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Prominent Midlands leaders who took over a struggling trust and quickly found themselves at the centre of a “poor behaviour” investigation have told HSJ of problems that were facing the organisation.

Joint Royal Wolverhampton Trust and Walsall Healthcare Foundation Trust leaders David Loughton and Steve Field have claimed Walsall was trying to balance its books with too few staff, while being unable to reassure itself on quality due to a “non-existent” governance system.

They also traced some of the problems back to when Walsall was placed in special measures and under scrutiny financially, adding that when organisations come under financial pressure, “it is quality that suffers”. The pair took over Walsall in April 2021 and an NHS England review found in February that Mr Loughton had “called Walsall directors useless” and Professor Field had been “ashamed to call himself chair”.

They said they were “motivated by patient safety” and that “difficult decisions” had to be made. Now 18 months on, there is an almost entirely new board of non-executive directors and 300 nursing staff and 30 consultants have been recruited. It is unclear what impact these appointments have had on Walsall’s current finances, although it did record a £2.5m deficit in August.

Altogether now

When speaking at Unison’s annual conference last month, general secretary Christina McAnea was clear that co-ordinated action was the way forward, saying that it “unites us”. It won’t then be a surprise to NHS leaders that trade unions are likely to time their strike days at the same time, potentially before the end of the year.

Unison’s head of health told HSJ this week that working with other health unions was the best way to ensure that industrial action is effective and said those backing action within the same employer would increase disruption further.

Trust leaders have warned that this co-ordinated action between the Royal College of Nursing, which announced members voted to strike last week, Unison and maybe even other unions like GMB and the Chartered Society of Physiotherapy too could turn “more hairy”, questioning how they will manage the impact.

And it’s not just health and care workers that NHS bosses are worried about – the wider impact of industrial action, if teachers, local authorities and social care workers also strike has been described as “significant”.

“We’ll be dealing with it for a lot longer than industrial,” HSJ was told.

Also on today

In The Download, Nick Carding reports on the results of a survey about which electronic patient records are favoured by trusts, and in a specially recorded webinar for HSJ Insight subscribers, HSJ editor Alastair McLellan talks to two seasoned observers about the relationship between the NHS and government.