Gloucestershire Hospitals NHS Foundation Trust's rating downgraded

Concerns over surgical safety, bullying and racial discrimination have been exposed in a report into Gloucestershire's two main hospitals.

The overall rating of Gloucestershire Hospitals NHS Foundation Trust has gone from good to requires improvement.

The Care Quality Commission said there were 11 "never events" - serious incidents that should be avoidable. Staff shortages were cited as a factor.

The trust said it was determined to "re-build confidence" in its services.

Inspections of surgical services and trust leadership at Cheltenham General Hospital and Gloucestershire Royal Hospital took place in April and June, after whistle-blowers contacted them to warn about bullying, poor leadership and a blame culture.

Care Quality Commission (CQC) inspectors raised concerns about the number of never events.

The cases all related to surgery or surgical specialities including care to the wrong part of the body or incorrect solutions being used.

Catherine Campbell, CQC head of inspection, said during the inspection of surgery services, both hospitals "were incredibly busy and we saw the impact that staff shortages were having on the service".

The trust reported a total of 11 never events across the organisation including seven never events in the surgery division from March 2021 to February 2022.

"There was limited evidence of learning from never events being shared with staff across the trust," Ms Campbell said.

She added that during its "well led inspection" they found "there was a lack of trust in senior leaders and a fear of speaking up".

"Some staff said they had tried repeatedly to raise concerns and due to either a lack of response or a negative response, eventually they had become disengaged and focused instead on day-to-day service provision," she said.

"There was also a disconnect in the governance of the trust, so senior leaders were not sighted and hence had not taken action to rectify issues and matters arising in wards and departments.

"There were some cultural challenges within the trust and leaders did not always promote equality and diversity in day-to-day work."

But the report did point out how hard staff were working despite feeling demoralised, unable to speak up and lacking leadership.

Deborah Lee, chief executive at the trust, said: "I am incredibly proud of my colleagues for their work over the pandemic.

"However, not all of the findings in this report can be explained away and I am determined that this report will provide further momentum and impetus to address issues."

Professor Mark Pietroni, medical director and director for safety, said their Quality Academy had been working with surgical teams for more than a year, with a particular focus on theatres where the majority of these events had occurred.

"We have made huge strides in this area and have not had a never event for 295 days in theatres from a previous average of one every 59 days," he said.

Dr Claire Radley, the trust's director for people and organisational development, added: "There are no circumstances when it is ever acceptable for staff to feel bullied, to be subjected to discrimination or to fear reprisals when they have had the courage to speak out."

The trust added it would be working to address the concerns set out in the report.

It expects the CQC to re-inspect its services in the next few months.

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