Major hospital trust’s rating drops from ‘outstanding’ to ‘requires improvement’

One of the country’s leading NHS trusts has been downgraded from “outstanding” to “requires improvement” following a series of Care Quality Commission (CQC) inspections.

Some staff at Newcastle upon Tyne Hospitals NHS Foundation Trust told inspectors they were worried about raising concerns with bosses, and some employees reported that bullying at work was routine.

The CQC undertook unannounced inspections at the trust, which runs the Royal Victoria Infirmary, the Freeman Hospital and other sites, over the summer.

A second, targeted inspection took place in the cardiothoracic surgery department at the Freeman Hospital in September, following whistleblowers’ claims about bullying, harassment and safety concerns.

Following this inspection, the overall rating for the trust dropped from “outstanding” to “requires improvement”.

The CQC found that how well-led the trust is has declined from “outstanding” to “inadequate”.

Safety has dropped from “good” to “requires improvement”, while caring has dropped from “outstanding” to “good”.

The CQC said the trust must make specific improvements within a timeframe and submit monthly reports to show progress that has been made.

Ann Ford, CQC’s director of operations in the north, said: “When we visited the Newcastle upon Tyne Hospitals NHS Foundation Trust, 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.

“We found leaders had the skills and abilities to run the trust but they weren’t using them to always manage the priorities and issues they faced in a timely way.

“Also, the board had a lack of oversight at all levels to effectively manage and reduce risks to people.

“We were also concerned to hear the trust didn’t have an open culture where staff could raise concerns without fear of blame or punishment.

“Some staff told us that bullying was a normal occurrence, and they were encouraged to ‘turn a blind eye’ and not report this behaviour.

“This is completely unacceptable and must be addressed by the leadership team as a priority to enable staff to provide the best possible experience to people.”

Ms Ford did praise staff for the care provided and trust employees said they were proud to work there.

She added: “Inspectors also found some outstanding practice.

“For example, in children and young people’s services at both hospitals, staff were exceptional in supporting families and loved ones to understand a child’s condition and they knew when to escalate concerns, so the child received appropriate care as soon as possible.”

Since the inspections, Dame Jackie Daniel has stepped down as chief executive and Sir James Mackey has taken over.

Accepting the CQC’s findings, he said: “Everybody is very disappointed.”

Sir James said the report’s recommendations are being worked on “as a matter of urgency” and he is confident matters can be resolved and improved.

He said: “A detailed programme of activity is already under way and will continue until we, and the CQC, are assured the issues have been addressed.

“This will involve some tough decisions but it’s important we get this right and that people can see change happening.

“Of course, it is a huge disappointment that our overall rating has been reduced and to hear of the difficulties experienced by some colleagues.

“I know from speaking to many staff over the last few weeks that providing the best possible patient care remains an absolute priority for everyone at Newcastle Hospitals.

“While this is a challenging time, it’s important to emphasise that the inspectors saw and highlighted the compassion and kindness of our teams and rated ‘caring’ as ‘good’.”

Addressing the issue of bullying, Sir James said staff will be encouraged to speak up.

“We want to make sure that people can feel confident that when they raise issues, they will be dealt with appropriately,” he said.

The chief executive added that the trust still offers strong services with caring staff and has the “raw ingredients” to regain its “outstanding” status.