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.

Voices
Barn owls are among species that could be affected
charity appeal
Sport
After another poor series in Sri Lanka, Alastair Cook claimed all players go through a lean period
cricketEoin Morgan reportedly to take over ODI captaincy as ECB finally wield the axe
Arts and Entertainment
a clockwork orange, stanley kubrick
film
News
news... you won't believe how bad their skills were
PROMOTED VIDEO
Life and Style
ebookNow available in paperback
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
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: Finance Director

    £65000 - £80000 per annum: Recruitment Genius: Finance Director required to jo...

    Recruitment Genius: Medico-Legal Assistant

    £15000 - £25000 per annum: Recruitment Genius: This is a unique opportunity fo...

    Ashdown Group: (PHP / Python) - Global Media firm

    £50000 per annum + 26 days holiday,pension: Ashdown Group: A highly successful...

    The Jenrick Group: Quality Inspector

    £27000 per annum + pension + holidays: The Jenrick Group: A Quality Technician...

    Day In a Page

    Homeless Veterans appeal: 'You look for someone who's an inspiration and try to be like them'

    Homeless Veterans appeal

    In 2010, Sgt Gary Jamieson stepped on an IED in Afghanistan and lost his legs and an arm. He reveals what, and who, helped him to make a remarkable recovery
    Could cannabis oil reverse the effects of cancer?

    Could cannabis oil reverse effects of cancer?

    As a film following six patients receiving the controversial treatment is released, Kate Hilpern uncovers a very slippery issue
    The Interview movie review: You can't see Seth Rogen and James Franco's Kim Jong Un assassination film, but you can read about it here

    The Interview movie review

    You can't see Seth Rogen and James Franco's Kim Jong Un assassination film, but you can read about it here
    Serial mania has propelled podcasts into the cultural mainstream

    How podcasts became mainstream

    People have consumed gripping armchair investigation Serial with a relish typically reserved for box-set binges
    Jesus Christ has become an unlikely pin-up for hipster marketing companies

    Jesus Christ has become an unlikely pin-up

    Kevin Lee Light, aka "Jesus", is the newest client of creative agency Mother while rival agency Anomaly has launched Sexy Jesus, depicting the Messiah in a series of Athena-style poses
    Rosetta space mission voted most important scientific breakthrough of 2014

    A memorable year for science – if not for mice

    The most important scientific breakthroughs of 2014
    Christmas cocktails to make you merry: From eggnog to Brown Betty and Rum Bumpo

    Christmas cocktails to make you merry

    Mulled wine is an essential seasonal treat. But now drinkers are rediscovering other traditional festive tipples. Angela Clutton raises a glass to Christmas cocktails
    5 best activity trackers

    Fitness technology: 5 best activity trackers

    Up the ante in your regimen and change the habits of a lifetime with this wearable tech
    Paul Scholes column: It's a little-known fact, but I have played one of the seven dwarves

    Paul Scholes column

    It's a little-known fact, but I have played one of the seven dwarves
    Fifa's travelling circus once again steals limelight from real stars

    Fifa's travelling circus once again steals limelight from real stars

    Club World Cup kicked into the long grass by the continued farce surrounding Blatter, Garcia, Russia and Qatar
    Frank Warren column: 2014 – boxing is back and winning new fans

    Frank Warren: Boxing is back and winning new fans

    2014 proves it's now one of sport's biggest hitters again
    Jeb Bush vs Hillary Clinton: The power dynamics of the two first families

    Jeb Bush vs Hillary Clinton

    Karen Tumulty explores the power dynamics of the two first families
    Stockholm is rivalling Silicon Valley with a hotbed of technology start-ups

    Stockholm is rivalling Silicon Valley

    The Swedish capital is home to two of the most popular video games in the world, as well as thousands of technology start-ups worth hundreds of millions of pounds – and it's all happened since 2009
    Did Japanese workers really get their symbols mixed up and display Santa on a crucifix?

    Crucified Santa: Urban myth refuses to die

    The story goes that Japanese store workers created a life-size effigy of a smiling "Father Kurisumasu" attached to a facsimile of Our Lord's final instrument of torture
    Jennifer Saunders and Kate Moss join David Walliams on set for TV adaptation of The Boy in the Dress

    The Boy in the Dress: On set with the stars

    Walliams' story about a boy who goes to school in a dress will be shown this Christmas