Special measures label ‘hurts people’, says trust CEO

Peter Reading, CEO of Northern Lincolnshire and Goole Foundation trust, told HSJ that targeted support from NHS England had brought “strong benefits” but said: “The label of special measures is one that hurts people, and so we are very keen to shed that label. I think I speak on behalf of all of our staff in that respect.

“It doesn’t help morale and there’s no question about it, if you give people a bad name, even when they’re actually delivering generally very good care, and they’re working their socks off, and the label does not help.”

The trust is hopeful that it can move out of the highest tier of mandated support in the new year, after a recent Care Quality Commission report upgraded the trust’s “safe” rating from “inadequate” to “requires improvement”. The overall rating remains at “requires improvement”, though Mr Reading said the trust was now “much closer” to achieving a good rating.

NHSE declined to say if it would make the change, instead stating it would “work with the trust and system partners to review current recovery support programme arrangements in the weeks ahead”.

NLAG was placed in special measures in 2017 for both quality and financial concerns, and then moved into its successor, the recovery support programme. 

Inspectors said leadership and some services had improved since the last inspection but warned some changes at a senior level were yet to filter down to wards and departments. The report highlighted concerns about workforce gaps and culture, which was reflected in the lowest staff survey results in the North East and Yorkshire region, though it acknowledged the trust was launching a wider culture transformation programme.

The trust CEO said: “Inevitably, when you are trying to transform culture, service delivery and so on, some areas move at a faster pace than others.

“We’ve been rebuilding what we do on so many different levels, bottom up and top down and across such a range of different services, that we knew that some are moving faster than others… it’s not yet job done.”

Mr Reading also insisted that plans to merge NLAG’s leadership team with its larger neighbour Hull University Teaching Hospitals, creating a £1.3bn group model, would not distract from the trust’s recovery.

“Our improvement process is well-embedded. It is obviously partly driven by the executive team, which will become a single executive team over the next six months or so, but it’s driven by our staff and it’s driven with our partners,” he said.

“None of these things will get derailed and actually there’s every reason to expect that we can reinforce them by operating on a slightly bigger template through the group structure.”

NHS needs to expand into social care ‘quite rapidly’

NLAG is working to offer care providers access to its staff bank for recruitment of healthcare assistants and launched a service that supports discharge of patients able to return to their homes in early October. The trust is now looking at extending the programme to more discharge pathways.

Mr Reading said the project was currently at a “modest” stage, adding: “We’re moving into that territory increasingly because the health service is better equipped to recruit and retain staff than some, particularly small private providers.

“We pay a bit better, we offer better career, training and development opportunities. And this is an area where probably the NHS needs to expand quite rapidly, but it needs to do it in partnership.”