Cambridge University Hospitals Foundation Trust has been placed in special measures after being given an overall rating of ‘inadequate’ by inspectors.

  • Cambridge University Hospitals put in special measures after CQC rated it “inadequate” overall
  • Inspectors found “disconnect” between senior managers and frontline staff and said trust had “serious problems” which pose risk to patient safety
  • First time a Shelford Group trust has faced either an “inadequate” rating or special measures
  • Keith McNeil, who resigned as trust chief executive last week, said the regulator is wrong to rate trust “inadequate”

Care Quality Commission chief inspector of hospitals Sir Mike Richards said the regulator had “found a number of serious problems” at the trust, posing a risk to patient safety.

The inspection report said the trust’s leadership was “inadequate”, citing a “disconnect” between senior managers and frontline staff. It also rated the trust’s ability to provide safe and responsive services as “inadequate”. The report was published today following news of the “inadequate” rating breaking last week.

Cambridge University Hospitals is one of the most prestigious teaching trusts in the country, and a member of the elite Shelford Group of “leading academic healthcare organisations”.

This is the first time a Shelford Group trust has been rated inadequate or recommended for special measures, and comes in the wake of the resignations of the trust’s chief executive and finance director last week.

Monitor today confirmed it was placing the trust into special measures. It said its investigations into the trust’s governance and finances had found serious problems. Its statement said: “The trust is predicting, at least, a £64m deficit this year, due to an average overspend of £1.2m a week. The investigation concluded that the trust lacks the adequate financial control it requires. It has failed to deliver the necessary savings and has not submitted a credible plan to address its rapidly growing deficit.”

Former CUH chief executive Keith McNeil, who announced his resignation from the trust with immediate effect on 14 September, spoke to BBC local radio last week ahead of the report’s publication.

“People’s lives are saved every day by that hospital. I cannot see why anybody would want to describe it as inadequate,” he said.

However, in a statement issued today, Sir Mike said: “Staff felt that senior managers were unaware of the issues they faced.

“There was a significant disconnection between the values of the board and the values of the frontline staff which must be addressed. For example, the chief executive stated that the trust was a tertiary specialist hospital and not a district general hospital. However, ward staff believed that they were a district hospital with specialist services.”

The inspection team said there was also a “significant shortfall of staff” in a number of key areas including critical care. Gaps were filled with bank or agency staff but this resulted in staff “sometimes working in services where they lacked proper skills and training, presenting a risk to patient safety”.

The CQC acknowledged the trust was already making progress on this.

The report also raised concerns about “pressure on surgical services” which meant routine operations were frequently cancelled and some patients were facing “long delays” for outpatient appointments.  

Monitor announcing in July it was investigating concerns that the trust did not have a robust grip on the cost implications of its eHospital programme and the impact this was having on its overall financial position.

The CQC’s report said “although the [new Epic IT system] was beginning to be embedded into practice, it was still having an impact on patient care and external professionals”.  

The trust was however rated “outstanding” on whether or not staff were caring. The report followed inspection visits in April and May.

Trust chair Jane Ramsey said: “I would like to say sorry to our patients for a lack of effective systems and processes across our trust, which has led to the Care Quality Commission today rating our hospitals as inadequate. We take this, and being placed in ‘special measures’ by our regulator Monitor, very seriously. 

“Part of Monitor’s enforcement action means we have a number of clearly defined quality, financial and governance failings to rectify as soon as possible.  We will take rapid action to address these concerns and maintain our record of safety and high-quality care. 

“The care our staff provide has been rated as ‘outstanding’ and we are very proud of them, and we continue to have a strong track record on safety, clinical excellence and introducing ground breaking treatments.”

This story was update at 10:15am on 22 September to add in Cambridge University Hospitals FT’s statement provided by the trust in the name of chair Jane Ramsey.