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Final 'Keogh trust' exits special measures regime

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The final trust from the first wave of organisations placed in special measures following the Keogh review has come out of the regime.

North Cumbria University Hospitals NHS Trust was one of 11 organisations placed in special measures in 2013 after NHS England medical director Sir Bruce Keogh’s review of hospital trusts with high mortality rates.

“We know there had been entrenched problems there for some time beforehand”

Jeremy Hunt

Regulator NHS Improvement today approved the trust to come out of the support regime for struggling providers, following a recommendation from the Care Quality Commission.

The CQC recommendation followed an inspection in December, which found improvements to the trust’s Cumberland Infirmary in Carlisle and West Cumberland Hospital in Whitehaven. The trust was rated as “requires improvement” overall.

Among the improvements still needed, said the CQC, were meeting the four-hour accident and emergency target, resolving patient flow in and out of hospital, making sure there are enough qualified staff across all wards, and improving the rate of short notice cancellations.

The CQC highlighted that nursing and medical staffing had improved in some areas since the regulator’s last inspection. However, there were still a number of nursing and medical staffing vacancies throughout the trust, it said in its latest report on the provider, published today.

“There must be enough numbers of suitably qualified, competent, skilled, and experienced persons are deployed across all divisional wards,” said the regulator.

“Staffing is still a concern in some areas of the trust”

Mike Richards

CQC chief inspector of hospitals Professor Sir Mike Richards said: “It is now almost four years since North Cumbria University Hospitals NHS Trust was placed into special measures because of concerns about mortality rates and standards of care.

“I am now pleased to be able to recommend they come out of special measures,” he said. “Although there has been progress, particularly in the effectiveness of the services being provided, there is still a lot of work to do.

“I note that despite ongoing recruitment campaigns, staffing is still a concern in some areas of the trust including surgery, and services for children and young people,” said Sir Mike.

“However, there have been some staffing improvements within medical care at West Cumberland Hospital, with the trust securing long-term locum contracts and implementing a staffing support agreement with Cumberland Infirmary,” he added.

Trust chief executive Stephen Eames called the decision on leaving special measures as “momentous” and a “milestone”.

Stephen Eames

Stephen Eames

Stephen Eames

He added: “Of the possible 78 ratings our services received, we now have 57 goods, which is the most we have ever had. The majority of our services are also good overall.

“While we have a lot to celebrate today, I am also under no illusions that we still have work to do,” he said.

The trust is a key partner in the region’s success regime, which is aiming to turnaround the troubled health economy.

Cumbria Clinical Commissioning Group leaders agreed a series of acute and community service reconfigurations last week on the back of the success regime consultation.

However, the county council voted to refer the CCG’s decision over maternity services to health secretary Jeremy Hunt.



Sir Bruce Keogh

Mr Hunt praised the staff at the trust. He said: “North Cumbria is the final one of the original 11 trusts first placed in special measures to exit the regime, and we know there had been entrenched problems there for some time beforehand.

“That makes the accomplishment all the greater – and it’s another step on the road to making the NHS the safest, most transparent health service in the world,” he added.

There are 11 trusts still in special measures but 19 have now exited the regime following CQC inspections.

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