PERFORMANCE: The Care Quality Commission has been called in to inspect Stafford Hospital following concerns its shortage of doctors has spread, causing more services to become ‘fragile’.

In an exclusive interview with HSJ, the Mid Staffordshire Foundation Trust special administrators Hugo Mascie-Taylor and Alan Hudson shared their reasons for asking the care regulator to conduct a focused inspection at the hospital.

The TSAs announced last week that they had requested the assistance of the regulator because of concerns about the “fragility” of services, linked to difficulties recruiting and retaining staff.

Professor Mascie-Taylor told HSJ the decision to call in the CQC had not been in response to a specific patient safety incident or “sudden deterioration” of services.

“These things are a continuum and there’s no absolute point at which something moves from safe to unsafe, it’s just all about assessment of risk,” he said.

“What we’ve observed is that, despite some pretty massive efforts, the recruitment and retention difficulty persists and we’re supporting services with some pretty active help from our neighbours.”

He said the decision to call in the CQC had been “triggered” because “we moved from a situation where we thought maybe there was one or two services at risk – purely through staffing – to more than that.

“At some point… you have to say this has now moved to such a state that although we’ve plans in place, we thought we should get an external view on whether the plans… are robust.

“It’s really in the spirit of just being transparent and open in what everyone understands is a very difficult situation.”

When asked which services were fragile, Professor Mascie-Taylor named the acute surgical rota, radiology, medicine for the elderly and anaesthesia.

“Had you asked us the question three months ago I would have said the major problem was with nursing,” he said.

“Because University Hospital of North Staffordshire Foundation Trust has been helpful and provided us with a number of well trained nurses capable of managing a ward, that constraint has receded, and so the new difficulty is with medical staffing.”

Professor Mascie-Taylor said recruitment and retention was “extraordinarily difficult” because of the trust’s “reputational issues”, and the small size of the trust made services especially vulnerable.

“Because the numbers in any particular service is so small, if one or two [doctors] go then that brittle situation turns into something which would require immediate action,” he said.

Despite the shortages and the CQC safety review, Mr Hudson told HSJ that special administrators did not “envisage” any change to the timetable for the dissolution of the trust.

He also said there were no current plans for further restrictions of services at the hospital.

The CQC’s inspection of the hospital begins on 30 June.