Downgrading of hospitals shows depth of the crisis
RECENT inspections by the Care Quality Commission (CQC) have downgraded the Newcastle upon Tyne Hospitals NHS Foundation Trust, which runs both the city’s Freeman Hospital and the Royal Victoria Infirmary.
A previous inspection by the CQC, an independent body that monitors and inspects health and social care providers, criticised Newcastle mental health provision in November 2022.
At that inspection, the CQC served a Warning Notice requiring significant improvements.
In the latest inspection, the CQC was particularly critical of the Freeman’s cardiothoracic department and of the RVI’s maternity unit.
The cardiothoracic department was reported to have a history of “bullying, intimidating and punishing staff who speak up over patient safety concerns”, and a history of serious incidents being “deliberately covered up”.
It was also noticed that the surgical units at the Freeman did not always have enough medical, nursing and support staff.
The inspection of the maternity services was in response to six whistleblowing concerns about patient safety.
The maternity unit was found to have inadequate numbers of both midwives and doctors and the report said staff were not always able to identify or act upon the clinical deterioration of women and babies.
To make things worse, women could not always be seen in the maternity unit when in need.
But the report about the Newcastle Hospitals is not entirely negative as it highlights some areas of outstanding practice and reports that some staff feel proud to work for the organisation and able to provide good care to patients.
The CQC report criticises the senior managers of the Newcastle hospitals and brands the hospital leadership as “inadequate”. The Newcastle Hospitals Trust has responded with the appointment of a new chief executive, and other senior manager changes are under way.
The downgrading of the Newcastle hospitals from ‘outstanding to ‘requires improvement’ has been reported by both regional and national media.
However the Newcastle hospitals are not in a unique position in our region as Darlington Memorial Hospital, the University Hospital of North Durham, the North Tees and Hartlepool NHS Foundation Trust, and Sunderland Royal Hospital have all been categorised by CQC as “requiring improvement”
The few hospitals that have kept an overall good rating include the Queen Elizabeth Hospital in Gateshead, the Northumbria Emergency Care Hospital at Cramlington, and the James Cook University Hospital in Middlesbrough.
Hospital managers like to put emphasis on what could be achieved with better leadership. Of course, better local management can make some difference.
Some reports of the Newcastle Hospitals downgrading singled out bullying as one of the main problems. In my experience, bullying is sometimes a consequence rather than the root cause. Some managers, when faced with problems they do not have the resources to resolve, may resolve to bullying as a cover-up strategy.
However, the reality is that the NHS as a whole is in crisis. It needs more funding, more capital investment, and a significant expansion of the workforce.
Maternity services are in crisis across England with two thirds of maternity units regarded as inadequate or requiring improvement.
Mental Health services are also in crisis, and there are unacceptable waiting times to see a GP and in Emergency Departments, as well as for hospital referrals.
According to the journalist Patience Wheatcroft (New European, January 25) the Rwanda deportation scheme is just a distraction from the real problems, like the NHS, that this Government is unable and unwilling to address. The NHS would be in a much worse predicament without the large number of migrant doctors and nurses who have come to work in the UK.