Morecambe Bay placed in special measures

University Hospitals of Morecambe Bay Foundation Trust has been put into special measures after it was rated “inadequate” by the Care Quality Commission.

Sir Mike Richards, the care regulator’s chief inspector of hospitals, made the recommendation to Monitor following an inspection in February, reports published on Thursday confirmed.

The CQC rated the trust’s safety and leadership “inadequate”. Services at its Westmorland General Hospital were given an overall rating of “good”, but its other two sites - Furness General Hospital and the Royal Lancaster Infirmary - both “required improvement”.

While care in some services, such as maternity and accident and emergency, had improved since previous inspections, other areas where the regulator had raised concerns “had still not been addressed effectively”.

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The CQC identified staff shortages in medical wards at the Royal Lancaster and Furness, and had “serious concerns” about nurse staffing levels on the critical care/high dependency unit at the latter hospital. It also flagged deficiencies in nurses’ record keeping, incident reporting and monitoring clinical performance.  

The CQC said Morecambe Bay “lacked a clear vision for its staff” and that “three distinct cultures” operated at the hospitals. This left staff feeling “disengaged and remote from the executive team and the board”.

However, the regulator said staff “worked hard to provide safe and compassionate care for patients” and rated clinical effectiveness of services as “good”.

Sir Mike said: “There is a long history of concern with the quality of service provided by [the trust], so it is disappointing to report that a number of the issues that have been identified in the past remain unresolved.

“I do not believe that the trust is likely to resolve its challenges without external support. This is why I am recommending that the trust is placed in to special measures.”

Under special measures, failing trusts are “buddied” with a high performing provider. They are also required to develop an action plan to turnaround performance, with an externally appointed improvement director holding them to account for the delivery of their plan.

Sir Mike added: “I note that last year the trust made some progress in recruiting more staff but the overall recruitment of nurses and doctors remains a fundamental concern, with too much reliance on temporary staff in a number of wards and departments.  

“While many patients we met told us of good and compassionate care from committed and professional staff, it was clear that in medicine staff shortages meant care was not always provided at a good standard.”

Monitor’s regional director Adam Cayley said: “The trust has cooperated with Monitor in making some improvements in recent years, but the chief inspector of hospitals has reported on wider failings in care that must be addressed.

“The pressure is on to turn things around for its patients, but the trust will receive extra support and guidance as it starts to address the many issues it faces.”

Morecambe Bay chief executive Jackie Daniel said: “We are all incredibly disappointed to receive the overall rating for the trust. The reports reflect the fact that we are part way through a process of significant improvement, which is still going to take a number of years to complete.

“I believe that special measures will provide the trust with focused support to make further change in a number of core areas, and we welcome this assistance.”

A series of deaths of mothers and newborn babies at Furness between January 2004 and June 2013 is currently being investigated by Bill Kirkup.