbell: ‘Sometimes you have to be economical with the truth’
newsFormer spin doctor says MPs should study tactics of leading sports figures like José Mourinho
News
news
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
Voices
Lance Corporal Joshua Leakey VC
voicesBeware of imitations, but the words of the soldier awarded the Victoria Cross were the real thing, says DJ Taylor
Life and Style
Alexander McQueen's AW 2009/10 collection during Paris Fashion Week
fashionMeet the collaborators who helped create the late designer’s notorious spectacles
Sport
football
News
i100
News
Perry says: 'Psychiatrists give help because they need help. You would not be working in mental health if you didn't have a curiosity about how the mind works.'
people
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Bookkeeper / Office Co-ordinator

    £9 per hour: Recruitment Genius: This role is based within a small family run ...

    Recruitment Genius: Designer - Print & Digital

    £28000 - £32000 per annum: Recruitment Genius: This Design and marketing agenc...

    Recruitment Genius: Quantity Surveyor

    £46000 per annum: Recruitment Genius: This property investment firm are lookin...

    Recruitment Genius: Telesales / Telemarketing Executive - OTE £30k / £35k plus

    £18000 - £35000 per annum: Recruitment Genius: This company specialises provid...

    Day In a Page

    War with Isis: Fears that the looming battle for Mosul will unleash 'a million refugees'

    The battle for Mosul will unleash 'a million refugees'

    Aid agencies prepare for vast exodus following planned Iraqi offensive against the Isis-held city, reports Patrick Cockburn
    Yvette Cooper: We can't lose the election. There's too much on the line

    Yvette Cooper: We can't lose the election. There's too much on the line

    The shadow Home Secretary on fighting radical Islam, protecting children, and why anyone in Labour who's thinking beyond May must 'sort themselves out'
    A bad week for the Greens: Leader Natalie Bennett's 'car crash' radio interview is followed by Brighton council's failure to set a budget due to infighting

    It's not easy being Green

    After a bad week in which its leader had a public meltdown and its only city council couldn't agree on a budget vote, what next for the alternative party? It's over to Caroline Lucas to find out
    Gorillas nearly missed: BBC producers didn't want to broadcast Sir David Attenborough's famed Rwandan encounter

    Gorillas nearly missed

    BBC producers didn't want to broadcast Sir David Attenborough's famed Rwandan encounter
    Downton Abbey effect sees impoverished Italian nobles inspired to open their doors to paying guests for up to €650 a night

    The Downton Abbey effect

    Impoverished Italian nobles are opening their doors to paying guests, inspired by the TV drama
    China's wild panda numbers have increased by 17% since 2003, new census reveals

    China's wild panda numbers on the up

    New census reveals 17% since 2003
    Barbara Woodward: Britain's first female ambassador to China intends to forge strong links with the growing economic superpower

    Our woman in Beijing builds a new relationship

    Britain's first female ambassador to China intends to forge strong links with growing economic power
    Courage is rare. True humility is even rarer. But the only British soldier to be awarded the Victoria Cross in Afghanistan has both

    Courage is rare. True humility is even rarer

    Beware of imitations, but the words of the soldier awarded the Victoria Cross were the real thing, says DJ Taylor
    Alexander McQueen: The catwalk was a stage for the designer's astonishing and troubling vision

    Alexander McQueen's astonishing vision

    Ahead of a major retrospective, Alexander Fury talks to the collaborators who helped create the late designer's notorious spectacle
    New BBC series savours half a century of food in Britain, from Vesta curries to nouvelle cuisine

    Dinner through the decades

    A new BBC series challenged Brandon Robshaw and his family to eat their way from the 1950s to the 1990s
    Philippa Perry interview: The psychotherapist on McDonald's, fancy specs and meeting Grayson Perry on an evening course

    Philippa Perry interview

    The psychotherapist on McDonald's, fancy specs and meeting Grayson Perry on an evening course
    Bill Granger recipes: Our chef recreates the exoticism of the Indonesian stir-fry

    Bill Granger's Indonesian stir-fry recipes

    Our chef was inspired by the south-east Asian cuisine he encountered as a teenager
    Chelsea vs Tottenham: Harry Kane was at Wembley to see Spurs beat the Blues and win the Capital One Cup - now he's their great hope

    Harry Kane interview

    The striker was at Wembley to see Spurs beat the Blues and win the Capital One Cup - now he's their great hope
    The Last Word: For the good of the game: why on earth don’t we leave Fifa?

    Michael Calvin's Last Word

    For the good of the game: why on earth don’t we leave Fifa?
    HIV pill: Scientists hail discovery of 'game-changer' that cuts the risk of infection among gay men by 86%

    Scientists hail daily pill that protects against HIV infection

    Breakthrough in battle against global scourge – but will the NHS pay for it?