• Pennine Acute Hospitals Trust upgraded to “requires improvement” after being rated “inadequate” in 2016
  • Dramatic improvements made within maternity and urgent and emergency services
  • Sir David Dalton calls for a “system reward” to help trusts take over troubled neighbours
  • He says that PAHT has received a “fraction” of finanical support offered to trusts in the south east

Sir David Dalton says the improvements made at a troubled hospital trust in Greater Manchester have been “incredible”, and have come despite it only being offered a “fraction” of the financial support given to struggling trusts in the south east.

The Care Quality Commission has upgraded Pennine Acute Hospitals Trust to “requires improvement” after being rated “inadequate” in 2016.

The trust’s leadership has been taken over by Salford Royal Foundation Trust as part of its emerging “hospital group” and Sir David is chief executive of both trusts.

In the previous inspection, the most serious concerns had centred on maternity services at North Manchester General Hospital and Royal Oldham Hospital, as well as urgent and emergency services at NMGH. The CQC previously rated them these services inadequate, but has now found them to be “good”.

The trust’s overall leadership has also improved from “inadequate” to “good”, and the use of a system to support nurses across the trust was described as outstanding.

Sir David told HSJ: “It’s been a difficult and challenging 18 months and this has meant a lot of hard work, dedication and willingness by staff to implement our improvement plan across our services.

“Staff can feel a lot of pride in this and heads can be lifted up, it’s an incredible result.”

He said the findings also represented an “endorsement” of the group model that has been implemented between the trusts, which has been branded the Northern Care Alliance, and suggested that national leaders should consider a “system reward” to help trusts that step in and take over troubled providers.

He said: “At the moment there isn’t a system reward for doing this, and that’s something that could be considered. Hospitals in London and Surrey were heavily supported in previous years and we’ve got a tiny fraction of what other trusts have got.”

Pennine Acute has received around £60m of additional funding from local budgets over three years. It is set to be formally acquired by Salford within the next two years.

In relation to its takeover of Heatherwood and Wexham Park Hospitals FT, Frimley Health FT was offered around £330m of national funding over four years, while the Royal Free London FT was offered around £260m over five years for the acquisition of Barnet and Chase Farm Trust.

Both these transactions were completed in 2014, but there has since been a sharp deterioration in the financial position of the NHS, particularly the hospital sector.

Ellen Armistead, the CQC’s deputy chief inspector for hospitals in the north, said: “A comprehensive plan to deal with the challenges faced by Pennine Acute Hospitals has been put in place and it is clear these arrangements have had a positive effect.

“We found a supportive and open culture that was focused on learning and improvement. There had been major changes to the leadership and management at the trust, staff talked positively about local leadership.”

However, the CQC said the trust still did not have enough staff of the right qualifications, skills, and training, and remained concerned about staffing levels in medical care, surgery, critical care and children and young people services.

It identified outstanding practice in terms of the implementation of a nursing and accreditation system across all the sites, saying: “This is a nationally recognised assessment tool designed to support nurses in practice to understand how they deliver care, identify what works well and where further improvements are needed.”