Morecambe Bay NHS Trust back in 'special measures' and ordered to urgently improve after damning inspection report

Health inspectors have ordered "significant" urgent improvements at The University Hospitals of Morecambe Bay NHS Foundation Trust after it was placed in a new form of "special measures".

Officers from The Care Quality Commission (CQC) recently visited the hospital and found a “significant downturn in the quality of services” at the trust and patients were not getting the care they deserved.

The CQC said it had undertaken its inspection at the trust, which runs Royal Lancaster Infirmary, Furness General Hospital and Westmoreland General Hospital in Kendal, after receiving concerns and whistleblowing information about the safety, quality and leadership of the services at all three sites. However, staff have been praised for treating patients with compassion, sometimes under difficult circumstances.

This is not the first time UHMBT has been put into the equivalent of special measures. The trust was placed into special measures in June 2014 after a CQC inspection identified concerns surrounding the safety and management of its services. However, in December 2015 the trust was taken out of special measures after an inspection found that, while further work was needed, improvements had been made.

The trust runs Royal Lancaster Infirmary

Now, the trust has been put into NHS England' s new national Recovery Support Programme in a bid to improve patient services. The NHS has already introduced a new improvement board to oversee UHMBT, as well as the appointment of an improvement director and the recruitment of senior nurses and doctors.

In the latest inspection of stroke services at both the Royal Lancaster Infirmary and FGH, inspectors imposed conditions on the trust, saying they were not assured that all patients had received care and treatment in a timely way, exposing them to the risk of harm.

The report stated: "Inspectors were not assured that all patients on the stroke pathway received care and treatment in a timely way, exposing patients to the risk of harm. In light of this, the ratings for medical care including care for older people were suspended.

"There was not always sufficient staff to care for women in maternity services. Women receiving maternity care, who were assessed for the risk of sepsis, did not always receive care and treatment in line with national guidance. Controlled drugs were not always stored, administered and recorded safely. The process for the administration of medicines following patient group directions was not followed."

However, the inspection also found: "Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff were focused on the needs of patients receiving care; they provided compassionate care and gave patients enough to eat and drink. In surgery there was enough staff to care for patients and keep them safe."

Ann Ford, CQC’s deputy chief inspector of hospitals in the north, said: “This recent inspection of University Hospitals of Morecambe Bay NHS Foundation Trust makes disappointing reading. We found a significant downturn in the quality of services provided by the trust, and patients were not receiving the standard of care they deserve.

“In the past, Morecambe Bay has demonstrated that it is capable of making some sustained improvements to the quality of services. Surgical services at both Furness General Hospital and Royal Lancaster Infirmary is one example where they have managed to maintain a sustained improvement over time.

"It is very disappointing, however, that this good work has not been replicated throughout the trust. The improvements which were demonstrated at previous inspections of Furness General Hospital’s maternity department have not been sustained and the service has deteriorated, affecting patients and staff.

“However, this does not detract from the excellent work carried out by staff within the trust who, on the whole are providing care, treating patients with compassion sometimes under difficult circumstances."

She went onto say: "While we understand that the leadership team is trying to resolve the issues, it’s clear to us the trust is unable to do so without support.

“Following the inspection, we fed back our findings to the trust leadership team and they have assured us that they were committed to ensuring immediate improvements would be put in place. We have also discussed our findings with NHS England and Improvement who are now supporting the trust via their Systems Oversight Framework and it will receive a package of support through the national Recovery Support Programme. This will give the trust the resources to embed the improvements they need to make.

“In the meantime, we will continue to monitor the trust closely and return to check on any improvements which have been made.”

Despite the CQC report, Trust bosses maintain they are "committed to providing the best quality care".

Aaron Cummins, Chief Executive of UHMBT, said: “We are committed to providing the best quality care to our patients, including recovering from the additional challenges Covid-19 has posed. The Recovery Support Programme provides an opportunity for us all to work together across Morecambe Bay to build better and more sustainable services for those patients for the future.”

The Recovery Support Programme was introduced across the NHS in July and a number of trusts were immediately placed under its guardianship. The programme is used to tackle “performance challenges” and to provide oversight at trusts which would previously have been placed in ‘special measures’.