'Bullying, harassment and sub-standard care' at a Liverpool NHS trust - report


An NHS community trust has been likened to Mid Staffordshire NHS Foundation Trust after a catalogue of failings were identified in a report.

There was a culture of bullying and harassment and sub-standard patient care at Liverpool Community Health NHS Trust, the review states.

The report criticises trust leaders for being too focused on achieving NHS foundation trust status and driven to reduce costs.

The report, by Capsticks Solicitors, states that cases of "inappropriate and unsafe" care were not addressed and response to such incidents was "grossly deficient".

Staff could not speak out about poor care, they said, adding: "The culture in the Trust was not conducive to raising concerns. It was hierarchical and seen by some as oppressive. Speaking out about concerns was not easy. Such was the impact of this culture that some staff were driven to the brink."

West Lancashire Labour MP Rosie Cooper has called for a public inquiry into the trust.

Ms Cooper said: "Each and every person who could have acted and should have acted to end this overwhelming failure of patients and staff at Liverpool Community Health NHS Trust should feel absolute shame. They owe patients and staff a personal apology for the unbelievable distress they allowed by their inaction.

"This report is a review of governance. What it has found is an NHS scandal similar to Mid-Staffs but in community services rather than a hospital.

"I believe we now need a full clinical inquiry to establish the full extent of any harm that has been caused to patient care and staff welfare."

The review states: "Our report into Liverpool Community Health NHS Trust sets out a series of events that began in 2011 with a sustained drive towards achieving NHS foundation trust status by the Board.

"What followed until the early part of 2014 was an accompanying focus to reduce costs, which resulted in enormous pressures on many front line services and the emergence of a culture of bullying and harassment of staff at various levels within the organisation and the delivery to some patients of poor and in some cases sub-standard care."

When quoting Sir Robert Francis QC's report into problems at Mid Staffordshire, the authors wrote: "As Francis said, 'It is a truism that organisational culture is informed by the nature of its leadership' and that effective leadership at Mid Staffordshire was 'significantly lacking'. We regrettably found the same at the Trust."

Liverpool Community Health NHS Trust, which was formally established in November 2010, appointed a "largely inexperienced" executive team that did not provide "sufficient scrutiny, challenge and oversight" across a number of key areas, the review authors said.

When issues were raised they were either "ignored or watered down by those in more senior positions to make them look less significant than they were", the report found.

"Our findings catalogue a series of failures at multiple levels," the authors conclude.

Regulatory bodies were also criticised for failing to provide "appropriate scrutiny and challenge".

The review does state that in the last 18 months a new leadership team has been appointed and is working to improve issues at the under-fire organisation.

Liverpool Community Health NHS Trust, which commissioned Capsticks to conduct the review, serves around 750,000 people in  Liverpool and Sefton. It provides community care to people in their own homes and more than 70 centres and clinics.

Carole Panteli, Liverpool Community Health NHS Trust's interim director of nursing, said: "The report is clear that the Trust lost its way a number of years ago and this can be seen in the sad catalogue of historical problems which climaxed in a series of critical inspection reports in early 2014. What happened was wrong and, on behalf of the Trust, we are sorry that these issues went unchecked and unchallenged for so long.

"Since the appointment of our new leadership team in April 2014 and embarking on our improvement journey, we've recruited more than 150 nurses, health visitors and other frontline clinicians.

"We've turned an important corner but it's important we never go back to the problems of the last few years.