Morecambe Bay Hospitals Trust under fire: Consultant calls for resignations (From The Westmorland Gazette)
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Morecambe Bay Hospitals Trust under fire: Consultant calls for resignations
10:00am Thursday 17th November 2011 in Lancaster news
UNDER FIRE: Furness General Hospital at Barrow
A DAMNING indictment of the management culture at Morecambe Bay Hospitals Trust has been delivered by one of its own consultants.
In an exclusive interview with The Westmorland Gazette, the whistle-blower called for ‘senior resignations across the trust’ following a catalogue of failures affecting patient care.
The clinician, who has asked not to be identified ‘for fear of reprisals’, claimed bosses at the University Hospitals of Morecambe Bay Trust (UHMBT) were ‘obsessed with hitting targets and box ticking’ rather than patients’ needs.
He said UHMBT’s chief executive Tony Halsall, ought to be ‘considering his position’ and called on the Secretary of State for Health, Andrew Lansley, to intervene.
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“The groundswell of opinion among clinical staff is that there should be senior resignations across the trust,” the consultant said.
“If a doctor or nurse had made mistakes of a similar magnitude, they would have been struck off.”
The consultant’s views were echoed by the patients’ pressure group South Lakes Health Action, which called on the trust board to ‘resign en-masse’.
The Westmorland Gazette put all the consultant’s comments to the trust.
The trust declined to respond to the clinician’s allegations of management failure and the calls for resignations but concentrated on recent problems involving delays in outpatient follow-up appointments.
It said that additional clinics and members extra members of staff were helping to ensure all urgent cases affected by delays were seen by December 3 and that an experienced hospital operations expert had been brought in to lead this work.
UHMBT, which runs Westmorland General Hospital (WGH), Furness General Hospital (FGH) and the Royal Lancaster Infirmary (RLI), has attracted criticism since the summer over a series of clinical failures which include:
- The death of baby Joshua Titcombe at FGH’s maternity unit
- The revelation that more than 30,000 patients could have had treatment delayed because of follow-up appointment failures
- Higher than average mortality rates
- Claims that patients are having to wait in ambulances outside RLI because the A & E department sometimes cannot cope with emergency cases
The consultant hit out at ‘lame duck management with no credibility’ and said: “I have never seen morale in the trust so low among senior clinical staff.”
The consultant described the failure to notify patients of follow-up appointments as ‘the worst problem the trust faces’ with more than 30,000 being affected.
Last month, it was revealed that patients’ records were being stored haphazardly around the three hospitals, sometimes piled up on office floors, which meant they were difficult to locate when needed by clinical staff.
He said there were parallels with the mid-Staffordshire hospital deaths scandal, which led to a public inquiry that blamed ‘shocking systematic failures of hospital care’.
“We have no idea how many patients may have suffered adverse outcomes as a result of this,” said the consultant.
“There is no doubt that people’s lives are being put at risk because of these failures.”
The consultant also claimed there had been ‘a failure of governance’ at the trust.
Although one governor, John Kaye, had criticised management ‘mistakes’ earlier this month, the consultant insisted governors generally had not ‘grasped the magnitude of the problem’.
The consultant also accused UHMBT of focusing too much on empire building.
This, in part, is a reference to the trust’s bid to take over the troubled North Cumbria NHS Trust – a bid that was dropped by Mr Halsall after the follow-up appointments scandal at UHMBT was revealed.
UHMBT is being scrutinised by foundation trust regulator Monitor, which was called in following the Furness maternity scandal.
The trust’s directors have previously indicated they will not step down.
However, if Monitor is not satisfied with the trust’s performance it can remove them.
Comments(29)
nikc
says...
3:58pm Thu 17 Nov 11
gadgetgadget
says...
4:37pm Thu 17 Nov 11
The NHS does need a revamp if only to get rid of the ridiculous and top heavy bureaucracy that seemed to prevail under the previous Labour government. That will only come when NHS management realize they can't keep cutting back on front line services - the current central government now have a task of ensuring that each trust doesn't cut back on the wrong things and each trust gets it's act in order.
The focus needs to be on caring for patients not tick boxes, targets, form filling in etc. When that becomes the real priority then the NHS will stand a chance of becoming healthy again.
simpleasabc
says...
9:43pm Thu 17 Nov 11
chrismc
says...
10:56pm Thu 17 Nov 11
lancaster expat
says...
11:11pm Thu 17 Nov 11
I am sure what the Consultant says regarding future mergers is a distinct possibility. With the future changes including more competition that the government is planning there are going to be casualties and the smaller hospitals are at greater risk. The population is getting older, and healthcare more expensive.
Things do look bad for the current management at the moment and it looks as though some will jump before they are pushed, while others may fall on their sword. Though a new management team will not solve all the problems as some are insurmountable in the current financial climate. One can only hope that whoever does lead the trust board will engage with the senior medical and nursing clinicians in the trust as this will give them the best chance for Morecambe Bay trust to have a prosporous future.
lancaster expat
says...
11:14pm Thu 17 Nov 11
We should continue supporting the hospitals though as there are many people working their hardest to provide high quality care for patients
give-up
says...
9:02am Fri 18 Nov 11
gadgetgadget
says...
9:24am Fri 18 Nov 11
I'll make this simple ...
1) He/she is a whistle-blower by definition - it's a senior member of clinical staff going public with the problems.
2) The Chief Executive and management of the trust have presided over a set of problems that in any other organisation would have led to heads rolling. Many of these failures were predicted by others PRIOR to them happening.
3) The media has a duty to report stories in the public interest. These stories are in that category - the problems with UHMBT place the health of the public in danger and must be resolved. For that to happen, the public need to be aware of the issues and keeping pressure on the trust to act is also in the public interest.
4) The good work of the hospitals is regularly recognized in letters to the WG, it's regularly reported by the local MP, it's even mentioned in the whistle-blower's comments - however all that is tempered by the low staff morale there - just because you don't necessarily see it doesn't mean it's not happening.
5) Which is better ? Get new management in with new eyes and a new outlook or potentially lose much more important patient care staff like doctors, nurses, consultants etc etc. I know which I prefer and it's not the patient care staff. "Monitor" can step in if necessary to force the issue.
6) It's unfair too to measure management performance by statistics such as those you refer to. Statistics can be massaged (see the recent mortality rate discrepancies) - it's actual patient care performance that matters.
6) Many times in life to get to positives like you want you have to go through negatives and learn from them. Unfortunately the management at UHMBT don't seem to be learning from the negatives (some of these issues they've known about for many, many months) and correcting them - that's their choice to not do so, act like ostrichs and pretend the problems are going to go away, that's their perogative but eventually it's gonna backfire on them.
That's the point we're at now - it's backfired and they've been exposed as what I would class as unfit for purpose. If it requires a mass management shake-up to rectify and put matters back right then so be it - I'd rather have a properly functioning local NHS with staff morale high than a disfunctional one where staff clearly don't trust the management anymore.
gadgetgadget
says...
11:03am Fri 18 Nov 11
Cumbria PCT (and the Mental Health trust) is already based on county boundaries it already commissions services from outside of the county (i.e. at Lancaster Hospital).
If the UHMBT was split up and based on county boundaries too what it would mean longer term in reality is a more likely need for ADDITIONAL services at WGH/FGH not further reductions simply because the transport requirements to the north of the county for serious emergencies would be unworkable or there would be an increased reliance on services outside of the county.
At present UHMBT can use RLI as an "excuse" for not allowing additional services at WGH/FGH (see the excuses for heart unit as an example) - change that boundary and the needs become radically different and much more positive for the local community in the long term.
johnwalker1000
says...
11:18am Fri 18 Nov 11
A friend of mine is also waiting for someone to contact them about another appointment and this keeps happening and in the end they end up chasing due to no response and their medication nearly running out.
give-up
says...
11:20am Fri 18 Nov 11
2. You and I don't know for sure what's going on behind the scenes - we know only what the media and people with a vested interest tell us and in my experience that is never the full story. Put every effort into getting the service right, and follow due process if disciplinary action is required rather than just reacting to hysteria.
3. A balanced view should be portrayed. There is much that is right about MBHT but we never hear of that. There are thousands of people receiving an exemplary service every year who's voices don't get heard.
4. Staff morale is low everywhere in the public sector, not just at MBHT. Sad but true.
5. Monitor messed up with Mid Staffs, and got it in the neck as a result. Their main concern with MBHT is to cover their own backs, not serve our community.
6. I didn't refer to any statistics specifically so what's unfair? The national media recently identified the ten worst hospitals in England for mortality rates and guess what - no mention for MBHT!! So who's telling us the truth and who's scaremongering? In terms of performance - see my reply to point 3.
The CEO has stated that every patient awaiting a follow up appointment will be seen by 3rd December. The urgent ones have, apparently, been done already, so you can't really say that they are not learning from the negatives and correcting them.
I would simply like a BALANCED view to be presented and I prefer not to throw the baby out with the bathwater. Staff morale cannot be improved whilst everyone associated with the Trust is being given such a negative press. I'm not saying everything is perfect .... but it's not ALL bad either.
gadgetgadget
says...
11:38am Fri 18 Nov 11
I'm certainly not reacting to hysteria and personally know a lot about what has been going on and what hasn't. What the consultant has described is IMO very accurate and how the Gazette have reported the incidents have been accurate too. So they only have the public interest at heart - unlike some actions from management.
If you prefer a balanced view then perhaps you might want to ask WHY the Chief Executive refused to comment recently. What was he frightened of ?
I made clear examples of the good comments about UHMBT made in the press etc (there's hardly a week goes by without a letter in the WG praising the clinical staff at UHMBT/CPCT) - and I agree there is a lot of excellent work done by the clinical staff but you need to understand that the management are undermining those clinical staff with their actions and frankly bad news is always more reportable than good. That's the way of the world unfortunately - UHMBT are not a different case at all.
If you think the current problems with the appointments system are new then simply you are WRONG - the problems were known about at least 18 months ago (I have personal access to evidence to prove that was the case and that management promised things and didn't deliver) and it has been ongoing during that time.
Management have publically and in their "blogs" denied during that period of time that there was a problem and it was only until it became public with the scale of the problem that they've reacted - that's not good or responsible management at all - prevention is better than cure !!
Staff morale CAN (and probably will) be improved by the issues being made public because then they will feel that they are not having to suffer in silence and have undue gags placed on them from speaking out in fear of losing their jobs.
Who is going to discipline the management of UHMBT if not "Monitor" or the government ? They are a foundation trust and are expected to effectively police themselves - frankly again it's not working !!
And you referred to "performance" between trusts - that's based on statistics provided by each trust - those statistics can be (and based on recent reports are) massaged.
I think you're missing the bigger picture (again !) and I worry that just wanting a balanced view (which the trust is given an opportunity to do BTW) is not the way forward. There needs to be action not words !! I'll say again - if that requires a mass-management shakeup and new faces/ideas then that can only be a good thing IMO.
give-up
says...
11:39am Fri 18 Nov 11
gadgetgadget
says...
11:43am Fri 18 Nov 11
gadgetgadget
says...
11:45am Fri 18 Nov 11
give-up wrote:You don't know that - if management got their act together and didn't spend money on tick box exercises that money MIGHT be available elsewhere. Patient care funds are available from central government - see the Chemotherapy unit at WGH recently as a really, really good example.
Sorry gadgetgadget, for the foreseeable future there's just no money for additional facilities - needed or not.
give-up
says...
12:11pm Fri 18 Nov 11
Look at the economic climate. There really is no more money to squeeze out of it. I fear for the future of our health service locally and we're just not helping.
gadgetgadget
says...
12:25pm Fri 18 Nov 11
Management don't have to conduct EVERY tick box exercise they perform - many are performed NOT as a directive from central government but as a local initiative.
There are many examples available locally for that - not just in the NHS.
The problem is that many of the tick boxes that management want CLINICIANS to perform are simply ridiculous - simply because they enable them to produce pretty spreadsheets - and often that information is readily available if only a bit more admin staff effort rather than clinical staff was put in. It's the responsibility of management in whatever role to make decisions about which ones to undertake or not. It's those tick box exercises that I was referring to.
I think you need to realize it's not just non-clinical staff that are expected to perform the tick-boxes but the clinicians themselves and that is taking valuable time away from what they should be doing.
I'd rather have clinicians spending time treating patients rather than filling in forms that serve no real purpose - that's the crux of the problem I was referring to.
I'm certainly not suggesting that the chemotherapy unit was just down to Tim Farron's efforts - but it is a clear example of how pressure to get local services that have a valid need can get funds from central government whether it be on the back of a tickbox exercise or public pressure.
Just because management AND public pressure got the chemotherapy unit here doesn't excuse their other management failures - please don't confuse the two.
I referred to the chemotherapy unit simply because it is a clear example of how funding can be obtained from central government for clinical needs rather than administrative ones. The economic climate makes it even more important that un-necessary administrative exercises are not given higher priority than patient care.
I also fear for the future of the Health Service but I also fear that unless a firm grip is obtained on the un-necessary level of bureaucracy that the money available to the NHS is being sucked into the wrong areas.
WilliamT
says...
1:06pm Fri 18 Nov 11
roadrunner66
says...
1:23pm Sat 19 Nov 11
Agree with all of the above and I know that all my colleagues and co-workers do too. We've been telling patients that the clinic system is full of holes for 18 months now and to ring up the hospital if (when?) the follow up appointment never arrives. Management took no notice. I think they prefer to listen to their own rhetoric rather than patients and staff.
It is far too late for the current senior managers to stay. The situation could have been turned around even a year ago, but they chose not to listen. Hence, they should now take responsibility for their collective failure to register the concerns of a range of staff and patients and stand aside.
Whistleblower was right to draw parallels with Mid-Staffs. The senior clinical staff were strongly criticised there for failing to challenge management over similar obvious failings. It may be late to do so here (Thanks William T) but better late than never. Yes, the coroner and James T' have done well and should be saluted for their courage in questioning standards at such a powerful organisation, but unlike whistleblower, they won't potentially lose their job/career and in any event, had whistleblower spoken out 6 or 12 months ago, no-one would have taken any notice. It is only the desperately sad issues covered by the coroner, the Dr Foster death figures and clinic failings that have made the almost universally held concerns within UHMB clinical staff real public news outside of it.
Can I strongly suggest that both patients and staff speak out strongly over this? It really is a case of "speak now or forever hold your peace".There has been a massive failure here and now is the moment to ensure that our hospitals overwhelming priority is realigned with the Trust motto. Current events make a grotesque mockery of it.
gadgetgadget
says...
2:26pm Sat 19 Nov 11
I know that our MP is aware of some of the more recent disingenuous tales that management have told especially about the appointments system and I hope that he too is able to join in and expose the failures even further - if necessary in the House of Commons on the record.
Can I suggest that a facebook/twitter campaign might be worth looking at ? and also get SLHA more on the case. The scenarios described by Whistleblower, yourself and those exposed by the sad events in the Joshua Titcombe case cannot continue without repercussions for senior management regardless of some of the good work they may do elsewhere - they are as you describe making a grotesque mockery of the Trust.
Perhaps some of your colleagues can use this page to make further comment anonymously.
Skeptical
says...
5:09pm Sat 19 Nov 11
logspot.com/2011/11/
joshuas-easily-preve
ntable-tragic.html
The story of Joshua Titcombe can be found on the website above. A tragedy that happened more than 3 years ago, yet the serious issues with maternity services at the trust are still ongoing. It should not have taken the intervention of external regulators before these issues were properly addressed. This is managerial incompetence at its very worst. Well done to the consultant who has spoken out. The resignation of senior management, including Tony Halsall is now essential for everyone (staff, patients and families affected by these tragedies) to regain the confidence and trust they deserve to have in our local hospitals. I hope other members of staff will now be brave enough to speak out and call for change.
redarmy11
says...
5:01pm Sun 20 Nov 11
Although this argument seems to be predominantly about maternity issues and outpatient appointments I feel it is the only public forum in which to inform the users; not only of the local hospitals but the health service in general of the mess in which the service now finds itself. I am an employee of the health service and work at WGH (there is more than one trust working within WGH) and I can tell you that unless some drastic changes take place then the NHS will in the near future implode. The staff on all wards at WGH, FGH and RLI are being worked to the extreme limits of their capabilities in the name of cost cutting. Patients are suffering as a result and staff are so demoralised that I have real concerns for their health and well being. It does not take a genious to work out that without the staff there is no patient care. I would any member of the public to take a walk through the staff car park at WGH on any week day between 9 & 5 and see that there is not a space to be had then, come again at weekend and see how empty it is; remember it is clerical and admin staff that work 9 - 5 and nurses and medical staff that are there 24 hours per day 7 days per week. The Royal College of Nursing has admitted that nurses are being lost through natural wastage eg retirement and are not being replaced. Yes admin staff are needed but if the health of the nation really is important then nurses and doctors are not just needed they are essential. Mr Halsall earns approx 110 THOUSAND pounds per annum, a VERY senior nurse earns approx 40 thousand per annum and a nursing assistant (the backbone of any ward) earns approx 16000 per annum, I know where the best value for money will be found and is not sat in an office on level 2 WGH. The nursing staff do there level best to ensure patient care continues to be given in the safest, most effective way (and they don't get a jolly to India to learn how). Because of superbugs like MRSA nurses are now also expected to be cleaners, by that I do not mean patient care areas I mean all areas of the wards including toilets and are expected to complete vast volumes of paperwork. I can with hand on heart say that patient care comes a long way down on a very long list of nurses duties. All managers of all trusts within WGH are well aware of the crisis that is unfolding but choose to ignore it as they always have in the past, all that concerns them is that boxes are ticked and spread sheets completed, the thing that leasts concerns them is the care of the patient and the wellbeing of the staff. Giving trusts foundation status was the biggest mistake I have ever witnessed it has given them permission to spend funds in the most careless way and then think that they have no one to answer to. There was not one ground floor staff member who felt that it would be a good thing and they were right. As you may be aware UNISON has called for a day of action on 30th Nov and for the first time in history the majority of nurses have voted to take action. It is my opinion that it is time that not only the unions but the public in general stand
up for the once great institution that was the NHS before we lose it forever
gadgetgadget
says...
6:05pm Sun 20 Nov 11
Redarmy11's comment directly confirms my arguments earlier in the thread.
One issue that hasn't been raised in this thread so far is :
Why do we actually NEED several NHS trusts to run the hospitals ??
It was a Labour Govt policy to introduce client/provider units across the public sector - but what has it actually done other than create multiple highly paid management positions. In the running of WGH alone there at least 3 trusts involved, UHMBT, Cumbria PCT, the Mental Health Trust - all of whom have directors, managers etc often in duplicated positions.
If the NHS is to survive surely the government should be looking at abolishing the need for multiple trusts in the client/provider model - it just doesn't work in the current economic climate.
agedcitizen
says...
12:43am Tue 22 Nov 11
Why do i say this ?
1. having working in and around South Cumbria for most of my life. I have seen with my own eyes Ambulances trying to thread their way through the holiday traffic to pick up dangerously ill patients, and unless our amblances are modelled on Chitty Chitty Bang Bang, there was no way they would get to Lancaster within 1 hour of being called out.
2. The above pre-supposes that there was an ambulance available "Immediately" from the nearest station, which i really believe not to be the case much of the time. From personal experience i waited 5 hours for an ambulance to take me to RLI from Kendal - Ok i was going in for surgery and at the time it was not considered life threatening.
The Ambulance that finally collected me had to come from Sedbergh, as the local Ambulances were "held - up " in Lancaster waiting to discharge their patients into A & E. I talked to the Paramedic about what i considered a ludicrious system and was surprised he openly agreed, as they spend much of their working life travelling up and down the M6 followed by long delays to discharge patients .
On the particular day i arrived there was 3 ambulances already waiting to discharge their patients ahead of the vehicle i was travelling in.
Having had several operations over the past 3 years, i have spent many weeks in our local hospitals either at clinics , day patients , or as an in patient, and i can only heap praise on the CLINICAL staff at WGH, RLI, and Ulverston.By Clinical staff , i include the porters , cleaners , kitchen staff and low grade admin staff that patients meet every day. They do a fantastic job in trying circumstances and i can offer nothing but praise for the care I received (one minor point - a little less pasta on the menu please ) I just wish the managers where of the same calibre.
I dont tar everyone with the same brush, but when top management has tranformed OUR hospital (WGH) into a glorified Office Block to build a vast beaurocratic empire over which to hold court then i am of the opinion it is time for them to move aside from their overpaid plush assignments and give way to someone with the best interests of the local populace at heart.
These beaurocrats should be made accountable and should be subject to re-elction to office by ALL members of the trust every 2/3 years just like governors.
davidearnshaw
says...
8:30pm Tue 22 Nov 11
I and other non medics, including our MP campaigned tirelessly and repeatedly warned management that their removing the Acute Services from Kendal, would place an untenable (last straw) strain on an already stretched to its limit -- Lancaster Royal -- they chose to dismiss this as no more than a good days work, and that all hospital receiving departments experienced "peaks and troughs" ---- they chose to say that departments / wards etc would be run and staffed via "averages" --- but we cannot do this in an Acute Service --- the Service has to be prepared and well able to cope with the highest level of demand without a reduction in standards ----- we see time and again Lancaster A & E beseiged with queues of Ambulances waiting for long periods to offload their patients --- so bad has the situation been at times, that North West Ambulance service has had to station a manager there, to liase with A & E staff. Ambulances based in South Cumbria, now spend a high proprtion of their time running up / down M6 to Lancaster, and then very often waiting in or outside the A & E department ----- this is serious professional time wasted, and must also affect response times to other emergencies -- that this would happen was repeatedly pointed out to Trust Managers and some Consultants, whose only answer was, that it is for the best benefit of the patients !!!??. For the treatment of Acute Heart Attacks --- WGH always outshone both Furness and Lancaster, in time taken to deliver vital life saving treatment --- yet the powers that be still carried on with their closure of the Medical services at WGH. Without doubt management will still deny there is a problem at RLI --- I sincerely hope those stressed to breaking point staff will please now start to come forward, whether by name or anonymously and tell it how it really is there ---- last week during one overnight period, the RLI was closed to all admissions from South Cumbria ---- it was full !!! -- but this is not uncommon.
Another "casualty" of management's mismanagement, has been the transfer of most of the Pathology Lab, blood testing services at WGH to Barrow or Lancaster ---- the result being that abnormal blood test results ( tests being done by S. Cumbria GP Surgeries during the day ) are being sent out to the Out of Hours GPs during late evenings, and even after 11pm, which can cause difficulties, as some folks have already gone to bed, which can leave the night GP - Dr with the dilemma of knocking on the door of a patients house when not expected --- again another example of mismanagement of such a vital service.
Anonymous Consultant says the Governors should have more of a handle on governance --- please believe me -- The South Lakes and Eden Governors know full well the shortcomings and problems within the Trust management, but as one would guess, management have engineered things to keep Governors at arms length when it comes to important decision and policy making -- they will not listen --- again.
We all know there are other significant problems across the Trust, we have unhappy and stressed staff -- denied by management of course -- and sadly by some senior nurses ---- what to do about it ?? ----- resignations ?? --- possibly or possibly more honourably an open admission that in a number of areas they --- management, have got it wrong -- and a promise to sit round a table with the dissaffected Consultants, other Drs and Nursing Staff to agree to unconditional discussions as to how to reverse this failing system -- sadly -- no doubt this will not occur, as many will still be afraid to stand up and be counted for fear of sanctions against them in their career pathways. I hope I am wrong.
Skeptical
says...
9:04pm Tue 22 Nov 11
gadgetgadget
says...
9:17pm Tue 22 Nov 11
I know from personal contact with you in previous health campaigns that you are an honourable man and well respected local GP.
It's a real shame that some other local health professionals do not appear to want to speak out (for whatever reason) - it's about time this was as you state put on an open table with a no-holds barred discussion of a way forward and management of UHMBT to own up to it's failings and where necessary for certain individuals to take personal responsibility and resign. Unless that happens there can be no real progress forward and staff morale there is bound to be gradually eroded even further. Sadly I agree it's highly unlikely to happen.
I also think there needs to be a no-holds barred involvement of the governors of the trust in all decision making of the board - the stories of restriction and gagging of governors is not good for not just the image of the trust but also for democracy in general.
There should be nothing at board level that should not be aired in front of governors - they are elected to represent the public - if they are blocked from certain elements of meetings that raises clear questions about what is being hidden and whether the "confidentiality" excuse is actually not the real truth.
Thanks again, Dr Earnshaw - let's hope that something constructive can come out of all of this however as I no longer have faith in the current Trust board I fail to see that it can happen without radical changes at the top.
WilliamT
says...
8:04am Wed 23 Nov 11
Helvellyn55 says...
12:42pm Thu 17 Nov 11
We can of course hope - how likely is this?