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Investigations into trusts with alleged cultural or bullying issues are always difficult: often staff are reluctant to step forward, even when offered reassurance that any inquiry will be independent of their managers and they will be able to speak confidentially.
So the way in which an independent investigation into The Christie Foundation Trust has been launched is somewhat surprising. NHS England and Improvement North West has not said who will be leading it, what it will look at and when it is expected to report – all aspects which might be expected to build confidence in the process.
Staff at The Christie were emailed about the investigation by the chief executive Roger Spencer and given very few details, other than that unspecified concerns had been raised “by a small number of staff” in the research and innovation department.
But as HSJ reports, the independent investigation comes after allegations that staff were scared to speak out and some were said to have been bullied and sidelined.
Ambulance handover delays are not a new problem for the NHS, trust chiefs have sent warnings about this for years.
However, as the NHS heads into winter while having to tackle a second covid-19 wave, it appears emergency services face a perfect storm.
This week HSJ reported a formal warning from West Midlands Ambulance Service FT to three acute providers in its region on their deteriorating handover delays.
WMAS warned lives were at risk and patients were being put in dangerous situations after being left to wait at the back of ambulances for hours. More concerning for WMAS was that these delays mean they cannot attend life threatening situations.
If handovers have always been a problem, what might have prompted poor performance currently? Covid-19 may in part be the answer. Infection control requirements mean trusts have to segregate and zone patients who attend with covid-19 symptoms and those who don’t.
This invariably results in less space within emergency departments and delays in A&E’s ability to see people.
On the face of it, it would seem there is little the acute trusts can do, but, as has been pointed out by regulators previously, ambulance delays are a symptom of wider system problems.