An NHS trust disciplined and suspended staff who blew the whistle about poor care and its controversial plans to slash staff in order to save money, an independent inquiry has found.
Liverpool community health trust was involved in “appalling instances of staff treatment” as it tried to keep the lid on a mounting series of problems, according to a report into its conduct.
A review panel, commissioned by the watchdog NHS Improvement and led by Sir Bill Kirkup, has uncovered evidence of bullying and harassment at the trust between 2010 and 2014. The trust also tried to “conceal” the extent of bad behaviour from outside bodies and failed to learn from incidents in which patients suffered serious harm, or even died, as a result of failings in the care it provided.
The report raises concerns that have parallels with the official inquiry into the Mid Staffs care scandal published five years ago this week, notably that the Liverpool trust sought to make unrealistically ambitious savings and reduce its headcount – despite already being understaffed – in a bid to become a semi-independent NHS foundation trust.
It has also concluded that problems at the trust, which specialises in providing care outside hospital, persisted for four years and that NHS and regulatory bodies failed to spot the problems. The report is due to be published on Thursday but has been leaked to the Health Service Journal.
According to the HSJ, the trust’s then human resources director, Michelle Porteous, presented plans at a private session of the trust’s board in February for “significant staff reductions” in areas of care that were “already being highlighted as a cause for concern, partly as a result of staffing shortfalls”.
Kirkup’s panel remarks that: “There was no apparent recognition of the irony inherent in this being taken to the same board meeting that had earlier considered the implications of the [Robert] Francis Report into failings at Mid Staffordshire NHS foundation trust.”
Staff told the inquiry how the Liverpool trust’s human resources department was guilty of “appalling instances of staff treatment” by the trust’s human resources department and victimised and suspended personnel who raised concerns. A number of staff who did speak out “were harassed and, in some cases, subject to disciplinary action, including suspension”.
The report accuses the trust of not learning lessons from numerous episodes of poor care it provided. These included up to 19 deaths of inmates at HMP Liverpool; five patients having the wrong tooth extracted by trust dentists; patients on intermediate care wards suffering repeated falls and broken bones; other patients ending up with pressure ulcers, which are usually a sign that someone has not been looked after properly.
In one year, the trust set itself a target of saving 15% of its budget through efficiency gains, even though, the report says, savings of anything more than 4% in a year in the NHS are generally considered unrealistic.