Newcastle Hospitals NHS Foundation Trust has experienced a “significant deterioration” in leadership, leading to a subsequent decline in the standard of its services, as revealed in a report by the Care Quality Commission (CQC). The CQC’s inspections, conducted between June and September, brought to light a culture of bullying where staff felt compelled to “look the other way.” This discovery prompted the CQC to downgrade the trust’s overall rating from “outstanding” in 2019 to “requires improvement.”
The CQC scrutinised surgery, services for children and young people, medical care at the Freeman Hospital and the Royal Victoria Infirmary (RVI), as well as maternity services and urgent and emergency care at the RVI. The patient transport service (NECTAR) also underwent examination. The trust’s overall rating experienced a decline from “outstanding” to “requires improvement,” with the evaluation of how “well-led” the trust was dropping from “outstanding” to “inadequate.”
Ann Ford, CQC’s director of operations in the north, expressed concern over the findings, stating, “We found a significant deterioration in how well the trust was being led. Our experience tells us that when a trust isn’t well led, this has a knock-on effect on the standard of services being provided to people.” She further highlighted instances where staff reported that bullying was normalised, with encouragement to ignore and not report such behaviour, deeming it “completely unacceptable.”
The report outlined specific declines in various categories, including “safety” dropping from “good” to “requires improvement,” “effective and responsive” decreasing from “outstanding” to “requires improvement,” and “caring” dropping from “outstanding” to “good.”
The trust, in response to the report, acknowledged the issues and stated, “We fully accept the CQC’s reports. Their clear recommendations for attention and improvement are being worked on as a matter of urgency, and I am confident we can fix this by working together across the organisation and focusing on what matters to patients and staff,” said Sir James Mackey, the newly appointed chief executive.
The inspection revealed that a new chief executive and other senior leaders have joined the trust since the evaluation. The CQC affirmed its commitment to monitoring the trust and conducting further inspections in the future.
Behind the scenes, serious problems were brewing for Newcastle Hospitals, despite its outwardly “outstanding” rating. The Freeman Hospital’s world-renowned cardiac work and the RVI’s status as the first to treat Covid patients in the UK concealed brewing issues. The focus of the inspection honed in on the cardiac surgery unit, where whistleblowers reported bullying and safety concerns.
The leadership, particularly in managing the cardiothoracic unit, faced severe criticism. Sir Jim Mackey, the newly appointed chief executive, is now tasked with changing the organisational culture and addressing IT issues, including thousands of clinical letters to GPs not being sent out.
The report raises concerns not only for Newcastle Hospitals but reflects broader challenges faced by trusts nationwide. The impact of Covid, strike action, A&E delays, staffing shortages, funding issues, and social care deficits are leaving trust leaders grappling with multifaceted challenges.
The CQC’s report is undoubtedly bad news for the staff, but it does note a “good” rating for the category of caring. As the trust endeavours to implement the recommended improvements and changes under Sir James Mackey’s leadership, the coming months will be crucial in determining the effectiveness of these measures and the trust’s ability to restore its previous standards.
In conclusion, the Newcastle Hospitals NHS Foundation Trust’s leadership issues, as highlighted by the CQC report, pose challenges not only for the organisation itself but also underscore systemic challenges faced by NHS trusts across the UK. The ongoing efforts to address these issues and implement improvements will undoubtedly be closely watched, with implications for the broader healthcare landscape.
