A health boss has vowed not to “shy away” from major concerns underlined by a damning inspection report that has seen Newcastle’s hospitals lose their ‘outstanding’ rating.
The Care Quality Commission (CQC) has downgraded the Newcastle upon Tyne Hospitals NHS Foundation Trust, which runs the Freeman Hospital and Royal Victoria Infirmary, to ‘requires improvement’.
Following a series of inspections in 2023, it reported that there had been a “significant deterioration” in the trust’s leadership and that some staff felt there was a culture of bullying.
Sir James Mackey recently took over as the trust’s chief executive, after Dame Jackie Daniel announced she would be stepping down last year, and has now promised urgent changes to address the failings and return the hospitals to their former status – including “decisive” action in a troubled department mired in harassment and safety concerns.
He told the Local Democracy Reporting Service that staff felt “embarrassed” by the CQC report and “like they have let people down”, adding: “But they are pulling together. There is real enthusiasm for people to fix this because it is all fixable.”
Sir James, who was previously interim chief operating officer of NHS England, refused to blame the problems on the immense pressure faced across the health service following the Covid pandemic and national concerns about staffing levels.
He said: “There is a lot of noise in the health service all the time about resource levels and whether we have enough people or enough money. Everybody is still recovering from what happened in 2020 and 2021 – understandably, it was a once-in-a-lifetime thing hopefully.
“Generally, we have more money and people than we ever have and we have to make sure they are supported to do their best. An awful lot of this is about management, leadership, organisational systems.”
Sir James added: “From my point of view, I would not buy the excuse that it is all about Covid, about money, about pressures etc. There is an awful lot that we can sort ourselves and that is what we are going to do.”
He also vowed not to “shy away” from the watchdog’s findings and sought to reassure patients that the hospitals’ services remain safe.
Among the raft of concerns detailed by the CQC were specific allegations of a history of bullying, harassment, and abuse at the Freeman’s cardiothoracic department.
The Hebburn-born chief executive said that behaviour problems in the unit “need to change” and that he would be personally involved in its reform.
Speaking at the Freeman on Tuesday morning, Sir James said: “One of the big concerns for the CQC is that they have been highlighted by previous reviews and not been dealt with decisively. They are being dealt with decisively now.
“That will involve conversations with individuals about where they work in the future, whether they are still here. There will be changes in the department in how it is led and managed.
“Those things are ongoing and there will be an increased executive involvement – I will be personally involved in how that part of the organisation works over the coming months to make sure we are all confident that those issues have all been dealt with.”
It was recently announced that the trust’s medical director Andy Welch and chief nurse Maurya Cushlow would be leaving their roles, though that is said not to have been in direct response to the CQC inspection, with several new directors also due to join.
Sir James said he planned to be “constantly tweaking the team and enhancing where we can” over the next couple of years but did not want a dramatic restructure of the trust’s leadership.
Bosses are also seeking a new director of midwifery to “lead the change process” in a unit where the CQC highlighted concern over significant workforce shortfalls leaving staff unable to provide “basic fundamental standards of care”.
The chief executive added: “Maternity is under a lot of scrutiny nationally. It is not an excuse, but it is not unusual for organisations to be rated in the way that maternity was.
“But there is a very strong desire to get back in a position where the service can be rated outstanding again.”
Sir James has promised to make the hospitals’ leadership more visible and has encouraged staff to speak to him directly about their concerns, adding that he was “very confident” of making improvements and repairing the trust’s reputation – something he said was “really important” to the identity of Newcastle as a city.
He added: “The report is hard to read – it will be hard to read for staff, for members of the public, and patients. I would reassure people that services are safe here – there are lots of good services here and lots of good staff, the CQC have acknowledged that in their report.
“But they have also pointed to some things that were not evident or strong enough here when they did their inspection. A lot of that is about how the organisation is run, led, and managed or to specific examples of culture and behaviour within certain departments.
“Probably the most worrying is the concern expressed by staff over when they have issues whether they can raise them and have them dealt with appropriately. That is really where the drift is – it is not really in the fundamentals of how the service works, or things to do with patients every day, it is the wraparound of how the organisation functions together and is led.”