Morecambe Bay Hospitals Trust under fire: Issues at Barrow baby unit ‘have been dealt with’, says trust (From The Westmorland Gazette)
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Morecambe Bay Hospitals Trust under fire: Issues at Barrow baby unit ‘have been dealt with’, says trust
10:30am Thursday 24th November 2011 in Lancaster news
DIED Baby Joshua Titcombe
TRUST bosses say they have met the demands of a health watchdog which has power to close the troubled maternity unit at Furness General Hospital.
The University Hospitals of Morecambe Bay NHS Foundation Trust this week handed evidence to the Care Quality Commission (CQC) in an attempt to prove it was fit to run services.
Trust staff said they were confident their improvements would calm concerns raised after an unannounced inspection of maternity units at Furness General Hospital (FGH), Westmorland General Hospital and Royal Lancaster Infirmary, in July.
The investigation was prompted by an inquest into the death of nine-day-old baby Joshua Titcombe, who died of a missed infection at FGH in 2008.
Inspectors found multiple failings at the site and said the trust was ‘compliant’ in four assessment standards, but created ‘moderate’ concerns in three areas and ‘major’ concerns in three.
Director of nursing at UHMBT Jackie Holt said it was up to the CQC to decide if improvements were enough to raise FGH’s maternity ward from a threat of closure.
She said: “We regret what has happened and we’re sorry if it has caused anxiety. "We’ve complied with the CQC’s warning notice, but from our point of view this is just the first milestone of improvement.
“We’ve done the best we can with a 26-year-old building that is not fit for purpose as a twenty-first century hospital.
“We are now focusing on continuing to work with our partner organisations, Maternity Liaison Group, mothers and staff to ensure we continue to make improvements to maternity services across the Trust and sustain them in the long term.”
Changes to trust services include:
- More staff employed to create a second ‘out of hours’ emergency theatre team at FGH
- A business case put together for long-term maternity service improvements in Barrow
- A shorter route from FGH labour ward to surgery theatres to preserve privacy
- Refurbished rooms and a multi-disciplinary staff room
- Staff training to encourage employees to report problems on risk registers
Sascha Wells, head of Midwifery, Obstetrics and Gynaecology, said: “It is extremely important women in Morecambe Bay continue to have confidence in our maternity services and I would like to reassure them our services are safe.”
Concerned patients can contact the trust’s helpline on 01539 715082.
Comments(74)
Skeptical
says...
10:24pm Mon 21 Nov 11
Behind the press releases and headlines, there are real families whose lives have been utterly devastated because of issues which the management of the trust should have addressed long ago.
I would also point out that not a single midwife has been dismissed following any of the incidents at FGH, you only have to look at some of the deaths to realise just how worrying the implications of this are.
The public can not be fully reassured until the CQC, Monitor and the Police have concluded their work. Until this happens, no one truly knows the full extent or seriousness of what has been happening nor that the all necessary actions have been taken in response.
ShahidAli
says...
10:35pm Mon 21 Nov 11
In all my dealings with the Trust Board, and bearing in mind I can say anything as I have no axe to grind I found the Trust Board to be one of the most open, transparent and dynamic i have worked with. Yes I can hear people saying I must have worked with some bad ones, No I havent, but the CE and DCE and the TB in my view are the right people to lead the organisation and if things go wrong they put them right.
People sniping should reflect on where UHMB was 5/6 years ago and how this management team have really changed things previously, and they will do it again.
Its clear some have hidden agendas on here, everyone should be working with the TB to pull in the same direction instead of point scoring, Every poster, emplyed or otherwise should ask themselves...what can they do for the Trust to help it, how can they make a difference...yet all we hear of is they want the TB to resign...people need to grow a backbone and realise they have responsibilities to help the Management deliver too. Babies dying and services not being up to the standard people want is not acceptable by anyones definition...however how will bringing in a new management board help. This board has done a lot of unbelievable work and are the ones that will make this better. Having left the Trust and not having to type a message would be very easy....All i will say is the people of North Lancashire are fortunate to have the Trust Board at UHMB that they have.
Disappointedalot
says...
10:52pm Mon 21 Nov 11
They need our support and backing to get things right and a lot of the comments, as much as it irks me to say it makes sense.
Lets back our hospital to get it right, lets all get behind them to get this right and gget the services for our people ring.
Lets make our hospitals great again.
WilliamT
says...
8:19am Tue 22 Nov 11
Skeptical
says...
8:23am Tue 22 Nov 11
Much has been talked about the cultural problems at FGH, how is a management team who have lost the confidence of its own staff, who have repeatedly failed to deal with serious issues and who have led the trust into such disrepute, going to turn this around?
The reason why the consultant has recently spoken out against the management of the trust, is because he/she cares deeply (as do the vast majority of staff that work in our hospitals) about delivering safe and effective care. Ignoring the concerns such as these, and pretending that serious management failures have not occurred is simply not going to help anyone.
ShahidAli
says...
9:25am Tue 22 Nov 11
Firstly I am not "suspiciously" pro management...Having worked there and experienced what it is like to work with on a daily basis members of the TB, and having first hand experience of this.....There is nothing "suspiciously" about it.
Secondly, just because I am not berating the management doesnt mean my views are any less valid, I would say moreso for the reason above.
Thirdly Tony Halsall has stated that the buck, as with any organisation CE, stops with him. Everyone seems fairly blaise about hanging the management team without the requisite time to see how this develops. UHMB have stated that they have met watchdog concerns so I dont see the need for hangings as yet.....If needed maybe the repercussions sohuld be flet with by people directly responsible rather than those who are "ultimately" accountable...Whenev
er anything in the NHS or wider afield goes wrong we tend to be very quick to call for heads to roll....how will heads rolling solve the problem. The problem would still be there. Best to sort out the issues in a detached well thought out manner and then look at who needed to go.
WilliamT
says...
9:46am Tue 22 Nov 11
gadgetgadget
says...
10:01am Tue 22 Nov 11
Tony Halsall's comments about "the buck stops here" and then refusing to resign on the back of these MULTIPLE MANAGEMENT (not CLINICAL) failures amplify the resentment towards himself and his management team.
Without a NEW set of eyes and ideas within the Trust (which BTW is a word the management have made a mockery of) then the actual trust of the public in their abilities to get any decisions right has been seriously and dangerously eroded.
The ONLY staff suffering from this lack of proper management are the one below their highly paid and cushy jobs i.e. the lower paid clinical staff etc. They are the ones who do all the REAL work in the NHS and the ones who end up being in the firing line when management fail.
Sorry ShahidAli and DisappointedALot but getting our hospitals back working again is only going to happen under NEW management and if necessary that should be multiple heads rolling as this executive has proved to the public that it is unfit for purpose.
gadgetgadget
says...
10:06am Tue 22 Nov 11
If it was just that unit that was the problem then I would have tended to agree that the focus on resignations should be on that area ... but quite simply as Skeptical has pointed out above - it's not just limited to FGH and it's Maternity Unit.
@WilliamT I agree fully !!
gadgetgadget
says...
10:15am Tue 22 Nov 11
How can you explain then why the UHMBT management (Two of which were made personally aware by ME and other family members) of failures in the appointments system over 18 months ago failed to act on those failures and the recent problems resulted as a failure of that inaction. They promised at the time to fix the serious problems with follow up appointments but as is clearly evident now they didn't do so.
How can anyone have trust in a management team who say they are going to do one thing but clearly don't ?
You state that we should all help the Trust Board but they need to help the public they are employed to look after and follow through on (and keep) promises they make - they haven't done so therefore it's now right that there is a public awareness of the seriousness of the problems with the Trust management.
If the buck stops at Tony Halsall then quite simply he has failed not once, not twice but multiple times on multiple issues - it's therefore quite right that there are calls for him to resign.
Skeptical
says...
10:18am Tue 22 Nov 11
gadgetgadget
says...
10:21am Tue 22 Nov 11
gadgetgadget
says...
10:29am Tue 22 Nov 11
Skeptical
says...
10:31am Tue 22 Nov 11
gadgetgadget
says...
10:36am Tue 22 Nov 11
WilliamT
says...
11:50am Tue 22 Nov 11
The Foster figures will come out in a national newspaper this weekend (is my guess), and after that it will come out that the Trust has been 'spinning' its mortality data for at least 18 months, using a further mortality indicator RAMI provided by commercial firm CHKS. This indicator was previously relied upon as an excuse by several trusts which employed CHKS, including Mid-Staffs., to claim lower adjusted mortality rates than provided by Foster. Interestingly, CHKS failed to detect the Bristol Paediatric Heart Scandal, yet Foster did- and who was right there? I have no connection with either company! After all this comes out, I think Halsall at least will have to go- we shall see.
give-up
says...
2:12pm Tue 22 Nov 11
gadgetgadget
says...
2:27pm Tue 22 Nov 11
Everyone who has made comment has the best interests of the trust at heart but we have different views on how it should be rectified.
I made clear reference on the other thread to other good work by the Trust and will repeat it here if necessary however the good work done by many members of staff is being undermined by the failures to management to get to grips with the VERY SERIOUS issues that you and ShalidAli seem to want to brush over.
It is the lower paid staff of UHMBT who do the VAST majority of the good work of the trust i.e. clinical care however they are being seriously let down by their management. There is a clear difference and I think ShalidAli and others here including yourself need to frankly understand that difference.
It's not up to us to decide whether Dr Foster's figures stand up to scrutiny - BUT they've already been PROVEN to be more accurate than other figures used in other trusts.
Whether Mr Vaughan has resigned or not is not relevant to the issue at hand - it was an example of clear management failure and raises the clear additional question : why didn't his successor get to grips with the problem if Mr Vaughan was incapable of doing so ?
There is TOO MUCH evidence stacking up against the trust management for the type of defence "that it'll all be ok if we let them carry on regardless" - that stance doesn't have any credibility any more - especially amongst CURRENT staff (go and read the other thread again it's now very interesting !).
Although I expect you'll just dismiss all of this as anti-management and vitriol - that's your choice to do so and your opinion just don't expect me to agree with you on this matter.
give-up
says...
2:40pm Tue 22 Nov 11
gadgetgadget
says...
2:48pm Tue 22 Nov 11
ShahidAli
says...
3:48pm Tue 22 Nov 11
I really have tried to have some perspective here but it is very clear that a few on here who have a complete vendetta against the TB. You would have to be blind not to see it.
Posters having a skewed perspective and vendetta against the management is amazing....after all who will suffer...the people of the area.
No one is saying there arent problems, on one is saying services cant be better and no one is saying people shouldnt be held to account for the failings...IF we all accept this as the basis of acceptance then the only difference we have is how this is resolved, settled or worked through.
I do not believe castigating a complete management team will bear any long term benefits for UHMB or the people of the area.
We need to wokr with them after all the people are the lifeblood of that organisation. I have worked with the Directors there during my secondment, and some will say I was only exposed to them for a short period of time....I would counter that with the fact that 2 years ish at the time of Monitor crawling over UHMB as part of its FT autorisation and being part of that process was no mean feat for UHMB to achieve. Posters saying it was "fiddled" (or words to that) need to take a good hard look at themselves as professionals as as humans.....what are they actually saying that Monitor, the CQC and every other body that was involved in the authorisation process oare naive and cant see anything....Well if thats the case lets all go home and close the NHS as a whole down.
Those posters imho have one goal...to get of the management team.
I did not realise Mr Vaughan had resigned, he must have his reasons and those need to be respected. What everyone needs to do now is take a deep breath and work with what we have.
Im not going to tell the TB what to do, they are very capable, genuine people who I had the privilege to work with and who have the best interests of the patients at heart and they WILL sort out the issues, believe me they will. What they need is support and everyone giving them breathing space to do it.
I could easily say feed them to the wolves, i dont work there anymore but I am giving an honest opinion that most of the people from the bottom up to the very top are amongst the best I have worked with.
Skeptical and gadget (x2) need to realise berating and shouting from the rooftops is not going to help anyone now....what UHMB need to fo is deliver what the watchdog wants .....i am certain from the delivery UHMB has done in the past it will continue to deliver....I would urge the posters above who are calling for the "gang of four" to be removed to look at their own individual behaviour as people and think ....are they acting in the best interests of UHMB or are they now a hindrance to things moving forward....Its clear from the tone of thep ostings that there is a massive vendetta against the management and I in isolation can only tell you of my experiences with the TB, and I have nothing but good things to say on how they worked and how they tried to deliver the best they could whilst I was there.
Lets help them deliver by backing them UHMB will now be the most scrutinised FT in the country....Maybe there is an opportunity to move forward whilst the scrutiny is on.
gadgetgadget
says...
4:19pm Tue 22 Nov 11
We all clearly have differing views on how the Trust should proceed - mine is clearly that a set of fresh management (especially at director/chief executive level) will do some long-term (not just short-term) good for the area because the existing one has proved to staff and public it can't really be trusted to act in everyone's best interests. Go and read the other thread and see what other CURRENT staff have to say about them !
I've lived in the area all my life over 40 years, I've never known a local NHS trust or previous NHS organisation be so badly run, so against public opinion and so so incompetant in it's management. Sadly these are the same management who promise to improve now that have presided over all the failures - if it was a private company they would have been dismissed. The public sector should be no different - in fact because it's public money it makes the situation much, much worse.
UHMBT and the local NHS can go forward - but only if they start listening to what people want (which unless it's been on the back of high profile cases/campaigns they haven't done so to do) and stop ignoring warnings when they are presented to them : that starts with a set of new thinking, less "empire" building, stick to and deliver on promises made, giving the public the services they need WHERE they are needed (and that's not centralized like in an urban environment) and that can only be achieved in my view with new management. The current CQC watchdog requirement is only the tip of the iceberg.
You're entitled to disagree but don't tell me what to do or think or that I'm not entitled to a different opinion coz guess what I'll keep fighting my corner.
agedcitizen
says...
4:57pm Tue 22 Nov 11
So much so that WGH became little more than an Executive Office Block until local people started banging the table for the return of services to Kendal.
Whilst there may be much statistical and financial reasoning behind such a move, meeting the aspirations of patients by providing good quality local services is surely the top priority.
When WGH moved from the Dickensian collection of aged buildings at the top of Beast Banks, to the new purpose built hospital on Burton Rd , patients were assured it would meet their every clinical need, and whilst medicine has "moved on", patients aspirations seem to come well back in the list of beauocratic priorities of the Trust Management.
The "suits" seem hell bent on cramming everything onto the already overcrowded site at the RLI
gadgetgadget
says...
5:20pm Tue 22 Nov 11
Underuse of WGH as a clinical environment is however just one part of a bigger problem.
I find it rather worrying that the "best" defence on this site oif UHMBT management comes from a seconded employee who spent just over a year at UHMBT and is a stance of "live and let live" and who thinks that we should just let the existing management fix the problems THEY were already responsible for.
Unfortunately "live and let live" isn't a stance that can be endorsed by removal of services such as A&E and the Heart/Stroke unit at WGH.
Trust Management were FULLY aware of the issues that would arise from those closures PRIOR to authorising closure - they were CLEARLY PUBLICALLY warned on numerous occasions (and in the form of a public campaign) what the effects of say more ambulances having to go to Lancaster were going to be. They didn't want to listen and lives have been put at risk as a result of just those two decisions. Worse was to come of course with the revelations about FGH's maternity unit referred to in this article.
Those are NOT IMO the actions of a responsible management team who have the aspirations of local patients at "heart" (!) - they are the actions of a management team who were hell bent on a course of action despite the public consultation on those closures overwhelmingly in opposition - i.e. they had already made their minds up and to hell with the consequences. Now they are having to backtrack on the A&E decision somewhat - is that good use of public money or a demonstration of good decision making in the first place ?
ShahidAli
says...
5:56pm Tue 22 Nov 11
Your grasp of facts is truly astounding....you never let the facts get in the way of a bit of fiction do you?
"seconded employee of little over a year" .... i would say 2 years is double "little over a year"...again its good to get facts right.
No one is saving live and let live...you seem hell bent on using the current situation to dredge up anything to beat up the current management.
Maybe if you were an employee or ex employee or closer to the situation you would have a clearer view...but again please don't let the FACTS get in the way of fiction.
Just keep on beating up the staff and management in the absence of anything meaningful.
Instead of helping you resort to finding anything to hammer UHMB with...why not get up and help?
Looks like your "get up and go" has got up and gone.
Skeptical
says...
6:15pm Tue 22 Nov 11
WilliamT
says...
6:39pm Tue 22 Nov 11
If Vaughan, the Director of Operations, is leaving it is certainly not the result of the outcry over the last couple of months' revelations, because it hasn't come to a peak yet. Such people never resign in response to a public crisis, they hang on in the hope that the Board members will award each other severance payments. However, sometimes they do manage to jump before the ship goes down- Vaughan was immediately responsible for compiling the Dodgy Dossiers of 'spun' mortality information, and there may be other trusts open to having a similar job done there- if he's leaving, he's going to another job before the publicity really hits the fan, for sure.
The rest of the increasingly isolated executives are sitting in the WGH bunker, reliving with each other the glory days when, by a Triumph of the Will, they succeeded in fooling the gullible CQC and Monitor that the Trust would not crash and burn within a year of becoming a Foundation Trust. The post war reparations, as with Mid-Staffs. will be a massive fortune as they have to pay for the Inquiries, the turnaround teams, the special advisers, the new FGH maternity building and the management consultants from the likes of PWC, Deloitte, Finnamore etc. etc that are no doubt either already feeding on the corpse or circling in the skies above it. If they can't get this money paid by a bung from the DoH to keep the whole thing quiet, then there will be some severe restrictions on health care in South Cumbria and North Lancashire.
The parallels with Mid-Staffs. become ever more evident- they too achieved the financial savings that Monitor craves by covering up the clinical failures at the time of Monitor authorisation- it doesn't take much to fool them-evidence at the Mid-Staffs. Inquiry shows that they can't cope with any numbers beyond what I will persist in calling £ s. and d., and certainly not standardised mortality ratios. Mid-Staffs. did get a bung of £20 million from the Strategic Health Authority- I wonder if NW SHA (which doesn't really exist any more) can pay up?
gadgetgadget
says...
6:51pm Tue 22 Nov 11
It's the clinical staff and lower end of the scale that suffer from these failures and as a result of the "fixes" you highlight will probably be the ones who suffer further with the knock-on effect directly on patient care.
WilliamT
says...
7:01pm Tue 22 Nov 11
gadgetgadget
says...
7:05pm Tue 22 Nov 11
Although I do like the Halsall Deep Penetration mole symbology !
I think there should be more agreement on this site when people agree with something !
gadgetgadget
says...
9:09pm Tue 22 Nov 11
http://www.thewestmo
rlandgazette.co.uk/n
ews/cumbria/9369386.
Morecambe_Bay_Hospit
als_Trust_under_fire
__Consultant_calls_f
or_resignations/?ref
=mc
It makes for chilling and highly disturbing reading about the attitudes of management !!
give-up
says...
5:06pm Wed 23 Nov 11
gadgetgadget
says...
5:35pm Wed 23 Nov 11
It's not a question of refuting any positive comment about the management it's about not accepting a view that isn't evidence based but is just an opinion - the evidence clearly demonstrates the failures and the inability to adequately address/fix those failures and to ensure if they are supposedly addressed/fixed that they don't reoccur or are not brushed under the carpet.
No-one here wants the hospitals to fail - but the way forward is not IMO just to stick our public heads in the sand and accept that the existing management can be entirely trusted to fix the issues at hand - they've had numerous chances to do so.
As I pointed out in my last couple of posts I would suggest you read Dr Earnshaw's comments on the other thread - they highlight a damning set of failures that UHMBT management have performed in the past and continue to ignore.
I'm certainly not going to personally judge the whys and wherefores of Mr Vaughan's resignation without further information.
WilliamT
says...
10:06pm Wed 23 Nov 11
I think there is a body of complacent opinion that all this is a fuss about nothing, with no real consequences. They are wrong. Knowledge of Mid-Staffs. shows how much being a failed trust costs in money and staff and disruption caused by bringing in emergency management- even if the board is prevented from voting payoffs to each other. They are now £millions down, but so is North Cumbria, who could reasonably shout 'foul' if services down South (the English Champion high mortality trust) are protected by subsidy, while they (pretty good clinically, one of the CHKS Top 40 Hospitals) are forced into a takeover which will disappear services out of Whitehaven New Hospital as if by magic. If there is no bung for UHMB there will be some major cuts which people will notice. The A&E at Stafford is now closed overnight. Acute Stroke services have gone. That trust is still in 'Significant Breach' after 2 1/2 years, and UHMB only started a month ago. They won't get out of this jam by urging the staff to work a few hours for nothing, as they tried before.
gadgetgadget
says...
8:55am Thu 24 Nov 11
Mr Halsall is sounding more and more like Sepp Blatter of FIFA every day....
"I Love My Job. I Won't Walk Away"
"No-one is going to be resigning" !!
The latter quote makes extraordinary reading if the reports of Mr Vaughan's resignation are true.
Mr Halsall needs to realize that he's making himself and the Trust look extremely foolish the longer this goes on for - he's further dragging the Trust's reputation into the gutter by not accepting ultimate responsibility for their failures which have happened "on his watch".
We don't even have independant verification that the Trust have met the CQC's requirements referred to in this article yet - however the Trust are "blowing their own trumpet" and even have the WG seemingly convinced that they have (see the editorial Comment).
If the "buck stops" at Mr Halsall, then Mr Halsall needs to take personal responsibility, resign - it would give the public at least some re-assurance that the Trust does indeed take it's responsibilities seriously and that someone very high up has taken the fall for what are catastrophic failures of adequate management at various levels. IMO if the "buck stops" at you Mr Halsall - take the fall and move on - allow a fresh set of eyes and ideas on the whole fiasco.
Like Sepp Blatter, does Mr Halsall like his position of power far, far too much to recognize that need ??
gadgetgadget
says...
9:02am Thu 24 Nov 11
I really fear for the future of local NHS services and their accessibility (WGH especially) because of the way in which it's services (with the major exception of the new chemotherapy unit) have been systematically stripped back by UHMBT and the previous PCT. This situation cannot continue - one of the greatest costs in the various Trusts in their own accounts are Director's salaries.
It's one of the reasons that I seriously question the "client/provider" model in the NHS introduced by the previous Labour Govt over a period of 12 years. That model creates duplicated managerial positions at very high cost to the taxpayer and for what end - do we get better care ? or do we get more bureaucracy and wasted money ?
gadgetgadget
says...
9:11am Thu 24 Nov 11
"We don't even have independant verification that the Trust have met the CQC's requirements referred to in this article yet - however the Trust are "blowing their own trumpet" and even have the WG seemingly convinced that they have (see the editorial Comment)."
What if the trust HAVEN'T met CQC's requirements ? and they have gone public very confidently stating they HAVE met requirements ? Without that independant verification it's only an aspiration that they HAVE not a FACT !
What are the public going to think of the board if they have gone boasting and haven't actually done what they need to do ?
Of course they may have met the requirement and good if they have, I'm just suggesting that this sort of "boasting" is potentially dangerous and could back-fire and create even more of a storm if it's not true.
ShahidAli
says...
9:25am Thu 24 Nov 11
It would be good if posters can rise beyond the slanging of management and calling the CQC, Monitor, Regulatory bodies gullible. Seems everyone is gullible and foolish except the ones calling for the head of the entire TB.
Whether the TB or the CE leave or not will come out in time, i don't think this story is going away anywhere fast, but equally having a Salem type lynch mob is not going to do anyone any good, least of all the posters on here who are being exposed very clearly as having a vendetta(for whatever reason) and beating the management with this.
Anyone can see there are hidden agendas on here and the current turmoil at UHMB is being used by these people to drag up everything from the 1970s onwards to attack the management with.
working together in any crisis is the sign of a real community, but it seems the community (or at the very least), or some individuals in the community want to see the demise of everything that has been built up.
If that is the agenda of the posters on here, then I feel for the 99% of the good and honest people of NLancs who are really going to lose out because of the vociferous few.
gadgetgadget
says...
9:36am Thu 24 Nov 11
It's quite simple - the same people who preside over the MULTITUDE failures are NOT the same ones who can be TRUSTED to FIX them.
If this was any other organisation other than a public sector one - THEY WOULD HAVE BEEN SACKED !!!
I see ShalidAli and give-up present NO EVIDENCE in defence of the trust board but prefer to rely upon just their opinions - opinions won't save the management there !!
And please remember these people don't just serve North Lancs at all - you again do your cause no credit at all - thanks for forgetting the hundreds of thousands of people in Cumbria who rely on UHMBT (and have had their services eroded by them). FFS grow-up.
gadgetgadget
says...
9:45am Thu 24 Nov 11
Ok - here's an analogy - I work(ed) with certain people who I liked personally, I got on with them thought they were nice people but who were actually very poor in their public role.
Do I defend them publically because I like them or do I take a professional stance and analyse the EVIDENCE and then determine to say what they have done or perhaps more importantly what they haven't done is right in the public interest ? I would suggest the latter is more appropriate.
Just working with them and thinking they are good people frankly isn't enough to convince anyone when the evidence states otherwise.
Perhaps @shalidali would like to reflect on that analogy before commenting further.
ShahidAli
says...
9:52am Thu 24 Nov 11
I think the reasonable fair minded people who read this column will realise a few things if nothing else:
1. Shahid Ali is more a real name than gadgetgadget
2. That you reside permanently on this column, and that if anyone posts anything impartial or slightly pro TB then you are onto it immediately
3. For all we know William T, Skeptical gadgetgadget could all be the same person, the views are amazingly similar as is the writing style.
4. Besides getting rid of management you have not once in the amount of time youve resided on this column (and I have to say you'll have to pay Council tax if you live on this column) have you come up with a plan to make things better. Not once. i think that says it all about your agenda
All I would say is maybe it would be good to venture out into the real world rather than waiting for a post to appear and so that you can unsuccessfully trash it.
Regards as always
gadgetgadget
says...
10:00am Thu 24 Nov 11
I note you don't respond once to the points that other people make. And if you've actually read my posts you'd know that I believe a new set of eyes and ideas are required at UHMBT to put matters right - that's wanting to make this better, I've also called for reinstatement of services at WGH (this isn't an isolated thread on the issues remember !)
I think you need to realize that just because people have similar views doesn't make them the same person - again FFS grow-up !
As for un-successfully trashing posts - I think you need to look in the mirror ! You've done nothing but blindly defend the management, all you want is for them to continue with the support of the community and to attempt to fix the things that they've actually broken. The big problem with your stance that you don't seem to realize is that the community are getting fed up with them and don't TRUST them anymore - not just me, WilliamT or Skeptical but hundreds of people - go and read todays WG issue if you don't believe me !
And yes I do pay my council tax and my other taxes - do you ?
Big hugs : sounds like you need one !!
WilliamT
says...
10:15am Thu 24 Nov 11
gadgetgadget
says...
10:17am Thu 24 Nov 11
i.e. they are not being gagged !!
That's what freedom of speech is about.
Oh but hang on a minute that's not what UHMBT management want according to the governors - they want staff not to speak out, governors not to challenge or even be involved in decisions. Now ask yourself does that sound like freedom of speech or responsible openness - IMO no it doesn't.
The username argument you use is frankly ridiculous and again doesn't stand up to scrutiny.
Keep trying though if you want - I'll keep fighting my corner.
Another Big Hug !
gadgetgadget
says...
10:19am Thu 24 Nov 11
ShahidAli
says...
10:27am Thu 24 Nov 11
You really are sounding a tad bitter.
Right on cue another basher arrives. No wonder the country is in a mess when we have people wanting mass cullings rather than coming up with defined well articulated plans other than "new management brings in new ideas"
For those who say regulator notices etc should be adhered to, are exactly the same people who said that regulators are simple and gullible.... So what is it then??
For info can you please at least get my name right...youve called me "shalidali" "shadidali" "shahidali"
"shaidali"
Surely its not too much to ask. Thanks in advance & have a nice day if you do venture out today.
gadgetgadget
says...
10:38am Thu 24 Nov 11
This is going off-topic now.
If you disagree with people here, you are in the minority, accept that and move on.
You want us to fix the local NHS - that's not the responsibility of the man on the street - the management at UHMBT, governors and my MP are already FULLY aware of my ideas but you forget that what I post here is not everything I know, what I do or WHO I know.
I'll again suggest you be very, very careful with the insults - you are in grave danger of breaching the site rules.
The country is in a mess because of wasteful use of funding - UHMBT is part of that problem, it's management have not spent money wisely. Again grow-up !
Constantly attacking me and others for having very sensible and evidence based views is frankly doing you no good - especially when you're resorting to tactics like "paying your council tax", anonymity and basic accusations that I don't go out much. Do any of those things you've accused me of sound like a reasonable stance to take on what is a major issue to local people ?? No it doesn't.
Now I strongly suggest that unless you STOP the insults of myself and others here who have been personally affected by the issues in question that you are being EXTREMELY insensitive and extremely disingenuous.
Stop the insults, debate the issues if you want but don't ridicule us for having views that differ from you just because you don't understand us.
Now why don't you do some work if you're still in the NHS instead of attacking me and wasting public money in the process !
Aw Bless ... Yet Another Big Hug !!
ShahidAli
says...
10:44am Thu 24 Nov 11
As far as i can see the insults have been one way and not from me. But i think i'm big enough to take them without resorting to big brother.
typo apols accepted.if you know people and you know a lot more as you allude to...then isn't it the reasonable thing to take those concerns, issues, off board.
Attacking the management serves no purpose. it really doesnt.
I know there are issues with UHMB no one is disagreeing, we are only disagreeing on how these should be dealt with.
You advocate a new broom, I advocate a lets see approach and see what transpires.
At the end of the day we although coming from differing perspectives want the same goal.........service
s in NLancs which the people of the are deserve.
Big hugs welcome :)
ShahidAli
says...
10:47am Thu 24 Nov 11
apologies if you saw them as insults, it wasnt meant as such.
regards as always
gadgetgadget
says...
11:04am Thu 24 Nov 11
I've already stated those ideas etc have been taken to them off-board !
But the problem with your approach is that the "let's see" attitude has ALREADY been tried and it has already failed.
That's the big issue here - we've already had promises from Trust management that they've done the right thing over and over again only to be proved wrong.
That's the whole issue with regards to TRUSTING them to do the right thing again.
That's why the EVIDENCE in the various failures is very, very important.
The A&E and Acute services are a very good cases in point.
How many chances are the community supposed to give the same people to put things right that they've supervised and failed to supervise which in the article this thread refers to resulted in the sad deaths of babies before heads are expected to roll ?? We are now at that point - the community (not just me) is fed up with UHMBT taking services away, putting lives at risk (and indeed actual loss of life as a result) and basically we don't see them taking personal responsibility for those decisions. They just want to say oh we'll put it right when the original decisions were flawed and pointed out very clearly by the public (prior to the decisions being taken) as flawed in the first place.
To the average person in the street, the management stance is one of outstanding arrogance and smacks of hanging onto power regardless - I alluded to the comparisons with Sepp Blatter of FIFA earlier - there comes a time when especially the board needs to recognize that they have failed in their public duties - after all they are there to protect the public not put them in danger.
Again this isn't a mindless attack on management it's based on very real concerns about their ability to put things right PRIOR to things going wrong - a really good management principle is prevention rather than cure isn't it ? Sadly experience and evidence proves that they haven't done that to date - it would be wise for them, especially Mr Halsall, to really, really reflect on that and if they had been on the receiving end of their failures would they have put up with them and not wanted heads to roll ?
Please stop forgetting that this isn't about North Lancs - it's about North Lancs and SOUTH CUMBRIA, and it's the latter that has been seriously affected by the problems. Patients who attended FGH in Barrow (in CUMBRIA) and WGH in Kendal (in CUMBRIA) are the ones who have been most affected by the failures of UHMBT management in these cases. Again focussing on North Lancs is disingenous and I would suggest insensitive.
I think once you understand that the local people especially in South Cumbria have really suffered from the mis-management of UHMBT then you'll realize that only through a fresh set of eyes and ideas at UHMBT that the community can regain the trust it needs to have in UHMBT to supply the health needs that it requires.
I fully agree that we all want the local NHS to work - the question is can it work with the same people who preside over one c0ckup after another being expected and trusted to put it right ? I personally think not and frankly I'm not alone.
Acknowledging the failures after the fact isn't enough - management need to prevent failure before it occurs otherwise they are not being responsible and are neglecting their public duty.
Have another big hug !
gadgetgadget
says...
11:43am Thu 24 Nov 11
gadgetgadget
says...
11:48am Thu 24 Nov 11
give-up
says...
12:03pm Thu 24 Nov 11
Fact: you and others are calling for "Directors" to resign.
Fact: Mr Vaughan is a Director
Fact: He has resigned
So, progress eh?
The difficulty I have with this whole situation is it ignores the politics behind the entrenched views that people take - politics to do with Trust boundaries, consultants working preferences, service distribution compromises that are driven by funding shortages and population densities etc etc. It is possible to predict precisely what stance consultants, GPs and the public will take based on the historical developments that have taken place and it is easy to garner "evidence" to support your position whichever side of the fence (or middle of it) you sit.
I have extensive experience of many hospitals across the country and it is on that basis that I say, please, be careful what you wish for. Many of them are far more badly run than ours but have managed to avoid publicity so get away with it. Evidence in support of this IS in the public domain and is far too complex to list here, which makes it easy for you all to pretend it doesn't exist and so ignore it. If that is me "defending management" then so be it, but my motivation is actually about trying to remove hysteria and find a sensible way through this mess that doesn't leave South Cumbria in an even worse position than it is now. Sadly, that's beginning to look inevitable.
tictoc1
says...
12:10pm Thu 24 Nov 11
gadgetgadget
says...
12:25pm Thu 24 Nov 11
You brought the resignation issue to light and unless there is more information about the reasons why he has resigned it is unfair to judge whether it's as a result of the failures or whether he has chosen to go for personal reasons/other job offer etc.
The fact that he is a director makes it more interesting in the current climate but the circumstances are not yet clear - indeed Tony Halsall has today stated "no one is going to resign" - does he even know Steven Vaughan has ?
Politics really have nothing to do with this - trust boundaries are no excuse, consultant working preferences are no excuse, population densities are no excuse - they are issues that management need to recognize and work around to provide an adequate service but they are not a reason for FAILURE to occur.
That's one of the roles of management - to manage resources not provide excuses for failing to do so.
Funding might be an issue but that again goes deeper than just a broad cutting of budgets - it's where the money gets spent that's important not necessarily the amount being received.
If management decide to spend money on pointless (and localized requirement) tick box exercises etc instead of front line services then that's their choice to do so but if they then try and justify cuts to front line services on the back of non-essential admin it is frankly insulting and arrogant. And there's no wonder that staff morale as a result is very, very low.
In fact, if Trust boundaries had been split on the same grounds as the PCT then it's highly likely that due to service requirements that services would not have been removed from WGH because there would have been a clear need for those services to have remained within the county boundary. UHMBT were warned clearly about the nature of the issues that would arise from those decisions to remove services alone - unless they accept responsiblilty for that then South Cumbria at least is going to get even worse NHS access than it has already. Closing access to RLI's A&E because it's full is ripe for a real disaster and a much bigger issue - unfortunately they seem hell bent on adopting a centralized model and ignoring the consequences.
The current UHMBT board presided over a set of decisions that have been proven to be flawed, they are now desperately trying to close the door after the horse has bolted, hang onto their positions in the face of public opinion (see other stories today on this site and in the printed copy) and go against medical recommendations. That is frankly breathtaking arrogance and not in the wider public interest.
I understand your concerns about "be careful what you wish for" - but frankly what we already have isn't working properly. Better to get it fixed with a new perspective IMO rather than carry on "putting a plaster over a leaking pipe".
I'll ask again - can the existing management who have already demonstrated that they have failed in their duties and on their promises be really trusted to put things right ?
Frankly what happens elsewhere in the country is also not an excuse either - it's important locally to get services right here for local people not across the whole country (that's a more wider ranging issue for the NHS as a whole). Bringing it up is clouding the issue at hand.
It's obvious to me from the information to hand that the public want change. These executives are paid by the public, they are meant to act in the best public interest - sadly they've failed to do so. They need to realize there can be and probably will be consequences for that - it would be better for them to go honourably rather than be forced out by external influences/regulator
s. Sadly their arrogance seems to prevent that realization. If that makes me appear on a vendetta then so be it, but it's clear that what we have now isn't working it's time for a real and practical change - that needs to start IMO at the very top of the organisation as it sets an example to all the others that change needs to occur.
gadgetgadget
says...
12:28pm Thu 24 Nov 11
There is a MASSIVE population explosion as we all know in the Lake District throughout at least the summer months - not just from tourists but from seasonal workers. Using just averages to base service needs on might work in an urban environment but it frankly doesn't work here. Another example of a serious mistake in how to assess service requirements.
gadgetgadget
says...
12:58pm Thu 24 Nov 11
That is not the case - the trust has provided evidence this week to the CQC of the changes made. It is not a fact (yet) that the changes meet the requirements of the CQC.
The trust BELIEVES they are but that is a completely different to the CQC confirming the trust actually has met its needs. i.e. it's a belief or aspiration not a FACT.
It would be wise for the WG in the circumstances to revise it's editoral comment this week me thinks.
Skeptical
says...
3:31pm Thu 24 Nov 11
There are so many flaws in your arguments that it is difficult to know where to begin. Let me start with you comments about the Foundation trust status application, suggesting that it would be impossible for bodies like Monitor and the CQC to get an assessment wrong and that we are ‘gullible’ for suggesting otherwise. You only have to look at history, for example the situation with Mid Staffs to know that this can happen. Any inspection of a service relies on information being shared openly and honestly. When the CQC carried out their assessment of maternity services in summer 2010, they would not have conceived it possible that the trust had in its possession a very damning report about the safety of maternity services which it had deliberately not disclosed. This is something which Monitor have subsequently expressed great concern regarding, as detailed in the evidence published when they found the trust in significant breach of its terms of authorisation.
It is obvious that the positive assessment of maternity services in summer 2010 was only as a result of the trust hiding important information from the regulators. This is evidenced by the fact that when the Fielding report was eventually disclosed (and it was not the trust who first disclosed this report to the CQC), they looked more closely at the issues raised and subsequently found the trust non-compliant in 6 areas.
Are you suggesting that actually the initial assessment was accurate in summer 2010, and that somehow between then and July 2011, maternity services at the trust went from fully compliant to non compliant? Please think about the situation logically. Of course if a service chooses to hide information, regulators may be hoodwinked into missing problems. The blame for this should not be placed at the door of the CQC, but at the door of deceitful management who choose to put empire building over the safety of mothers and babies.
Presumably ShadihAli, you support this kind of management culture and would tell families who have lost loved ones as a result of subsequent failures in maternity services, to ignore these issues and give the management another chance to yet things right?
I have not seen you put up any reasonable arguments to defend this situation, but you repeatedly berate those of us who are legitimately highlighting these concerns (and some of us have been directly affected by them), and blindly declaring your unwavering admiration for the perpetrators.
The only comfort I draw, is that your views are clearly in the minority. At the last count, 87% believe that Tony Halsall should resign; patients, families, GP’s and consultants are now starting to speak out. The level of anger people feel is becoming clear. The writing is now on the wall.
When the dust settles, people will look back on this era of management as being very dark days indeed for our local hospitals, the legacy of which will sadly be with some of us for a lifetime.
Your opinions are not going to change the above.
chrismc
says...
9:58pm Thu 24 Nov 11
Admitted with broken arm, no other serious health problems (pathologist at Inquest stated all vital organs typical for person's age, all had reserves! Whilst in hospital my Mother suffered 3 falls, the third resulting in surgery for a broken hip, diagnosed with Clostridium Difficile, a day prior to this after showing symptoms some days earlier, initial complaint submitted outlining concerns; staff shortages, lack of supervision, lengthy waits for calls bells to be answered, planned discharge without assessment, dignity and care, communication etc.
My own investigations revealed systematic failures in Care; the hospital failed to;
provide support over a period of 7/10 days for my Mother who had neither the will or the energy to support herself,
act upon POTTS, observations were not increased and medical reviews were not initiated
notice inflammatory markers recorded on Lab reports
follow Doctor's written requests for blood tests and I.V. Fluids
administer prescribed medications to the recorded instructions
have knowledge of contra-indications of medications, prescribed inappropriate medications on 9 occasions
to provide adequate Clinical Care
to provide adequate Nursing care
to recognise signs of dehydration
to recognise signs of sepsis
to provide comfort and dignity
accurately monitor fluid balance and food intake
keep daily nursing records, with there only being one entry over a period of 9 days
follow infection control procedures
inform the Family of Infection Control Procedures
record Family conversations relaying concerns
listen and be influenced by Families repeated expressions of concern
Local resolution - 3yrs+ simply either myself or Icas driving the Complaint Procedure forward, initially, denials that events had happened as I had perceived, repeated requests for vital information, a strong feeling my concerns were not being taken seriously, no opportunity offered to be involved with meetings between the Coroner and the Trust following Inquest, many appologies, eventually only through my sheer determination for the Truth and concerns over Patient Safety, an Internal review? some acceptance of shortfalls and reassurances........
...
HCC - Complaint was submitted just as the HCC was being abolished, case was to be forwarded to PHSO until I presented the HCC with a catologue of patients bad experiences, gained from responces to a local reporters story surrounding the care afforded to his Mother in Law, following this, I was promptly offered a further meeting with the Trust and firmly led to beleive this was now my only option. Feeling totally worn out I reluctantly accepted. I am prepared to share all documents related over the 3yr period and offer my thoughts on the many obstacles I was faced with should you be interested!
I was trying to ‘Move On’ after battling for answers in the hope the Trust had learned lessons when I was yet again faced with the terrible ordeal of witnessing my terminally ill Mother in Common Law succumb to further failures of care many falling very short of the Essential Standards and not meeting the promise of care in the Trusts Nursing and Midwifery Strategy.
I would like to raise your awareness that I am not alone with regards to concerns over End of Life Care at the Trust, according to Mr Halsall, taken from his online blog of 14 February 2011 which can be accessed through this link http://www.uhmb.nhs.
uk/media-centre/blog
/ "I spent three hours in a meeting with a lady who wanted to raise concerns about the death of her friend in hospital. She was admitted in the later stages of a terminal condition which is about all I can say about the case itself" after reading this I had an urgent need to try and make contact with this lady however my efforts have come to no avail - it would have been interesting to share our experiences to see if there were any similarities regarding our concerns.
Whilst the following has no bearing on my current complaint, I feel I must share my feelings of sadness and distress after reading the story of Mrs Jean Dawson, http://www.guardian.
co.uk/society/2010/n
ov/11/nhs-care-elder
ly-starved at the same time this lady was suffering (March 2009) I was being reassured that fundamental basic care issues raised in my complaint following my Mother's death (November 2006) were being addressed, you can imagine my utter despair, it would appear lessons are not being learned at this Trust further evidence can be found in the recent CQC report into essential standards of care at Lancaster http://www.cqc.org.u
k//newsandevents/pre
ssreleases.cfm?cit_i
d=37438&FAArea1=cust
omWidgets.content_vi
ew_1&usecache=false the three essential standards not met at Lancaster are clearly mirrored in my complaint of Furness General Hospital, I believe the most highly dependant vulnerable patients are suffering through these shortfalls in care.
I have shared my latest complaint with Quality Care Commision.
Please listen when I tell you, Patient Safety will continue to be compromised whilst Trusts investigate their own failings, it is so very sad and honestly inconceivable that many bereaved relatives are at the forefront of battling for change whilst their grief is being supressed because they are spending so much time in a system that does not satisfy their need of preventing what happened with them ever happening to other’s.
chrismc
says...
10:55pm Thu 24 Nov 11
a.b.oatman
says...
2:40pm Fri 25 Nov 11
tictoc1
says...
2:52pm Fri 25 Nov 11
a.b.oatman wrote:My thoughts exactly. Thank you for your comments. It's nice to know I'm not alone.
I give up!
nixon1
says...
2:56pm Fri 25 Nov 11
The ten Commandments
1337 words
The Decleration of Independance
13,458 words
Comments made on here that make me not want to be Cumbrian
chrismc
says...
11:55pm Fri 25 Nov 11
lancaster expat
says...
10:49am Sat 26 Nov 11
gadgetgadget
says...
12:41pm Sat 26 Nov 11
WGH did have a fully working A&E department, it's services were gradually eroded by the removal of other services such as acute services etc.
UHMBT made a FINANCIAL decision not to invest in additional required equipment to support acute services in WGH (such as a CT scanner) - yet somehow they've been able to find funding for chemotherapy (!) from central govt. As an example another CT scanner in Kendal would again have relieved services in RLI - but again UHMBT are hell bell on following the URBAN model of centralization - they continue to fail to recognize that in a rural envrionment with greatly fluctating seasonal populations that model simply doesn't work.
In addition Ambulances were INSTRUCTED NOT to take patients to WGH's PCAS unit regardless sometimes of the level of injury and thus RLI became overwhelmed. That decision is having now to be reversed somewhat as the realization has kicked in that the decision was wrong.
UHMBT were warned of the consequences of these actions BEFORE they took them.
WGH's services could be restored with a massive reduction in NHS management and bureaucracy costs. For instance why do we actually need separate Hospital, PCTs and Mental Health Trusts all with duplicated director levels and high management costs. It shouldn't be necessary with the right people in place to have so many NHS trusts - the previous Labour govt introduced the Client/Provider model into the NHS and as a result funding was deflected away from actual patient care into management and bureaucracy costs. It's high time that move was reversed and patients put first instead of bureaucracy.
gadgetgadget
says...
1:21pm Sat 26 Nov 11
If that cost is duplicated across all approx 400 trusts in the NHS in the UK then that amounts to £206m in just Executive Salaries.
Reduce the number of trusts by say half and that figure can be drastically reduced and the money reinvested into patient care.
Just think how much could be achieved with over £100m every year !!
lancaster expat
says...
8:03pm Sun 27 Nov 11
Kendal was based as a type 3 A&E. It did not take surgery or major trauma. It was unable to recruit doctors to work there. It relied on GP cover overnight. It only had consultant cover for one day a week. There was no dedicated anaesthetic cover. It was never a major A&E department. Apart from about 8 ambulances a day it is still seeing the same patients it always has. I.e. minor injury and minor illness.
gadgetgadget
says...
8:22pm Sun 27 Nov 11
In 2002 I can personally vouch for the accessibility of consultants and anaethetic cover as both saved my life in WGH's A&E prior to transfer to RLI - I wouldn't have surivived the extra travel to RLI.
See other threads.
The problem is that A&E at WGH was downgraded as a result of the removal of Acute Services not the other way around.
Staff recruitment is a management issue and proves that trust management have failed - if they couldn't recruit staff that's most likely because of their own actions.
Frankly who would want to work for them at present ?
chrismc
says...
9:22am Mon 28 Nov 11
!!
http://www.telegraph
.co.uk/news/inter
active-graphics/g
raphic-of-the-day/89
18796/Hospital-gu
ide-compare-your-hos
pitals-performanc
e.html
Using official figures, it assesses how many deaths actually occurred at an acute trust compared with how many were predicted given the types of patients treated.
For the first time, it uses four different methods of calculating mortality rates including deaths after surgery and deaths among low-risk patients, in order to give as full as possible a picture of the care delivered at a hospital.
It also reveals the places where patients face worse care at weekends and overnight, often because fewer senior doctors are on duty, as our front-page story shows.
In addition, the report identifies hospitals where elderly patients have to wait too long for emergency hip operations, and looks at success rates for planned joint replacement surgery at private sector units as well as NHS ones.
Full details can be found at www.drfosterhealth.c
o.uk
gadgetgadget
says...
10:21am Mon 28 Nov 11
No doubt some spin will be put on these figures to try and justify them though (!).
I find it very ironic that the Trust rely upon so-called "studies" to supposedly determine service requirements (but only if they are in their favour or match their financial plans) then go to great lengths to dismiss figures that prove they are not performing well enough.
Like I said in another thread - the service requirements need to be determined not just on the basis of figures (of any kind) but also on patient and staff experiences unfortunately this so-called "trust" don't want to listen.
Like you said @chrismc on another thread - there is no substitute for real life experiences.
gadgetgadget
says...
12:41pm Mon 28 Nov 11
cumbria24.com/news/2
011/11/28/mp-calls-g
overnment-intervene-
following-damning-re
port-hospital-trust
Cue Anti-Farron brigade ...
gadgetgadget
says...
2:12pm Mon 28 Nov 11
http://www.cumbriacr
ack.com/2011/11/28/r
cn-northern-region-r
esponds-to-dr-foster
-report/
Interesting line on that one is "The RCN Northern Region has repeatedly called on all Trusts to introduce robust, evidence-based processes to ensure that we have the right number of nurses with the right skills at all times" - Says it all really.
gadgetgadget says...
5:56pm Mon 21 Nov 11
The CQC (and indeed the police) needs to decide whether it's enough - not the Trust.