Failing trusts but what about failing leaders of failing trusts?
In April this year, ITV News reported that Northern Lincolnshire and Goole NHS Foundation Trust was to become the first trust in the country to re-enter a failure regime after inspectors found that patient safety and quality of care had "deteriorated".
"Having seen improvements to patient care previously, we are disappointed that our latest inspection of Northern Lincolnshire and Goole NHS Foundation Trust found these improvements had not been sustained and there had been an overall deterioration in quality and patient safety. We will continue to monitor the trust and will return to check on the progress it must make. NHS Improvement will be working closely with the trust to ensure full support is available to make the improvements needed."
– Ellen Armistead, Care Quality Commission www.cqc.org.uk www.cqc.org.uk
Clearly something was going very wrong there but at a public consultation held at Grimsby Town Hall, hosted by Northern Lincolnshire and Goole NHS Trust (Nlag), aimed at updating local people on the progress Nlag is making to be removed from special measures the trust chairperson insisted that things were improving.
If that is so, then why had a senior manager felt the need to write anonymously to the local MPs stating that
"It is with sadness and regret that I find myself in the invidious position of having to write to you anonymously regarding the leadership and general direction of travel for the above organisation.
I do not feel able to identify myself and despite having held a senior position in the organisation for many years I feel the time has come for me to share my concerns.
Despite the CQC having recently visited us, I don’t feel that culture and general leadership have been addressed sufficiently for long term change to be made.
Despite our second visit to “special measures” in a short space of time it appears that the divisive Executive Team remain in situ. Since the CQC visit, things have worsened dramatically – the imposition of impossible deadlines, no clear sense of direction of travel and veiled threats do nothing to enhance patient care, and produce a sense of cohesiveness and wellbeing for staff.”
When I read the response of the chair, Anne Shaw, I knew there was seemingly little hope of change for that anonymous senior manager. A humble, caring, compassionate leader would apologise to the manager who had felt so powerless and thank them for taking that step, that obviously cost them dear, especially when the CQC had mentioned their concerns about the culture too.
However, her response underlined how dysfunctional the management team had become. The Grimsby Telegraph reported ‘in response, Ms Shaw, hit back at the author
Ms Shaw, said: "We need people like that to think about what they are doing. My door is always open to talk to staff. I want people with concerns to come to me first.
"Headlines like this make people feel anxious and upset and don't tell the whole story. It bears no relation at all to us as an organisation.
"This person is part of the reason the trust is in special measures. This individual is disappointing and is clearly frustrated.
"Any staff member who doesn't feel valued has people who they can talk to."
Having made that attack on the anonymous author, the newspaper report went on to say -
Ms Shaw also apologised on behalf of the trust for its lack of efficiency, and blamed the CQC's findings on "complex and numerous issues", as well as the "sheer number of people" seeking care, who go to hospital with complex needs.’
Yes, the numbers of people seeking treatment have risen alarmingly and it is a huge problem for trusts but what was the management speak all about - these "complex and numerous issues”!
There you have it, a trust in great difficulty and a management that is still allowed to function, even though the CQC officials said they remained concerned about the organisation's culture, adding:
"There was a sense of fear amongst some staff groups regarding repercussions of raising concerns and bullying and harassment". – Care Quality Commission reported by ITV News.
For the sake of the anonymous whistleblower, I hope s/he hasn’t been identified and is able to leave before more damage is done to that person’s health and family life, that the writer described.
What hope is there for those employees while the trust continues with those managers, and how many staff will give up before then and get out, whilst patients continue to suffer?