Friday brief: Report finds ‘unhealthy culture’ within Kettering hospital’s children’s ward
Report finds ‘stress, negativity, and dysfunction’ became the norm at KGH, plus Reform UK administration takes charge at the North unitary and major incident declared as fire breaks out
Kettering General Hospital’s ‘perceived’ workforce shortages and inexperienced staff are creating a ‘very serious risk’ of increasing the numbers of sick children dying, an independent report has warned.
An ‘us and them’ culture between KGH departments caring for ill children which is at times ‘combative’ has been operating according to independent reviewer Ibex Gale, which was commissioned by the hospital to carry out a patient safety review after concerns were raised by parents and staff.
The report, which is based on findings from November to this February, concluded that ‘stress, negativity and dysfunction’ have become the norm within the children’s departments; staff felt demand was ‘immense’ and that among the staff there was a perception of ‘long term dysfunction’ within the consultant paediatrician team.
Problems within the hospital have been long known. In December 2022 the hospital’s services for children and young people was rated as inadequate after an unannounced inspection by the Care Quality Commission. This was removed and the service was rated as requiring improvement in May 2024. Last November Northamptonshire’s coroner ruled that neglect had contributed to the death of Market Harborough teenager Chloe Longster, who died from sepsis at the hospital in November 2022.
The report, which was presented to the University Hospitals of Northamptonshire (UHN) Board earlier this month, looked at workforce, service demand, lack of collaboration and leadership.
The board, which is chaired by former M&S director Andrew Moore, says it will accept Ibex Gale’s 47 recommendations in full. The hospital told NN Journal today that improvements are underway.
The report made a number of concerning findings, including:
Ultimately, the perceived staff shortages and the concerns raised regarding the inadequacy of Agency/Trust Adult nurses’ paediatric skills and experience create a very serious risk of increased mortality and morbidity for patients.
The ability of teams to work collaboratively together for the Service is inhibited by a ‘them and us’ culture that has developed between PED (paediatric emergency department) and Skylark (a children’s ward). Additionally, the actions of the Clinical Site Management Team and demand for delivery of elective interventions also perpetuate feelings of clinicians feeling that they are not valued or respected.
The impact of individual teams and a disjointed service culture, all of which have low psychological safety are also impacting the ability to strategically and effectively plan demand and service surges, due to staff feeling reluctant to put forward ideas, offer suggestions or have challenging conversations.
Overall, these issues relate to the ‘immense service pressures’ which we were advised exist across the PED and Skylark/PAU and that not only have the Services experienced an increase in the number of patients, but it is also the perception of many staff that there has been an increase in the level of patient acuity in recent years, and the Trust has not matched this increase in demand with sufficient resources.
Difficult working relationships were identified between medical and nursing teams in both CED [emergency department] and Skylark. Poor collaboration between the two services was highlighted as negatively impacting patient safety and operational effectiveness. Specific issues included delayed admissions and transfers, suboptimal handovers, and a lack of shared ownership of patient care.
Although many ‘new’ leaders have been positively received, leadership generally across the teams is seen as not visible, present, understanding and helping those they lead. Leaders do not consistently appear to hold staff to account for their actions and behaviours which has the impact of those leaders being perceived as tolerating unacceptable behaviours.
The recommendations are extensive and include: reviewing staff sickness levels; ensuring staff flag concerns about behaviour; looking at why staff are leaving; creating escalation plans for when the department is at capacity and increasing leadership visibility with a ‘back to the floor’ initiative.
UHN’s chief Nurse Julie Hogg said:
“We are committed to creating the best service possible for our patients, families, and colleagues.
“As part of our improvement work we commissioned a review to look into how we could improve our culture within the service to have a positive impact on patient safety.
“The report identified a number of areas that we need to improve, and our new Children and Young Person’s leadership team is focusing on working with colleagues, and listening to our patients, to make and embed the changes swiftly and effectively.
“We have accepted all of the recommendations made the external company we employed to do this and the recommendations will inform a comprehensive improvement plan.
“This plan will be tracked through governance structures and reported publicly to ensure transparency and accountability.
“I would like to thank colleagues for supporting the review, and for their work so far to improve the care we deliver.”
The hospital says improvements underway include: monthly training to improve collaboration; ‘listening events’; away days; plans for a ‘meet the matrons’ clinic where parents can access senior staff; twice daily safety meetings and checks to discover whether children are seen in a timely manner. The hospital is also carrying out a review of all existing systems.
UHN was established in July 2021, with the merging of Northamptonshire’s two hospitals into one trust with one board. Since then the standards within Kettering children’s services have remained below the expected standards and there has been a significant turn over within senior management. Richard Mitchell is the overarching chief executive of the group and also oversees three hospitals in Leicester. Deborah Needham was the boss at Kettering General until she departed in June 2024 and now Laura Churchward is the joint chief executive of both Kettering and Northampton hospitals.
News in brief
A major incident has been declared after a large fire has broken out at a recycling warehouse in Rushden.
The fire service says the fire started shortly before 6.30am on the Sanders Lodge industrial estate and crews have been working since then to stop it spreading. All roads on the estate have been closed and gas to the site has been isolated.
Twelve engines, three aerial appliances and a high volume pump have been deployed as well as assistance from Bedfordshire Fire and Rescue Service.
Area Manager Mick Berry, from Northamptonshire Fire and Rescue Service, said:
“This is a large fire that is having a significant impact on the Sanders Lodge industrial estate in Rushden.
“A multi-agency decision has been taken to declare a Major Incident, but fire crews are working extremely hard to prevent the fire from spreading and reduce the smoke plume.
“We would urge people to stay away from the site while emergency services deal with this incident and ask nearby residents to close windows and doors due to the large amount of smoke issuing from the site.
“We anticipate that we will be on scene over the rest of the weekend, and we appreciate the impact this is having on local businesses on the estate and would like to thank them for their patience.”
North Northamptonshire Council (NNC) officially appointed its new Reform UK leader last night, as elected members gathered for their first public meeting since the local elections.
Councillor Martin Griffiths has now taken on control of the unitary authority as its second-ever leader.
Cllr Griffiths told the chamber:
“The overwhelming majority of people put their mark on their ballot paper for Reform. I think it is fair to say on May 1 we witnessed a significant, if not monumental, event- a turning point in politics in the future of this country.
“My fellow councillors and I are absolutely committed to delivering changes for the better. The work we do within our communities is what we should all be judged on and it’s where we can make the most difference to our residents.
“I am keen to help remove what could, at times, feel like a combative environment in the past. I strongly believe we can do more for the people of North Northamptonshire if we work together in a collaborative and constructive way, even when we do not agree.
“We must never forget we are voted for by our residents and we must therefore listen to them as we set our priorities.”
One of the first acts will be a residents’ survey to assess what people think of the services.
The new majority administration demolished the Tories strong grip on the county at the ballot boxes, winning 39 seats and tripling the size of the next largest group.
Green party leader Emily Fedorowycz said that her group would not support “leadership or action that’s dictated by Westminster”.
“We don’t want national figureheads or parties running this council,” she said.
“We want it to be run by the people and represented by us in this room. I very much hope that the national policies don’t have to get in the way of us doing good for our communities.”
Mark Pengelly, who has been appointed as group leader of the four Labour councillors said the public had seen many failures from the previous council, including ’embarrassing’ roads and asked Reform to make a commitment to a full scrutiny review of the Kier highways contract.
A statement from the outgoing Conservative administration, read out on behalf of their new group leader Helen Harrison, said: “It took hard work to get to this point and it will take a lot more hard work to continue that journey of constant improvement.
“Our residents deserve the best and we, the Conservative group, are here to help in any way we can. We will give the executive our full support when we agree with what they are proposing, but when we think mistakes are being made we will argue our case.”
A further two-strong group on the council has been formed between Jim Hakewill (Independent) and Simon Fairhall ( Liberal Democrats ), named the Communities Alliance.
The new executive will be:
Cllr Eddie McDonald, holds responsibility for the Adults and Health Partnerships portfolio.
Cllr Graham Cheatley, Executive Member for Finance, Efficiency and Change
Cllr Ken Harrington, Executive Member for Assets, Waste and Environmental Services
Cllr Elizabeth Wright, Executive Member for Children, Education and Families
Cllr Chris McGiffen, Executive Member for Highways and Travel
Cllr Jan O’Hara, Executive Member for Planning and Economic Growth
Cllr Kirk Harrison, Executive Member for Regulatory Services
Cllr Gregory Wilcox, Executive Member for Communities
Cllr Barry O’Brien, Executive Member for Health and Leisure
Report by Nadia Lincoln
Staunch members (left to right) Iain Scotland, Julia Fletcher and Sharon Cole fought against the appeal as a Rule 6 party. (Image: Nadia Lincoln LDRS)
Plans for a major solar farm in Northamptonshire countryside went to a public hearing this week after developers challenged the council’s refusal.
Wood Lodge Solar Project Limited applied to build the energy facility on 145 acres of farmland by the A14, near Thrapston and Titchmarsh. At the end of last year, North Northamptonshire Council’s (NNC) planning committee threw out the plans against the recommendation of their planning officers.
Government-appointed planning inspector Philip Major is set to make a final decision on whether permission for the energy site should be granted. The Planning Inspectorate started proceedings for its two-day public hearing on Tuesday.
According to the plans, the development would generate up to 49.9 megawatts for a temporary period of 50 years. The applicant said it would create enough energy to power up to 15,000 homes through green energy.
The main reasons for NNC’s refusal were the impact on the landscape and visual amenity, and loss of habitat in the protected area of the Upper Nene Valley.
Campaign group Staunch (Save Titchmarsh and Upper Nene Countryside and Habitat) is fighting the appeal as a Rule 6 party. This happens when a group other than the appellant and local authority has permission to provide evidence to the inspector.
Earlier this year, NNC said it would no longer be giving evidence at the hearing to back its refusal decision. The authority stated that, though it continues to hold “legitimate concerns” in respect of the development, the reasons they gave at committee level would not be sufficient to maintain its refusal at appeal.
Report by Nadia Lincoln
Plans for a new local centre in a residential expansion on Towcester have been submitted to West Northants Council.
Midpoint No.1 Limited has been working alongside Persimmon Homes to deliver a main local centre in Towcester Grange, which will provide a number of shops and amenities to residents. The project benefits from outline planning permission granted in 2015 for up to 2,750 homes along with local centres, employment land and schools.
The site will be on the corner of Redcar Road and Long Morris, directly opposite Marie Weller Primary School. Much of the surrounding area has already been built out as a residential neighbourhood.
According to the plans, the site will offer a large convenience store and six additional commercial units. There will also be a mixture of houses and flats around a central public parking provision.
Members of the public can submit comments on the proposals to WNC until June 10. A decision on the application is set to be made by the authority in July.
Report by Nadia Lincoln
We desperately need to stop burning gas and wood to generate electricity. Solar panels on buildings and solar farms on fields are both essential. Agrivoltaics combines solar farms with food production, but even if it’s just a solar farm it’s better to have 0.6% of our land impacted by solar farms than 100% of our land impacted by extreme weather caused by the climate crisis. Currently solar farms occupy less than 0.1% of the UK’s land. To meet the government’s net zero target, the Climate Change Committee estimates that we will need 70GW of solar by 2035 and 90GW by 2050. That would mean solar farms would at most account for approximately 0.6% of UK land – less than the amount currently occupied by golf courses. The biggest threat to our food security is climate breakdown, not solar farms. The UK Government Food Security Report, published in 2024, says: “The number of undernourished people around the world is increasing. Climate change, nature loss and water insecurity pose significant risks to the ability of global food production to meet demand over the longer term.” Once we’ve built the solar farms that we need we’ll still have 99.4% of land left for farming. https://solarenergyuk.org/wp-content/uploads/2024/06/FactSheet-Solar-Farms-and-Agricultural-Land-2024.pdf