Inquiry launched into Liverpool Community Health failures

Close up district nurse at workImage copyright Getty Images
Image caption Liverpool Community Health provided services such as district nursing, dentistry and diabetes care

An independent inquiry has been launched into the running of a failed NHS trust – amid concerns 150 deaths were not properly investigated.

Liverpool Community Health (LCH), formed in 2010, ran services for about 750,000 people on Merseyside until 2018.

The inquiry will look into “historic incidents of serious harm” and 17,000 cases related to patient safety.

Health minister Stephen Hammond said families deserved answers.

The trust previously apologised to patients, families and staff.

The new inquiry will be overseen by a panel led by Bill Kirkup, who led a 2018 investigation into the trust, as well as a review into the Morecambe Bay scandal at Furness General Hospital.

LCH’s successor, Mersey Care NHS Foundation Trust, said it had held an initial review into 150 deaths where the “standard of investigation” was unsatisfactory.

Mr Hammond said: “We owe it to the patients and families affected by substandard care in LCH to establish the full extent of events and give them the answers they need.”

What was Liverpool Community Health?

LCH was set up in 2010 to provide services such as district nursing, dentistry and diabetes care.

It ran healthcare services at Liverpool Prison between 2011 and 2015.

The trust stopped running healthcare services in 2018 after criticism from regulators and a report commissioned by itself.

LCH no longer exists, with most of its services now run by Mersey Care.

What went wrong?

Image caption Dr Bill Kirkup’s 2018 review of the trust’s management found it was “dysfunctional from the outset”

A March 2016 review by law firm Capsticks, which was requested by the trust, found an “oppressive” culture led to poor services, bullying of staff and may even have contributed to some deaths.

The review highlighted “failures at multiple levels” and revealed one man suffering from lung cancer was not diagnosed for four months.

It said the trust also failed to fully investigate an attack on a health worker taken “hostage” and seriously assaulted by a patient’s relative in 2013.

The 2018 Kirkup review found LCH was “dysfunctional from the outset” and patients suffered harm because the senior leadership team was “out of its depth”.

Dr Kirkup’s review said many of the problems stemmed from the trust embarking on a major cost-cutting programme after its formation in a failed effort to become a foundation trust, which would have allowed greater freedom from regulators.

Mersey Care chief executive David Rafferty said its initial review uncovered a “disturbing picture” of the way LCH had recorded incidents.

The trust’s medical director David Fearnley added that “flawed” recording meant it was “likely that avoidable harm occurred because the learning that could have been in place wasn’t in place”.

What action has been taken so far?

Image copyright Nugent
Image caption Bernie Cuthel is now on the governing body of a Liverpool-based charity

A 2014 Care Quality Commission (CQC) report found significant problems at the trust, prompting the resignation of top executives.

They included former chief executive Bernie Cuthel, who was helped to find a 12-month secondment in a new role at Manchester Mental Health and Social Care Trust by NHS regulator, the Trust Delivery Authority (TDA).

Emails seen by the BBC said the TDA believed the role “would provide Ms Cuthel with a period of rehabilitation, enabling her to reflect on learning from her experiences in Liverpool”.

Four former members of LCH staff are also facing fitness to practice hearings at the Nursing and Midwifery Council. They began in May and are due to last 14 weeks.

They include former director of nursing Helen Lockett, who was suspended in 2016.

What happens now?

Image copyright PA
Image caption Rosie Cooper MP said families and staff needed “certainty and stability”

The Department of Health and Social Care’s investigation will focus on serious incidents at the trust between 2010 and 2014.

It will “draw upon fresh evidence” from the Kirkup report and speak to families of former patients and staff to identify individual patient safety failings and look into the trust’s handling of deaths.

The review will “determine the scale of patient harm” and make recommendations to NHS trusts nationally.

Mr Rafferty said more serious cases would be “reviewed properly” and families of some patients would be informed once the inquiry was set up.

West Lancashire MP Rosie Cooper, who called for the 2014 CQC report, said: “It is important that those responsible are held to account.

“Patients and staff of LCH need certainty, stability and assurances that the harm caused by past failings will not be repeated.”

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