Fears over morale as hospital boss admits 'our systems have let people down'

By Jonathan Humphries

The NHS has faced possibly the most difficult 18 months since it was created and now managers fear a collapse in the morale of overworked staff.

Liverpool University Hospitals NHS Foundation Trust, which runs the Royal Liverpool Hospital, Aintree Hospital and Broadgreen Hospital, is seeking to find ways to stop the drain of nurses, clinicians, and non-medical staff.

While morale has undoubtedly been hammered by the intense strain caused by covid, as it has across the NHS nationally, the Royal has also been struggling with the pre-pandemic delays in moving to its new home.

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The ECHO also recently reported how some staff at the Royal felt not enough protection was in place after a doctor's nose was broken and a health care assistant was struck with a metal pole during separate assaults by patients within the space of 24 hours in the A&E department.

Concerns have also been raised by newly installed interim chief executive, Sir David Dalton, over an imminent inspection report expected to be damning of the hospital's Accident and Emergency Department.

Although the report, from healthcare watchdog the Care Quality Commission (CQC), has not been published yet, the CQC issued an immediate Section 31 notice after the inspection in July - meaning the trust had to make immediate improvements.

In a report to fellow board members, Sir David said: "Following their Core Services, Well-led and Use of Resources inspection in July, the CQC issued the Trust with a Section 31 notice.

"They had identified patient safety concerns within our Emergency Department. Publication of the final inspection report is expected in October.

"We understand that this will be a challenging report for the Trust.

"As I have set out to colleagues though it is systems and processes that have let people down not individuals.

"Consistently the CQC has acknowledged how caring staff are.

"We now need to provide the assurance required that our systems and processes will support staff to provide high standards of care reliably."

According to a briefing to staff, the CQC's fears were "predominantly focused on timely access and flow through the emergency department and the impact on patient safety/quality/experience."

The trust reports there has been a deterioration in patient experience in A&E with a reduction in satisfaction levels.

Two specific risks relate to the Trust’s ability to meet the national four-hour target for patients to be seen and the 12 hour target for patients to remain in the department.

With the scathing report imminent, Sir David also raised concerns about staff turnover, describing too many new starters leaving the trust within the first 12 month on the job and a "high percentage" of staff stating in exit interviews that they would not return to work for the trust.

He said: "Staff are still feeling under pressure and are concerned about the frequency of being moved to cover other areas."

Debbie Herring, Chief People Officer at Liverpool University Hospitals NHS Foundation Trust, said: “We are hugely appreciative of the hard work, commitment and dedication of our staff working through what has been the most challenging period in the history of the NHS.

"We provide a range of health and wellbeing services and we regularly engage with staff to look for ways we can improve their experience at work. We are committed to creating a safe environment and we take a zero-tolerance approach to any abuse or aggression towards our staff and patients.”

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