“Staff worked in a culture of intolerance, disbelief and fear,” is just one damning comment from the independent review into the widespread failings of Liverpool Community Health NHS Trust (LCH). The review was conducted by Dr Bill Kirkup CBE and commissioned by NHS Improvement. It looks into the issues at the Trust from November 2010 to December 2014, as well as the oversight of the Trust by the NHS Trust Development Authority, NHS England and commissioners.
LCH was created in 2010 and its services included adult care, child and adolescent care, community dentistry, prison healthcare and public health.
The report outlines how cost improvement programmes imposed by the Trust in a bid to gain Foundation Trust status put the safety of patients at risk, and that a culture of bullying meant that staff were scared to speak up or that incidents were ignored or not escalated. The review found that the external overview of the Trust failed to identify the service’s problems for at least four years, and concluded that earlier intervention would have reduced the avoidable harm that occurred to patients and staff across the Trust.
Dr Kirkup makes a series of recommendations for NHS Improvement, the Care Quality Commission, NHS England, the Department of Health and to the Trusts currently providing services that used to be run by LCH. Recommendations concern how the level of risk is assessed, the use of information, recording and communicating information, levels of expertise particularly of the Board and the need for a system of support and mentorship.
For organisations taking on the services previously run by LCH, it says the handling of previous serious incidents should be reviewed to ensure they have been properly investigated and lessons learned. Organisations taking on former LCH staff should review the handling of all disciplinary and whistleblowing cases to ensure they have been properly and appropriately resolved. Further, they should ensure those members of staff are not put back into working relationships that were previously the subject of bullying and harassment.
Ian Dalton, Chief Executive of NHS Improvement says: “We are grateful to Bill Kirkup for this report which highlights significant failings in patient care.
“The report has important lessons for our organisation and the whole of the NHS. We will carefully consider its findings and take appropriate action.”
NHS Improvement will respond fully to the review’s findings and recommendations by late March 2018.
