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Morecambe Bay findings 'at risk of being localised'

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The chair of the Morecambe Bay inquiry has said there is “no indication” there will be a national review of isolated healthcare services that looks beyond maternity units, despite this being one of the key recommendations from his investigation.

Some of the issues encountered at University Hospitals of Morecambe Bay NHS Foundation Trust are likely to be found at other organisations, but parts of the healthcare industry want to believe they are not nationwide problems, said Dr Bill Kirkup.

Speaking at a recent board meeting of the Care Quality Commission on the response to his report – which was published in March – Dr Bill Kirkup said his recommendation for a national maternity review was “motoring at full speed”.

But he was yet to see evidence that a wider review across different services would take place.

“There is evidence that there is a desire to localise this… to Furness General and to maternity services”

Bill Kirkup

The Kirkup inquiry – which revealed the full extent of care failings at Furness General Hospital that led to the deaths of mothers and babies – found the unit’s geographical and clinical isolation was part of the problem.

It concluded that many regions of England, Wales, Scotland were affected by isolated practice and noted “the challenge of providing healthcare in areas that are rural, difficult to recruit to or isolated is not restricted to maternity care and paediatrics”.

One of its 44 recommendations was for NHS England to carry out a review of the provision of care across a range of services in these isolated circumstances.

“Although the recommendation for a national maternity review has been picked up avidly…the other [review] hasn’t and I have no indication that anybody will be picking that one up”

Bill Kirkup

Dr Kirkup was asked by CQC board member Louis Appleby last week whether the broader NHS system had recognised that findings from the inquiry were universally applicable.

In response, he said: “There is evidence that there is a desire to localise this in both senses of the word – a) to Furness General and b) to maternity services.”

He added: “[In the inquiry] I was specifically concerned about the context of a small, isolated – not necessarily geographically isolated but clinically isolated – unit where standards can drift.

“And although the recommendation for a national maternity review has been picked up avidly and is motoring at full speed with [review chair] Baroness Cumberlege, the other one hasn’t and I have no indication that anybody will be picking that one up,” he told the CQC meeting.

He later added that in general there had been “a bit of a black hole” in the response to his inquiry from NHS England so far.

“[The Morecambe Bay investigation] demonstrates how this is … [a problem] about culture and the system”

Robert Francis

Sir Robert Francis, who led a separate inquiry into care failings at Mid Staffordshire NHS Foundation Trust, is now a board member of the CQC.

He said at the meeting that the Morecambe Bay inquiry echoed the findings of his own report into Mid Staffs.

“The depressing thing seems to be that what you found echoes so much what was going on at the same time in Staffordshire and that it if nothing else demonstrates how this isn’t a problem about maternity,” he said.

“It’s not a problem about an isolated hospital in the north of England, it’s [a problem] about culture and the system,” said Sir Robert.

Bill Kirkup

Bill Kirkup

An spokeswoman for NHS England said it was currently considering the Morecambe Bay report’s recommendations.

“It is fundamentally important that we are able to deliver high quality care to patients regardless of where they live and we are currently considering the report’s recommendations about reviewing healthcare services for rural populations,” she said. 

She added: “We are exploring how the NHS needs to evolve over the next five years as part of the Five-Year Forward View. We will also contribute to the fuller response to the outlined recommendations in the overall report which is being coordinated by the Department of Health.”

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Readers' comments (3)

  • Sir Robert has hit the nail on the head. Buurtzorg healthcare model… low cost, high patient satisfaction and good job satisfaction for nurses.
    For those suffering from dementia… Namaste care meantime.

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  • 'it’s [a problem] about culture and the system'
    If this is endemic in the NHS what is being done to address it

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  • Hear, Hear to Sir Robert Francis and Bill Kirkup!
    This is my comment published in The Westmorland Gazette, 12 March 2015, p38:

    This report has many similarities to the Francis Report into failings at Mid-Staffordshire in 2013. Both highlight that a defensive culture and poor communications were key factors in failure to learn from errors.
    We can only hope that Morecambe Bay Trust will make sure that it has an open and transparent culture in which feedback from patients (and staff) is integral to all services.

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