• Former chief executive of the scandal hit Liverpool Community Health Trust was offered a secondment by the TDA
  • Review finds regulators “acted in line with guidelines and accepted practice at the time” by arranging the temporary role
  • Full extent of cultural problems at LCH was not known at the time, review says
  • Ex-CEO of Manchester Mental Health and Social Care Trust says she was made aware of the “general circumstances” when accepting the secondment

Regulators who facilitated a secondment job for the chief executive of a scandal hit NHS trust “acted in line with guidelines and accepted practice at the time”, a review has found.

The secondment was offered to Bernie Cuthel, the former chief executive of Liverpool Community Health Trust, before the full extent of the trust’s cultural problems had emerged, according to the independent reviewer.

Ms Cuthel was removed from the LCH board in early 2014 after the Care Quality Commission identified serious care failings, and after regulators from the NHS Trust Development Authority were made aware of “complaints and issues relating to bullying and harassment arising out of the CQC visit and its outcome”.

As part of her removal, the TDA, which is now part of NHS Improvement, arranged for Ms Cuthel to be seconded to a project director role at Manchester Mental Health and Social Care Trust.

NHSI commissioned an independent review to examine the circumstances around this arrangement after a damning report in February 2018 found that LCH had sought to “conceal” serious care failings and multiple cases of patient harm under Ms Cuthel’s leadership.

The temporary posting was arranged by Lyn Simpson, who is now NHSI’s executive regional managing director for the north region.

The review, carried out by HR consultant Susan Newton and published by NHSI in their public board papers, said two options were identified once it had been decided to remove Ms Cuthel from the LCH board; a disciplinary process undertaken by the trust; or a resignation facilitated by an “alternative, temporary position in the NHS which would better suit her skills and abilities”.

The review said the full extent of the problems and poor culture at the trust were not apparent at the time, adding: “Had such clear evidence been available when the secondment was being arranged the TDA would probably have handled the situation differently…

“Hindsight might suggest that had Bernie Cuthel been allowed to stay in post, with the evidence gained from subsequent reviews, a disciplinary process may have led to her dismissal.

“However, the time taken and costs involved may not have been a good use of public money and would surely have distracted from efforts to turn LCH’s performance around.

“The decision was made that suspending and disciplining the CEO was not in the best interests of the trust and a swift departure of its CEO was facilitated.”

The review also said that the chief executive of the Manchester trust was made aware of the circumstances surrounding Ms Cuthel’s departure from LCH (see box below).

The review said the secondment was brokered alongside David Flory, the former chief executive of the TDA, and David Eccles, an HR associate who still works for NHSI.

It added: “The findings support the view that the TDA executives involved acted in line with guidelines and accepted practice at the time, and their decisions were made with the best interests of the trust and its patients in mind.”

The review also noted that NHSI has begun working on a new “talent management” framework, which will include new guidelines on “managing failure” and “distinguishing between situations where an individual should no longer work within the NHS, and those where someone can be supported to learn and make a valuable contribution”.

The February 2018 report into care and governance failings at LCH also criticised regulators, including the TDA, for failing to identify the trust’s problems earlier.

Manchester chief aware of “general circumstances” of secondment

The independent review said Michele Moran, the former chief executive of Manchester Mental Health and Social Care Trust, was “aware of the circumstances” when she agreed that Bernie Cuthel could be seconded to her organisation in May 2014.

This appeared to contradict a letter which Ms Moran sent to an MP in 2016, in which she wrote: “Neither myself, the chair or the trust board were aware of the ‘serious issues pertaining to her departure from LCH’ (your words).”

When asked by HSJ to clarify what she had been told by the TDA, Ms Moran, who is now chief executive of Humber Foundation Trust, replied: “I can confirm that in 2014 the MMHSCT chair and myself were aware of the general circumstances behind the secondment, but it was correct to say in 2016 that we were not aware of the serious issues being raised at the time of her transfer on secondment.”

HSJ has asked NHSI to provide further details of what Ms Moran was told, but has not yet received a response.