Wirral University Teaching Hospital – Leaks to Cascade

 

 

APH-NO-EVOL

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.

 

Advent Farewell 22 : WUTH – less this Christmas

There’s been a strangely muted response in the local press to the ‘stepping down’  of Wirral University Teaching Hospital Foundation (WUTH) Foundation Trust CEO David Allison . Allison doesn’t even get a namecheck in the Wirral Globe headline about his sudden departure. The story is somehow spun that it’s ‘All About Frank’ and the Birkenhead MP’s support for the Globe’s petition to get the current car parking charges for nurses changed – which is much like his ‘starving mites’ schtick. No right thinking person thinks nurses should be paying such high car parking charges just as they wouldn’t want children to go hungry. Here’s the Globe’s take : Tank Top Frank

We were given the heads up that Allison was heading for the exit with indecent haste by the following message :

David Allison – taken the money now running

Along with his useless Director of Workforce (replaced the useless Sue Green – yes – married to the useless David Green) James Mawrey – same job just a different title so her role could be made redundant and she could a massive pay-off…..

I dread to think what incompetent fiickwitts will follow in their steads

BTW – don’t give up – please!

However for us to get a fuller picture of what’s been going on we had to go to campaigning journalist Shaun Lintern who writes in the Health Service Journal :

WUTH

The concerns recorded in the document include:

  • NHSI was told the board “was not functioning as a unitary board . Pre-meets are carefully managed and concerns suppressed . It is felt that the CEO has a lack of grip on the issues facing the organisation and was not paying attention to quality indicators . The CEO responds to quality concerns with dismay and aggression. There is a concern that some key data and supportive narrative may be being carefully managed
  • NHSI was told executives have been instructed not to involve non-executive directors in any initiatives or issues in their portfolios without going through the chair
  • The executives ” felt the organisation had a culture that prohibits raising concerns as there was a lack of transparency and honesty when difficult issues were raised. this translated into a lack of visibility of quality and safety and reluctance to escalate concerns”
  • NHSI was told ” senior colleagues were moved out of the organisation very quickly with no obvious explanation .. They felt that this was related to a reluctance to escalate concerns and inability to accept appropriate challenge”
  • Consultants at the trust were said to be ” reluctant to take on senior leadership roles as history showed that they may (be) subject to investigations (and/or) intimidation if things did not work out”

Well fancy that! Were WUTH and Wirral Council separated at birth?

None of these allegations come as a surprise to us as we’ve long received similar allegations (see below), often sadly from whistleblowers who were subject to a culture of fear even more virulent than Wirral Council and therefore less willing to go public. We think it is significant that it was senior managers who blew the whistle because we’d like to suggest that there are WUTH staff further down the pecking order (and with considerably less influence and power) who have tales to tell about the trust’s toxic culture.

Indeed here we have some scary stats courtesy of NHS whistleblower and campaigner Minh Alexander which details whistleblowing contacts 2015-17 with useless health and social care regulator the Care Quality Commission (CQC) 

MINH whistleblowing

Home

Talking of useless regulators who are seemingly unwilling to accept that there was an increasingly worrying governance and culture problem brewing at WUTH we are also aware that Monitor were involved in a complaint about the highly questionable removal of a WUTH Governor in 2014 which had the hallmarks of a ‘kangaroo court’. They lamely concluded “…….we expect the Trust to explain departure from the Code of Governance in its annual report. However in the absence of further or new information , we will not be taking any further action over the above matters”  

The history of this case is worthy of a post of its own but might we suggest it would be more instructive for this particular former Governor to contact NHS Improvement to tell them of their experience.

We’ve trawled our other leaks to discover similar allegations to those mentioned above about WUTH . The first of which we publish in the interest of balance to the comment made above :

For the record, Sue Green, HR Director, left the Trust a few months after my removal. Wirralleaks reported on the circumstances of her leaving at the time. She had been suspended for disciplinary reasons but later cleared. During her suspension, the post of HR Director was dispensed with and she was made redundant. My experience of her was that she was an honest, conscientious and efficient professional who got on well with those she had contact with and was a loss to the Trust. Apparently, she did not fit in with the new culture of the Trust since the recent appointment of the new CEO, David Allison. 

And here’s another:

Michael Carr is the CEO’s puppet and has been given two extensions to his contract by governors for exceptional reasons (don’t know what reasons are but they will have been invented by Allison) after he had completed two periods of three years, which is the norm for an NHS FT Chairman. Allison wants him in post because he does not cause any problems for him. He is very compliant!

Suddenly doesn’t the chaos , disarray, low morale and lack of beds that we frequently hear about Arrowe Park Hospital make tragic sense when we get a peak at what goes on behind the scenes and how the place is seemingly (mis)managed?

However just to finish on a lighter , reassuring note like they do on News at Ten isn’t Orlando Agrippa simply the best name ever ?!