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NHS managers usually get the blame for organisational failures, but often the problems lie with senior clinicians.
A review at Hull University Teaching Hospitals Trust, commissioned by the trust’s management, found multiple cultural problems among consultants in the cardiology services have impacted on patient care.
In a report published in the trust’s board papers, the Royal College of Physicians reported a “perceived tendency to downplay clinical incidents and to undermine those who wanted to raise patient safety issues”.
It added: “We met a group of individual consultants who did not work well as a team. There is a culture of distrust, a lack of departmental cohesion and allegations of bullying in the department…
“There have been a number of allegations of belittling, intimidation and undermining… The review team heard accounts of a culture where datix has been used as a tool for possible personal reprisal along with ignoring/downplaying incidents that have been raised.”
The review, finalised in August 2021 and published by the trust last week, noted there had been a decision to “stand down” the clinical leadership team for the service, and said it supported this.
Credit to HUTH for publishing the report in its public board papers, because as HSJ has previously revealed, many trusts prefer to keep them quiet.
The good, the bad and the unexplained
NHS England’s new regulatory regime has deemed just one integrated care system but 32 provider trusts “consistently high performing” but the methodology is still unclear.
Only one of the 42 ICSs – Frimley Health and Care – is in segment one, and five (about 12 per cent) in segment four, of the system oversight framework.
All trusts and ICSs have been placed in one of four segments. Segment one means the organisation is “consistently high performing”, while segment four replaces “special measures” and reflects ”very serious, complex issues manifesting as critical quality and/or finance concerns that require intensive support”.
Across all types of NHS organisations, the region with the largest share in segment four is the East of England. But the Midlands and South West have the largest shares of their trusts and ICSs in segments three and four combined.
Ambulance trusts have the most problems, where none is in the top segment and two out of 10 are in the bottom segment.
However, the reasons why specific ratings have been given to individual organisations, or what indicators have been used for the different sectors, are not clear.