‘Significant downturn’ in quality of healthcare at Morecambe Bay NHS Trust – Care Quality Commission

A previously scandal-hit maternity unit has been downgraded to inadequate by health inspectors, while the overall trust it is part of has been told it must improve.

The Care Quality Commission (CQC) said its report into University Hospitals of Morecambe Bay NHS Foundation Trust makes for “disappointing reading”.

The watchdog’s deputy chief inspector of hospitals in the north, Ann Ford, said there had been a “significant downturn in the quality of services” at the trust and patients were not getting the care they deserved.

The trust comprises of Furness General Hospital (FGH) in Barrow (pictured), the Royal Lancaster Infirmary and Westmorland General Hospital in Kendal.

All three have been rated as requiring improvement after the latest unannounced inspection in April and May, with both FGH and Westmorland General Hospital being downgraded from their previous ratings of good.

The maternity rating for FGH has dropped from good to inadequate, with Ms Ford saying past improvements “have not been sustained and the service has deteriorated, affecting patients and staff”.

Major care failures were linked to at least 12 deaths of mothers and babies at FGH between 2004 and 2012 in what became known as the Morecambe Bay scandal.

The CQC said it had undertaken its inspection after receiving concerns and whistleblowing information about the safety, quality and leadership of the services at all three hospitals.

After the inspection of stroke services at both the Royal Lancaster Infirmary and FGH, the CQC imposed conditions on the trust, saying inspectors were not assured that all patients had received care and treatment in a timely way, exposing them to the risk of harm.

Inspectors noted that, overall, risks were not always identified correctly with appropriate mitigations put in place, and not all senior leaders demonstrated the necessary experience or knowledge to lead effectively.

The CQC said the culture within the trust was varied, with inspectors saying: “There were some services where the culture was poor and had remained so for some time.”

The rating of the trust for being well-led went down to inadequate, as inspectors found that risks, issues and poor performance were not always acted on by leaders “in an effective or timely manner”, including within stroke services, maternity and urgent and emergency care.

The CQC said the trust did not always collect reliable data, analyse and use it to make improvements, and it had concerns about the management of incidents and learning from them.

It said: “Incidents were not consistently identified and reported on. Not all incidents were dealt with appropriately or quickly enough and there was limited thematic learning across the organisation.

“We saw examples of incidents that should have been reported and had not been recognised or reported as such.”

The CQC also said the trust had a “significant challenge” in managing the size of the financial deficit and how it was affecting operational performance and the quality of the trust.

Ms Ford said: “This recent inspection of University Hospitals of Morecambe Bay NHS Foundation Trust makes disappointing reading.

“We found a significant downturn in the quality of services provided by the trust, and patients were not receiving the standard of care they deserve.”

She said while the trust had previously shown a capability of making improvements, for example in its surgical services, it is “very disappointing” that the progress “has not been replicated throughout the trust”.

Ms Ford added: “The improvements which were demonstrated at previous inspections of Furness General Hospital’s maternity department have not been sustained and the service has deteriorated, affecting patients and staff.”

She praised the “excellent work carried out by staff within the trust who, on the whole are providing care, treating patients with compassion sometimes under difficult circumstances”.

But she said it was clear the trust is in need of support, which would come through the national recovery support programme, through NHS England and NHS Improvement.

Ms Ford added: “This will give the trust the resources to embed the improvements they need to make.

“In the meantime, we will continue to monitor the trust closely and return to check on any improvements which have been made.”

Aaron Cummins, chief executive of the trust, said: “Our staff have worked incredibly hard throughout the pandemic and we are pleased the CQC recognised some of the improvements the trust has made since its last inspection, but clearly there is still work to be done and we know our colleagues, patients and local populations deserve better.

“The safety of our patients and staff is our absolute priority and we have already started making improvements to address the concerns raised, including creating dedicated stroke beds in our hospitals, appointing more colleagues in emergency care and launching new electronic patient record systems in maternity.

“We will continue to work with our teams to make further changes to ensure we are delivering the safest and best care for our patients and their families.”

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