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West Suffolk Hospital boss apologises for CQC 'requires improvement' rating

The chief executive of West Suffolk Hospital has apologised for ‘shortcomings identified by the CQC’.

In an interview with the Bury Free Press, Dr Steve Dunn said: “I’m sorry that we’ve let local people, patients and our staff down."

The Bury St Edmunds hospital's trust lost its 'outstanding' rating and was judged 'requires improvement' by the health regulator.

Dr Steve Dunn, chief executive of West Suffolk NHS Foundation Trust
Dr Steve Dunn, chief executive of West Suffolk NHS Foundation Trust

Although staff were praised for treating patients with 'compassion and kindness', inspectors highlighted issues with the trust's leadership and how some staff felt unable to raise concerns 'without fear of retribution'.

“I’m absolutely committed to delivering the required improvements," Dr Dunn said.

"This is an opportunity to learn and make services and our culture better.

“We’ve taken action on the immediate safety issues –services are safe. We’ve got a detailed action plan and we’re going to make sure we deliver on that action plan.

West Suffolk Hospital in Bury St Edmunds. Picture by Mark Westley
West Suffolk Hospital in Bury St Edmunds. Picture by Mark Westley

“I’m pleased the report does acknowledge how hard-working our staff are and that they care and treat local people with compassion and kindness but there are lessons here we need to learn.”

Asked how and why the hospital’s CQC rating had dropped to ‘requires improvement’, Dr Dunn listed a number of areas highlighted by the regulator.

In maternity services they needed to ensure they were tracking and recording the monitoring and observations of mothers and their newborn babies.

“We’ve taken action to ensure we do that and they’ve delivered significant improvement,” he said.

“There are certain specialities where we’ve had challenges about making sure we are tracking and following up patients who need ongoing care and we’ve both addressed the issues in our vascular pathway and made sure we’re clear of other areas where we track and follow up patients’ care that they’re robust, clear and we’re auditing and taking action on those areas.”

Some of the most damning aspects of the CQC ‘s report were around leadership style after some staff ‘stated the executive team listened but did not hear’.

Questioned on this, given that as chief executive the buck stops with him, Dr Dunn said: “I want every member of staff to be listened to and valued and understand we do care. I’m determined we listen and learn the lessons in this report.

“The report does acknowledge that it’s an experienced and stable leadership team and we will be acting and responding to the report. I and the chair (of the trust Sheila Childerhouse) have already met with medical staff and conveyed my regret for the way in which certain investigations have been handled.

“Mistakes have been made, we’ve acknowledged that but we’re determined to put them right. We’re reviewing our culture and some of our HR processes and thinking about how we can be even more kind and supportive of all our staff but especially our hardworking consultants in these challenging times.”

Has he apologised to staff about the issue of being worried to speak out?

Dr Dunn said he apologised ‘around the difficult internal investigation that has not been handled well’ relating to requests for handwriting and fingerprint samples to identify a whistle-blower.

“I’ve apologised to all our staff and consultants about the handling of that internal investigation.”

He expressed a commitment to implementing any recommendations from an independent rapid review by NHS England and Improvement (see right).

Dr Dunn said he expected the CQC to re-inspect maternity services in the next few weeks and the ‘requires improvement’ rating would result in more frequent inspections. The NHS staff survey, conducted during the inspection, would also contain ‘important feedback to act upon’.

He added: “I would like us to deliver improvements as quickly as we can and continue to provide as good local services for local people as we can do.”

Whistle-blowing issues

Rumblings of West Suffolk Hospital’s fall from grace began late last year when The Guardian detailed complaints by doctors of alleged harassment over efforts by the hospital’s trust to identify a whistle-blower.

The issue of whistle-blowing and the way some staff felt they were treated has been highlighted by the CQC.

CQC’s findings

The CQC said it received 10 whistle-blowing concerns between September 2018 and September 2019, five of which were received in the three months leading up to last year’s inspection.

Several of the whistle-blowing concerns included ‘factors around poor engagement, communication and leadership’.

There was a ‘growing disconnect between the executive team and several clinical specialities which had impacted on consultant involvement with the running of services’.

The CQC noted: “Six of the 10 whistle-blower contacts we received between September 2018 and September 2019 raised concerns that there was an apparent reluctance by the senior executive team to hear and accept feedback of a negative nature.

“We heard examples from staff that information they had provided in confidence, to various individuals including the FTSU (Freedom to Speak Up) guardian, had become known.”

A complex serious incident investigation was ongoing during the inspection and, while internal HR processes were adhered to, some staff ‘felt the actions undertaken by the trust were questionable in purpose’.

Communications sent during the investigation were seen by some staff as ‘quite threatening in nature with a focus for apportioning blame’.

A meeting was held to address concerns but a subsequent letter to the medical staffing committee chair ‘could be considered intimidating, and confirmed the continued disconnect around communication’.

Trust response

Chair Sheila Childerhouse said: “Although inspectors reflected that we ‘promoted an open culture’ and had ‘visible and approachable’ leaders, it is clear that in some areas our staff are not feeling as supported as they should be. We appreciate and value our staff and know their knowledge and expertise will be at the heart of addressing some of the problems the CQC has identified.

“We will be reviewing our culture and openness to make sure there is an environment where everyone – including our patients, our staff and our commissioners – has an opportunity to contribute and play a full part in our improvement.”

She added they were ‘immensely proud’ of the work of staff and they ‘will make the improvements required’.