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Mental health trust rated inadequate for third time

Charity says troubled Norfolk and Suffolk Foundation Trust is too big

Mark Gould

Wednesday, 28 November 2018

The Care Quality Commission (CQC) has rated England's worst performing mental health trust inadequate for a third time. Previous reports have found that Norfolk and Suffolk NHS Foundation Trust (NSFT) had unsafe acute wards and was seriously understaffed. The trust was rated Inadequate overall and placed into special measures following CQC inspection in July 2017. On their return, between 3 and 27 September this year, inspectors found the trust had failed to make significant improvements. As a result, CQC is recommending the trust remains in special measures.

The CQC said senior staff repeatedly failed to protect patients. Inspectors found patients left unsupervised in segregation, a high proportion of urgent referrals downgraded unsafely and that unfilled shifts led to 139 incidents in six months. However, adolescent and child mental health wards were rated outstanding.

NSFT is the only mental health trust in the country to have been put into special measures, a step first taken in February 2015. The trust came out of special measures in October 2016, only to have that status imposed again a year later.

NSFT was rated inadequate in the areas of safety, management and response. It required improvement over the effectiveness of its services but was found to be good at being compassionate in its care for patients.

Paul Farmer, the chief executive of the mental health charity Mind, said: "When a trust fails and then fails again, you have to ask questions about what action needs to be taken to change that."

He said that the trust, covering the vast majority of East Anglia, was too big and options available to a health secretary included having parts of the service taken over by another mental health trust.

Labour MP Clive Lewis, whose constituency is in Norwich, said the safety risks and problems at the trust had been known about since at least 2014.

"This has become a national disgrace. We are looking at a national and local system-wide failure of governance, commissioning, regulation and inspection," he said.

"Unless we change course, I know exactly what's coming next. Senior trust board members will mouth the same platitudes about lessons being learnt and plans for change - even though those same people have long track records of failure in various parts of the local NHS."

Mr Lewis said the CQC had "the power to put the trust into Special Administration and get rid of this board".

And Lib Dem MP Norman Lamb, who was a health minister in the coalition government and whose constituency is also in Norfolk, said it was "totally intolerable for families and individuals affected".

The CQC's lead for mental health, Dr Paul Lelliott, said: "Managers have not ensured that when things go wrong, they learn and share lessons to reduce the likelihood of the same thing happening again."

He said issues first raised in 2014 had still not been fully addressed. "The trust leadership team has not taken action at the pace required to bring about sustained improvement and to resolve failings in safety," he said.

The CQC has asked NHS Improvement to support the trust to make immediate changes to keep patients safe, and would be monitoring.

Antek Lejk, NSFT's chief executive, said: "Our priorities now will be to resolve ongoing issues around access to services, waiting lists, care planning and staffing levels, while also making sure we have the right systems in place to ensure patient safety at all times."

A Department of Health and Social Care spokesperson said: "NHS Improvement is providing intensive support to Norfolk and Suffolk NHS Foundation Trust to improve patient safety and deliver sustainable improvements. The situation is being monitored closely and we expect to see progress made in the coming weeks."

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