• South Tees Hospitals Foundation Trust downgraded to “requires improvement” from “good”
  • CQC says leadership lacks necessary “experience, knowledge, [and] capacity”
  • But trust chair says remarks have left his team “scratching their heads”

The chair of an acute trust has been left feeling puzzled and questioning inspectors’ assessments after the Care Quality Commission criticised its leadership model.

The CQC, which also downgraded South Tees Hospitals Foundation Trust’s overall rating from “good” to “requires improvement”, said not all of the trust’s board members and senior level staff had the necessary “experience, knowledge, [and] capacity” to lead effectively.

Inspectors were also unconvinced leaders and the corporate team understood the challenges to quality and sustainability in care, and criticised their engagement with staff.

But Alan Downey, chair of South Tees FT, told HSJ the remarks had left the trust’s leaders “scratching their heads a little bit”.

He added: “I actually questioned the CQC inspectors quite hard on this point, and what it really boils down to is that, for a number of our executive directors, this is their first time at board level.

“We have an unusual medical model within the NHS. Instead of having a single executive medical director, we have four.

“But we have to take the point and what we will be doing is arranging for coaching and development activities for all of our board members – particularly the executive board members – and we will be arranging leadership development sessions.”

The CQC report, which was published earlier this month, also rated South Tees FT  “requires improvement” in the safe, effective and well-led categories and “good” in the caring and responsive areas.

Other areas of criticism for the trust included its critical services, which were rated “inadequate” for safety and found to have “deteriorated significantly” since the previous inspection in 2016.

However, inspectors also highlighted areas of good practice. This included examples of high-quality care by surgical services at Friarge Hospital, and urgent and emergency services patients consistently praising the care and experience they had.

Mr Downey believes the report contained insufficient recognition for the financial pressures the trust faces, which have arisen particularly from the £155m private finance initiative deal to transfer all of its Middlesbrough services to The James Cook University Hospital in August 2003.

Acknowledgement from national bodies, such as the CQC, about such pressures is central in helping the trust restore its previous rating, he added.

He said: “We’re really under the cosh financially and we don’t have the ability to simply raise more money. We can’t generate capital and the money that we have to run the hospital on a day-to-day basis is the money that we’re given by the NHS.

“But we do need recognition of the financial challenge that we face, and, if we can get that, then I’m absolutely confident that, not only will we return to a ‘good’ rating, but I’m absolutely confident this is, in a multitude of ways, an ‘outstanding’ organisation.”

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