Pennine Acute Hospitals Trust has been rated inadequate by the Care Quality Commission.
The inadequate rating followed the first inspection of its facilities.
Staffing levels, infrastructure, systems, culture and leadership were all considered cause for concern by the regulator.
Pennine Acute Hospitals Trust operates services across four sites in Greater Manchester.
Inadequate services were reported at both North Manchester General Hospital and Royal Oldham Hospital.
Fairfield General Hospital was rated as requiring improvement, while Rochdale Infirmary and the trust’s community services were considered to be good.
The Care Quality Commission was particular critical about the levels of safety and leadership demonstrated by the trust.
Already the Pennine Acute Hospitals Trust Has acquired over £9 million worth of financial support from local commissioners and regional and national health and social care partners.
It is hoped that this will play a major role in improving the safety and reliability of the way services are delivered at the trust.
CQC deputy chief inspector of hospitals Ellen Armistead reflected on the issues which had led to the inadequate verdict.
“We had serious concerns about the systems and procedures that are in place to keep people safe and free from harm. The trust did not have a robust understanding of its key risks at departmental, divisional or board level. In a number of services including A&E, maternity, children’s and critical care, key risks were not recognised, escalated or mitigated effectively.”
It is already well known that major concerns have been raised regarding such issues during an impromptu inspection which was conducted earlier this year.
Sir David Dalton of Salford Royal Foundation Trust was subsequently installed as the interim Chief Executive as a result of problems which were identified at that time.
The Care Quality Commission has now confirmed that the organisation will be placed into special measures as a result of these ongoing difficulties.
Dalton accepted the findings of the Care Quality Commission in a statement:
“The CQC report doesn’t make comfortable reading and whilst staff will be very disappointed with the trust’s overall rating, we welcome this report which I believe is a fair assessment of the issues facing the trust. The CQC report is holding up a mirror to the organisation and reflects very much what staff have been saying for some time on issues related to staffing pressures, inadequate systems, culture, leadership and resources.”
Recent data indicated that the Care Quality Commission has tended to file scathing and critical reports on trust across England, with a relative handful of organisations being considered outstanding.
Financial challenges facing organisations in Greater Manchester will require a radical upscaling of shared services across the acute sector, according to NHS health leaders.
The financial outlook for the region ensures that the trust will need to share back office, diagnostic and clinical support functions going forward.
Plans have already been put in place in Greater Manchester that will see the region’s emergency services consolidated into four single services.
But the document submitted as part of the region’s devolution bid prepares the ground for further “bold decisions” to be made.
The Manchester Health and Social Care Locality Plan aims to completely reorganise specialised services in Greater Manchester in light of significant financial difficulties.
According to the plan itself, a funding gap over £300 million in Manchester’s health and social care economy should be expected between now and 2020-21.
The document is intended to create a framework in which specialised services can be organised on a more efficient and effective basis.
As a result of efficiency savings suggested by the documents, the gap in expenditure is expected to be cut significantly to around £84 million.
Sharing will be a central part of the efficiency plans, and Central Manchester Hospitals Foundation Trust and University Hospital of South Manchester Foundation Trust will partially merge with this aim in mind.
The two organisations will create a single service for emergency care as part of the ‘Healthier Together’ process.
However, it is worth noting that the plans for this concept cannot be finalised at the time of writing due to a legal challenge.
Nonetheless, the two foundation trusts have indicated that they intended to work together in a raft of other areas.
A spokesperson commenting on behalf of the two organisations stated that “the potential benefits of shared back office functions such as payroll or supplies are fairly clear – we are already working together to develop a joint approach to procurement.”
The spokesperson also stated that the two organisations were considering the prospect of expanding their agreement in the future.
“In principle there could be similar opportunities in diagnostic and clinical support services, which we will be exploring going forward but there are no plans for shared clinical support services at present.”
With regard to specialised services, the client also states that populations in south and central Manchester have “significantly higher rates of tertiary activity than areas where the local hospital is not also a tertiary centre”.
There is thus the intention of addressing this variation and inequality in the immediate future.
The Central Manchester Hospitals Organisation have also indicated that they are exploring partnership working arrangements with Salford Royal Foundation Trust across radiology and immunology.
It is clear that collaboration will be an important part of efficiency savings in the future.
A major new proposal which gives responsibility for Greater Manchester’s £6bn health and social care budget to councils and health groups in the region has been given the go-ahead.
Chancellor George Osborne is expected to confirm the decision on Friday (27 February).
It means that from April 2016, control over regional healthcare spending decisions will pass from NHS England to local politicians, clinical commissioning groups and NHS trusts. However, actual budget control will not take place until the following year.
The unprecedented move to integrate health and social care in the region is intended to ease the mounting pressure on hospitals and establish a better standard of home care services.
Welcoming the devolution of healthcare spending to the Greater Manchester region, Councillor Mike Connolly, Labour leader of Bury Council, said: “Decisions need to be made in Greater Manchester and not Westminster.
“We are all agreed, certainly in the Labour Party, that health and social care must be integrated because it’s about providing that primary care – and it can only be good for healthcare across Greater Manchester.”
The devolved spending agreement will also see, from 2017, a directly-elected mayor with responsibility for transport, housing, policing and planning, in addition to health.
The Pennine Acute Hospitals NHS Trust in Greater Manchester has partnered with LloydsPharmacy to trial an innovative new pharmacy-led clinic at its North Manchester General accident and emergency department which sees over 100,000 patients each year.
With figures suggesting that around one in four people who visit the A&E department at North Manchester General Hospital could be treated more appropriately by a pharmacist or another local NHS service, the LloydsPharmacy First Care Clinic pilot has been developed to explore and understand how pharmacy can form part of the solution.
The service provides patients with free treatment by a clinically trained pharmacist for minor injuries and common ailments such as minor burns, scalds, neck sprains and earache.
The clinic aims to see patients within 30 minutes of arrival and 15 minutes after triage.
“Our A&E at North Manchester is one of the best performing sites in the country in relation to the national A&E access standards and waiting times”, said Dr Jimmy Stuart, consultant and clinical director of urgent care at The Pennine Acute Hospitals NHS Trust. “This is a result of hard work from our staff and a reflection of the innovations and improvements we are making in ensuring patients are treated, moved to a ward, or discharged in a timely manner when they are medically fit to do so. But this is an ongoing challenge as we try to cope with the huge numbers of people that turn up to our A&E departments.”
Cormac Tobin, Managing Director at LloydsPharmacy, added: “Pharmacy is a long-term partner of the NHS and this latest initiative is an example of how we can take a fresh approach to working together to meet the challenges of today, and the future.”