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12.08.16

Manchester trust involved in mammoth hospital merger rated ‘inadequate’

One of the Greater Manchester trusts currently involved in devising mammoth plans to merge three providers into a single hospital trust has been rated ‘inadequate’ by the CQC.

Pennine Acute NHS Trust, which was selected earlier this year to merge its North Manchester General Hospital services with University Hospital of South Manchester NHS FT and Central Manchester University Hospitals NHS FT, was rated as ‘inadequate’ for being safe and well-led, as well as ‘requires improvement’ for the criteria of effectiveness and responsiveness.

Ellen Armistead, the CQC’s deputy chief inspector of hospitals, said staff treated patients in a compassionate and sensitive way, but there were “serious concerns” about the systems and procedures in place to keep people safe.

“The trust did not have a robust understanding of its key risks at departmental, divisional or board level. In a number of services including A&E, maternity, children’s and critical care, key risks were not recognised, escalated or mitigated effectively,” she added.

“Although the trust had undertaken work to determine appropriate staffing levels, we found significant shortages in nursing, midwifery and medical staff.

“Over recent months the trust had put in place systems and processes to improve clinical governance and leadership. However, at the time of our inspection the new structures had not yet been fully embedded and were not well understood. As a result, clinical and performance risks were not being managed effectively.”

Armistead said that “such is the level of concern” around quality and safety that the CQC would have considered recommending the trust enter special measures, which would involve the appointment of an improvement director and supporting infrastructure.

Instead, Salford Royal NHS FT, hailed as one of the best providers in the country, was asked to assume leadership of the trust immediately following inspection. The foundation trust, rated ‘outstanding’, has put in place a comprehensive plan for further investigation into the challenge Pennine faces, including action plans to deliver improvement.

“It is important that the findings of this inspection mark a turning point for the trust,” Armistead continued. “CQC will be monitoring very closely the improvements that need to be made to ensure the safety and well-being of people using the services at the trust.”

Sir David Salton, the chief executive of Salford Royal who took over as CEO at Pennine in April, promised the trust had “not waited for the publication of this report to put an improvement plan in place”.

The CQC’s report comes at a crucial time for the trust, which is heavily involved in developing merger plans already approved by Manchester City Council. The plans are so enormous and complex – hailed as the largest in NHS history – that they would only be possible with “no hitches whatsoever” in the examination of the process by NHS Improvement.

The proposed benefits of the single hospital trust include reducing healthcare inequalities and service gaps within the city, standardising care pathways, recruiting more specialist staff and improving use of estate and data.

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