An open letter from Sir David Dalton, Chief Exec, re Pennine Acute Hospitals NHS Trust's CQC Report

To all colleagues and patients of The Pennine Acute Hospitals NHS Trust,

This week marks the start of a new journey for all of us. A journey that I believe will result in our hospitals and community services becoming safe and reliable – and in time, being amongst the best in the country.

The recent Care Quality Commission (CQC) report that rated Pennine Trust as ‘inadequate’ held up a mirror for us to see what was happening and reflected what many of our staff had been saying: that there were issues relating to staffing pressures, systems which didn’t allow the Board to understand risks experienced on a ward or department, and a culture which began to tolerate inappropriate standards or behaviours. Yet, from my four months in the Trust, I know we have staff who care deeply about the service they want to provide to their patients. I will work with them, together with the leadership team, to steadily make the necessary improvements so that patients can receive reliable, high quality care, whatever the day of the week and whatever the hour of the day.

The issues identified at Pennine could occur in any organisation if allowed to go un-checked. As the Chief Executive of Salford Royal, one of only five Trusts in the country to be rated “outstanding” by the CQC, I will listen to staff and where appropriate, will deploy Salford’s systems and experience to help support staff in Bury, Rochdale, Oldham and North Manchester to deliver the high standards of service which are desired by all.

All the evidence shows that staff are best placed to know what needs to be improved in their ward or department – and so we will introduce a system, tried and tested in Salford, which involves staff and supports them to test their ideas for improvement and where they are shown to work – we will replicate them across a whole hospital. This turns on its head the idea that those in senior managerial positions always know what’s best for patients on a ward, instead it recognises and supports the expertise which front-line staff have.

We have already secured a further £9m to invest in improvement and the signs look good with the recruitment of 90 nurses, 40 midwives and additional doctors for our critical care units and emergency departments. Our improvement journey will then focus on reviewing and resetting safe staffing levels in our wards and departments.
We will be setting clear nursing standards for each of our wards with regular assessment and the publication of the results. We will also be introducing the award winning, nurse-led, bereavement service; and pursuing new patient safety initiatives that tackle issues such as reducing the number of cardiac arrests, and reducing the harm that patients can experience in hospital such as falls, pressure ulcers and infections.

But these improvements cannot be done in isolation; we are already working with our health and social care organisations across Greater Manchester to support us in our efforts, such as improvements in our emergency and maternity departments, and this is great evidence of how our new devolution arrangements are working for the benefit of patients.

I am convinced and optimistic that we will become stronger as a result of the CQC report. I am delighted to have been asked to lead the Pennine Acute Trust on this improvement journey, uniting it with colleagues at Salford Royal, and look forward to reporting the improvements that our staff will have made in the months ahead.

Sir David Dalton
Chief Executive
Pennine Acute and Salford Royal Trusts