Ruthless WUTH

Whilst Frank Field continues his relentless pursuit of headlines as an Independent Labour MP it was inevitable that he would revisit the issue of nurses being charged to park at local hospitals especially as he had a bit of time on his hands from not publicly supporting the Cammell Laird strike. Read more:  MP’s message for hospital boss: ‘What are you doing about parking for our nurses?’

We can get with the campaign to stop nurses being charged for parking (why is this even still a thing?) but might we suggest there are more pressing cultural issues that Field may want to discuss with  WUTH’s latest CEO Janelle Holmes.

You may remember that we reported the appointment of Sir David ‘Diddy’ Henshaw as the interim Chair of WUTH  in our reports Marmalizing the Bullies : St Frank or Sir Diddy?  and WUTH – Carr Crash OUT, Sir Diddy IN

After receiving the following  tip off last month we were anticipating that the  new Chairman of Wirral University Teaching Hospital (WUTH) would have been announced by now

Sirs
I write to let you know:
WUTH will interview and appoint its next chairman “by the end of this month”
There is only one applicant; despite advertisement in The Sunday Times & elsewhere; Sir David Henshaw
2 points arise:
If there is no University of Wirral – how can there be a Wirral University teaching hospital ?

Will god continue to help and save us all in the face of this abomination?

To recap you may also recall that on 21/12/2017 Health Service Journal published “Trust Directors blew the whistle over chief executive”, containing excerpts from the record of the minutes of a meeting held with National Health Service Improvement (NHSI) North medical director Vince Connelly.
WUTH Executive Directors Susan Gilby, David Jago and Janelle Holmes raised concerns with CEO David Allison – precipitating his resignation, followed by Michael  Carr with Dr Gilby leaving soon after in unusual circumstances to be Medical Director of Chester /CEO.
NHS England investigated the complaints and found there to be no substance to any of them in a report titled Investigation Report of NHS Improvement re: Wirral University Teaching Hospital NHS Foundation Trust – Issues Arising from Senior Staff Concerns Reported in Late 2017.

So having helped create a CEO vacancy and despite concerns about allegations of bullying Holmes then applied for the post. A WUTH insider tells us that whilst the WUTH website [at that time] said that Holmes as  Chief Operating Officer had a “focus of improving patient quality and safety” apparently nothing annoyed her more than when senior medical staff highlighted clinical risks or incidents. Those staff then found themselves subject to the type of processes uncovered by a Freedom of Information request published by Wirral Leaks. Our source tells us :

Executives use ‘Maintaining High Professional Standards’ (MHPS) as a disciplinary measure and try to say individual has ‘volunteered’. You may not know but at this time WUTH was invoking those processes on at least 3% of senior medical staff – this rate is about 40 times national average.

11 of 234 is very nearly 5% of the consultant staff 1 in 20 – none were picked up by appraisal process.10 of consultants left unexpectedly in same timeframe…It’s bullying.These processes include absolute confidentiality so consultants who manage to keep their job also know to keep schtum about Janelle Holmes.10% of consultants left in a hurry during this time.

 

Page 131 of the following document provides details of 11 of the 234 senior medical staff at the Trust who were subject to  an MHPS investigation. https://www.wuth.nhs.uk/media/10550/public-board-of-directors-28112018.pdf

Consequently concerns were raised about the possibility that Janelle Holmes might get the CEO job – and several directors and Non Executive Directors were formally put on notice that she was not a ‘fit and proper person’ to hold any director position – these same people were on her interview panel.
Luckily for Holmes so was Sir David Henshaw and her old boss at Salford Sir David Dalton.
The result was not announced because WUTH Council of Governors declined to ratify it. Staff groups made representation to The Governors with clinicians  submitting this letter :

Discussed several concerns
The advert for the position specified a preference for an experienced CEO [this was not JH]
One of the candidates has been identified in press leaks as one of three executives acting against the previous post-holder of CEO……we would be concerned about the apparent probity of appointing a candidate identified as seeking the investigation and termination of the previous post-holder.
Thirdly, the Trust is expecting a CQC report on, among other things, how well led the organisation is under the recent leadership. We would counsel a delay in any ratification of appointment of any current executive manager to CEO until July’s report is available.
We are concerned that promotion of a current executive board member under this level of uncertainty involves the Trust in unnecessary risk.We were disappointed that there was not any apparent clinical involvement in the appointment, beyond the legal minimum.
After recent consultant staff surveys highlighted a closed culture and lack of clinical involvement, we find this process unfortunate.
We would be grateful if you might raise these concerns with your fellow governors and the chairman at the meeting of 20th June, and have no concerns with your sharing this letter with them.

We understand Sir David ‘Diddy’ Henshaw attended The Council of Governors meeting on 20/6/18 and explained to them that they were simply too late in raising any objection and were doing so through the wrong channels.
It is anticipated that Janelle Holmes may not be or was not on Sir Diddy’s appointment board – as he is the only candidate this probably isn’t necessary.
Nor will any clinician – given how Sir Diddy acted with another high profile whistleblower  – https://www.dailymail.co.uk/news/article-2293567/This-brilliant-surgeon-work-NHS-Is-blew-whistle-child-deaths-leading-hospital.html – it is doubtful they would be so unwise as to say anything…

Wirral University Teaching Hospital – Leaks to Cascade

 

 

Lessons have been learned ? – A Wirral Leaks picture from our January 2014 story GREEN LEAVES would suggest not. If leaked documents had not been sent to Health Service Journal would bullying and management concerns ever been made public?

Leaked email from Wirral’s largest employer which appears to confirm that it suffering from the same toxic culture that afflicts Wirral’s second largest employer. The media exposure referred to are articles published in Health Service Journal and not the local press.

From: Communications (Wirral University Teaching Hospital NHS Foundation Trust) Sent: 12 January 2018 17:05 Subject: FOR INFORMATION: Health Service Journal (HSJ) media exposure Message sent on behalf of Dr Susan Gilby, Medical Director Please cascade to those not on NHS Mail Dear Colleagues, As my executive colleague, David Jago highlighted in his global communication today (issued at 13:12), I would like to further update you on likely media exposure following this matter. Many of you keep up-to-date on social media and via the local press, however for those that do not, I felt it was only right to share with you an article that has today (Friday) appeared on Twitter and online in the Health Service Journal (HSJ). Upon joining the Trust early last year as Medical Director, I requested that a medical staff engagement survey was carried out as I felt there was a widespread perception of ‘disconnect’ between management and medical staff. As a result of my early observations, it was clear that this benchmarking exercise, with a strong evidence base, would enable the Board to support a strategy for cultural change within the organisation. On behalf of the Executive team, I would like to say that the Trust is extremely grateful to staff that have raised concerns and we deeply regret any failures to identify and effectively deal with some of these highlighted attitudes and behaviours that this survey has uncovered. It is my intention to now plan and commission an external cultural change programme which will help address the root causes of unacceptable behaviours and embed the positive behaviours that staff would expect to consistently exhibit and witness. In the spirit of openness and transparency, I will keep you all fully informed on its progress and will feedback its findings later in the year. For colleagues not on social media, or who do not follow the press, I have placed below the full HSJ article in order to prevent rumour and inaccuracy. I would like to take this opportunity to thank colleagues for showing great and ongoing understanding to the Executive and Senior team during this period of challenge and I look forward to working with you all on our journey towards quality improvement. Kind regards, Dr Susan Gilby Medical Director HSJ article published 12/01/2018: Leaked documents reveal bullying and management concerns at trust Wirral University Teaching Hospital Foundation Trust  doctors reported high levels of bullying and “disconnect” from management, according to documents leaked to HSJ. They resonate with serious concerns raised about management and culture at the trust that were reported by several of the trust’s executive directors to regulators, and revealed by HSJ, last month. Documents seen by HSJ also allege former chief executive David Allison, who left suddenly in December, dismissed a proposal to appoint clinical leaders, saying it would happen “over my dead body”. Trust medical director Susan Gilby raised the results of a first medical staff engagement survey at a private board meeting in summer last year. The survey reported “a continuing widespread perception of ‘disconnect’ between management and medical staff”. Results of a second survey of 95 doctors, carried out in March 2017 and also leaked to HSJ, revealed 43 per cent of respondents said they had experienced harassment, bullying or abuse in the previous 12 months. A report on the findings said “most of [this] was from managers”. Only a third of doctors in this survey said they felt able to make improvements happen in their area of work. Changes suggested by doctors included improving culture and behaviours of managers towards doctors. Minutes of three trust executives’ meeting with NHS Improvement in November show they raised the survey and told the regulator they “felt the organisation had a culture that prohibits raising concerns as there was a lack of transparency and honesty when difficult issues are raised”. The same minutes said: “One example cited [of poor culture] was the recent poor results from the medical engagement scale which in the view of the MES team were extremely poor. “The [medical director] raised this with the CEO and chair [Michael Carr] and at private board but did not receive support from the CEO to address the concerns. “He was heard to say to the company secretary that the doctors would be leads of their services ‘over my dead body’. The minutes of the private board meeting discussion on this topic did not adequately reflect the discussion. “In the pre-meet before the subsequent [public] board meeting the MD was told by the CEO not to go into detail in addressing the required amendments [to minutes of the private board].” According to the survey results of more than 100 doctors, the trust scored among the lowest for medical engagement of 110 NHS trusts with which it was compared. The report on the second survey, passed to HSJ by a member of staff, concluded: “The views of medical staff in Wirral University Teaching Hospital Foundation Trust suggest a general perception of very low levels of medical engagement compared to the medical engagement norms for NHS trusts.” It pointed out that the trust’s results had deteriorated from an earlier survey in 2012 warning: “Medical engagement is not significantly improving and in some areas appears to be getting worse. The results suggest a continuing widespread perception of ‘disconnect’ between management and medical staff characterised by insufficient contact and authentic communication.” The report states that, comparing the 2017 to 2012 results, the survey showed a 29 per cent decrease in staff feeling they were involved in decision making and a 21 per cent fall in staff feeling valued and empowered. The report said there was a “consistent divide” between managers and doctors with 63 per cent of managers saying they work closely with doctors compared to just 12 per cent of medical staff. In total, 70 per cent of managers agreed that senior management actively encouraged innovative thinking by medical staff compared with just 7 per cent of doctors. Only 13 per cent of medical staff said they could trust non-medical managers to take their opinions on board. The report said: “Clearly, many members of medical staff feel that there is little opportunity to talk freely with management about future plans and consequently their ideas and opinions are either not taken seriously or simply ignored by management staff… “The results reveal a consistent tendency for managers to overestimate medical engagement and this over-optimistic perception may well indicate that managers are far from fully aware of the working challenges that medical staff face, and do not take the medical engagement as seriously as they might.” In a statement to HSJ, Susan Gilby, the trust’s medical director, said: “As a result of my early observations upon joining the trust last year, a survey around clinical leadership and collaborative working was commissioned. It was felt that this benchmarking exercise, with a strong evidence base, would enable the board to support a strategy for cultural change within the organisation. “The trust is hugely grateful to staff that have raised concerns around bullying and harassment and we deeply regret any failures to identify and effectively deal with some of these highlighted attitudes and behaviours. “As an executive team, we wish to make it clear that there is no place for such attitudes and behaviours in the trust and we can only apologise to staff that may have experienced this culture.” She said the trust now planned to commission an external cultural change programme to help address “the root causes of unacceptable behaviours and to embed the positive behaviours that staff would expect to consistently exhibit and witness”. NHS Improvement has previously said it will launch an investigation into the concerns raised about the trust.