Staff working in emergency, maternity and children’s departments at a struggling acute trust are “under immense pressure” as they work “incredibly hard” to deliver services, the organisation’s chief executive has said ahead of a highly critical report from the regulator expected later this week.
In response to a local news report revealing problems found during an inspection earlier this year, Pennine Acute Hospitals NHS Trust chief executive Sir David Dalton said the organisation had already put in place a number of immediate actions to address the regulator’s concerns.
“Some important services provided by Pennine Acute, particularly at North Manchester General Hospital, are facing severe challenges at the moment”
He said they included measures to tackle inadequate staffing levels and procedures to assure patient safety at the trust, which runs Rochdale Infirmary, North Manchester General, Royal Oldham, and Fairfield General hospitals.
But he acknowledged there was ”a need to accelerate and take further actions” to ”support our staff to ensure our services are as safe as they can be and more reliable, particularly in our pressured services such as accident and emergency, maternity and children’s services” where staff are “stretched”.
Sir David is also chief executive of the nearby Salford Royal Hospital NHS Foundation Trust, which is often highlighted for good practice and performance.
He is providing support to Pennine Acute – along with other senior members of the Salford leadership team, including chief nurse Elaine Inglesby-Burke – after ongoing performance problems there.
According to a Manchester Evening News report, during a visit in March the Care Quality Commission found there were not enough children’s nurses to meet safe staffing nurse-to-patient ratios.
In addition, understaffing was identified in maternity services – particularly at North Manchester General – and the emergency department, and problems with leadership and culture were found.
“We will not allow this organisation to run unsafe services”
Sir David Dalton
According to the local newspaper, the trust immediately closed a number of its paediatric beds to keep children safe, later followed by further closures meaning around a third (16) of it children’s beds were shut in total.
It is also understood that midwives from the nearby Central Manchester University Hospitals NHS Trust will be seconded to Pennine Acute to help alleviate staffing problems.
The planned secondment is part of efforts to pool resources among health and care organisations in the area through the Greater Manchester Health and Social Care Partnership, set up to control the devolved health and care budget for the region.
It is expected that North Manchester General’s maternity services will eventually be brought into a new city hospital trust formed by the merger of Central Manchester University Hospitals NHS Trust and University Hospitals of South Manchester NHS Trust.
Sir David was drafted in from Salford in April to help tackle problems at Pennine Acute Hospitals Trust and led his own review, which uncovered similar problems to those expected to be published in the CQC report due on Friday.
In a statement, he said his review had focussed on patient safety and governance arrangements, as well as operational and performance standards.
This led to the trust setting up an improvement board made up of health and social care organisations including local clinical commissioning groups, local authorities, NHS England, and neighbouring trusts, he said.
It is chaired by Jon Rouse, the new chief officer of Greater Manchester Health and Social Care Partnership, who said “urgently strengthening and stabilising” A&E, maternity and children’s services at the trust was the board’s “top priority”.
“Some important services provided by Pennine Acute, particularly at North Manchester General Hospital, are facing severe challenges at the moment, notably A&E, maternity and children’s services,” he said.
“Urgently strengthening and stabilising these, under the leadership of Sir David Dalton, is our top priority and we are working together across Greater Manchester to make this happen,” he said.
“However we and others would recognise that some of the issues at Pennine are more long-standing. Our new partnership approach under devolution means we now have the opportunity in Greater Manchester – and the means – to tackle these far more effectively than in the past, ” he added.
Sir David also said: “Our priority is to keep our busy A&E departments and our maternity services running safely and to ensure patients receive good safe treatment in a timely manner. We will not allow this organisation to run unsafe services.
“It is recognised that for this trust to make services safer and more reliable, it requires the support from our health and social care partners to provide over the next six months and to consider longer-term solutions for services across Greater Manchester,” he added.