Staff at a hospital trust being investigated over baby deaths say there is a “culture of bullying and harassment”, a report has revealed.
Shrewsbury and Telford Hospital Trust (SaTH), which is already in special measures, has now been rated inadequate by the Care Quality Commission (CQC).
Emergency and maternity services at its two hospitals were deemed unsafe.
Trust chief executive Simon Wright said: “You cannot be unaffected by a report like this.”
The 112-page report, published on Thursday, lists a catalogue of issues at the Royal Shrewsbury Hospital and Princess Royal Hospital in Telford, Shropshire. The trust was previously rated as “requires improvement” overall.
The trust is currently being investigated over alleged maternity failings, with more than 200 families raising concerns about care at the trust.
- Baby death review: What do we know?
It recently abandoned a plan to close Telford’s A&E department at night because of a shortage of doctors, drafting in extra staff instead.
Inspectors also said as well as the bullying and harassment claims they “found a culture of defensiveness from the executive team”.
The report said staff felt they were not listened to and were sometimes fearful to raise concerns or issues, there was low morale among staff and high levels of stress and work overload.
A former nurse previously told the BBC of a “bullying, intimidatory culture” at the trust, with junior staff frightened to raise concerns or questions for fear of being labelled troublemakers.
Inspectors also found:
- Medical care, surgery, critical care, end of life at both sites require improvement
- Medical and nurse staffing “was not adequate to keep patients safe” particularly at Telford
- Staff did not feel valued, supported or appreciated by senior staff
The CQC’s report said inspectors were “particularly concerned” about the trust’s emergency department and maternity services.
A temporary midwife-led unit at Shrewsbury being used after its original building was damaged by snowfall last December was deemed “unfit for purpose” with senior staff “crisis-managing”.
There has also been a shortage of midwives due to sickness and maternity leave, inspectors found.
The CQC has given the trust a raft of improvements to make, listing 81 issues that needed to be tackled, including ensuring staff are trained to protect patients from harm, and reviewing midwife staffing levels to keep women and babies safe.
It said the trust should also improve how it escalates cases of women at high risk at the midwifery-led unit or day assessment unit and review its policy on reduced foetal movements for midwives and sonographers.
Other required improvements covered the maintenance of safe environments, speeding up complaints handling, the secure storage of medicines and records and the administering of antibiotics for patients with suspected sepsis.
However, inspectors rated the trust as “good” for being caring and said they did find “examples of outstanding practice in end of life care services at both sites” as well as in its postnatal maternity care.
The trust said some of the CQC concerns had been addressed through recruitment and improved reporting by its maternity services.
By Michael Buchanan, BBC social affairs correspondent
This damning report will be an awful read for the families who have lost babies as a result of errors by this trust.
Speak to any of them, and their fervent wish is that nobody has to go through the same experience as they did.
The continuing inability of the trust, therefore, to ensure heart rates are properly monitored and the failure to learn lessons after incidents, smacks of a callous arrogance towards those families.
Fundamentally this is a trust that has been badly led for years.
Today’s report is stark in its denunciation of the current management – not all of them have the “right skills and abilities” to provide “high-quality sustainable care”.
Chief executive Simon Wright insists he is not out of his depth, but under his watch the trust has demonstrably deteriorated.
The recently appointed chairman said on Wednesday that they “can’t carry on doing the same things with the same people”.
The growing chorus in Shropshire for Mr Wright to resign will certainly hope so.
Prof Ted Baker, chief inspector of hospitals at the CQC, said: “While we found staff to be caring and dedicated, there is clearly much work needed at the trust to ensure care is delivered in a way that ensures people are safe.
“We remain particularly concerned about the emergency department and maternity services at Shrewsbury and Telford Hospital NHS Trust.
“We have already taken urgent action to protect people and we are monitoring the trust extremely closely.”
Chief executive Mr Wright apologised and said the trust was “disappointed that we have not made as much progress to tackle the issues and challenges that the Trust faces as we all want”.
“But people should not lose sight of many things that SaTH does not just well but significantly better than many other trusts around the country.”
An independent review into a series of baby deaths at the trust was commissioned by the government last year.
Previously, an estimated 3,000 people marched in protest over SaTH’s plan to close A&E at The Princess Royal at night, with the trust citing staff shortages for its decision.