A foundation trust has pledged to shake up the management of its breast screening unit after a probe found an “extremely poor” working environment that must be having “impact on patient care”.

The Public Health England investigation of University Hospitals of Morecambe Bay Foundation Trust was carried out earlier this year after concerns were flagged up by two whistleblowers.

University Hospitals of Morecambe Bay Foundation Trust

The PHE report raised concerns about the culture and management of Morecambe Bay’s breast cancer screening services

Its final report on the service, seen by HSJ, found it met national minimum standards but pointed to serious concerns about its culture and management.

According to the report, the director of breast screening was “not taking on the responsibilities incumbent with the role” and staff appeared to have “little respect for each other’s professional opinions”.

“The working environment is extremely poor and if it is not addressed urgently the service is unlikely to be able to continue to provide a safe service to the women of north Lancashire and south Cumbria,” the report added.

It also pointed to “a reluctance to challenge opinions of colleagues resulting in defensive decision making as a consequence”, adding that “this must be having a degree of impact on patient care”.

The trust, which is currently at the centre of an independent inquiry into poor maternity care, has accepted the report’s findings, is reviewing the service’s management, and has drafted in an occupational psychologist to work with staff.

Medical director George Naysmith told HSJ the service director had not yet been replaced as potential candidates were reluctant to step into the role. “It is not appropriate to have someone in that role who is effectively being line managed by themselves,” he added.

“We will look at the overall structure and redefine it, we will readvertise these roles and they will be appointed to.”

The findings come as the trust’s media handling of the report has been questioned by its staff.

One source at the trust, who did not wish to be identified, accused managers of “dishonesty” after it approved press statements that included heavily edited extracts from the report.

In one statement, seen by HSJ, Morecambe Bay included a quote from the report that was cut short, excising the report’s references to the poor working environment and the potential risk to patient safety.

The statement, approved by trust chief executive Jackie Daniel, did go on to quote her acknowledging change was needed to the “culture and working environment” at the service.

The trust source alleged it had “twisted the conclusions of the report to shift the focus away from issues of bad management”.

Deputy chief executive Aaron Cummins told HSJ the media statement had been “prepared to be used reactively”.

“It states clearly the findings of the review and explains that we accept all of its recommendations. Any journalist who contacted the trust and hadn’t yet received the report was referred immediately to PHE to receive a full copy.”

A spokesman for Public Health England said it was “content” with the trust’s response and that all such reports were always only available on request.