Serious safety concerns over third major specialty at struggling trust

The Care Quality Commission has issued an immediate warning notice in relation to the stroke service at University Hospitals of Morecambe Bay Foundation Trust, following an inspection earlier this month.

A full report will be published later this year, but the immediate issues have been outlined within various documents published ahead of the trust’s board meeting on 26 May.

According to a summary within the papers, the CQC warning notice has flagged “a range of incidents… identifying poor care that requires investigation”, governance concerns around the grading of incidents, poor levels of training and competencies, and worrying delays around administering thrombolysis.

The problems were predominantly found at Royal Lancaster Infirmary.

NHS England has recently sent an improvement team to UHMB, amid high-profile investigations into serious whistleblowing concerns with the urology and trauma and orthopaedics specialties.

In a post-inspection letter, the CQC noted the “significant level of external support within the organisation”, but said it was “too early to judge whether the board had the capacity and processes to ensure that any changes were maintained once the support ends”.

The letter added: “We have heard and received information about the systems and processes being put in place… to manage risk and quality. Whilst this was still ongoing, we were significantly concerned about the timely and effective management of incidents and learning from them.

“The team noted that the board talked about difficult issues and the trust’s challenges. However, from this and documentation reviewed to date we have not detected a strong sense of pace… We thought there were elements of required change that the trust could have acted upon internally and swiftly.”

It noted how the visibility of chief executive Aaron Cummins within the trust was “positively commented on and was commendable”, but added this “appeared less so with other executives”.

A summary report within the board papers said: “We are understandably disappointed with the feedback in relation to stroke services and have instigated immediate actions to address these areas, most notably a clinically led and executive driven stroke improvement group, providing a level of oversight and improved speed of change.”

It added an NHSE director would also provide additional management capacity.