NHS bosses accused of ‘putting politics before patient safety’ as leading hospital struggles to cope with second wave

‘I am utterly demoralised by the catastrophic leadership failure at a national and regional level,’ says Liverpool hospital medical director

An NHS hospital at the epicentre of the coronavirus second wave is facing the threat of action by the care watchdog as it struggles to keep patients safe, The Independent has learned.

Senior NHS bosses in the northwest region have been accused of putting politics ahead of patient safety and not doing enough to help the hospital to cope with the surge in Covid patients in recent weeks.

The Care Quality Commission (CQC) warned the Liverpool University Hospitals Trust on Friday that it could face action after an inspection carried out last week in response to fears raised with the regulator. 

More than 30 per cent of the trust’s beds are occupied by coronavirus patients, with a total of 476 patients in the hospital on Friday. Across the northwest more than 2,660 patients are in hospital with Covid-19, including more than 200 patients on a ventilator.

In a message to his colleagues on Friday, Liverpool University Hospitals (LUH) Trust medical director Tristan Cope warned the hospital had been overwhelmed by coronavirus and standards of care could no longer be maintained. He criticised NHS England and said the trust had been “abandoned” as coronavirus cases surged.

He confirmed the CQC’s intention to take action against the trust but said the regulator had failed to appreciate the pressure staff in the hospital were under.

In the WhatsApp message to doctors, shared with The Independent by multiple sources, Dr Cope, a consultant in anaesthesia and critical care, said: “LUH is now essentially overwhelmed by the demand. We cannot maintain patient flow and usual standards of care. We have put forward a proposal to further reduce elective [planned] activity, but maintaining capacity for the most urgent cases that would suffer from a two-four week delay.

“It is a very sound plan that our divisional teams have worked up. However, NHS England are prevaricating and delaying with the usual request for more detail, more data, etc. It is clear to me that the politics is outweighing the patient safety issues of the acute crisis.

“There has been no meaningful support from the acute cell or NHS England. In fact, they are blocking us from acting in a rational way that would help us to manage the acute pressures.”

He added: “I am utterly demoralised by the catastrophic leadership failure at a national and regional level. I feel I have done everything I can in terms of escalation and lobbying for some courageous and meaningful action, but apparently to no avail, at least so far. Not sure what else I can do.

“At the moment I feel that I have lost all confidence in, and respect for, the regional NHS England team. We have quite literally been abandoned by them and then criticised for failure to cope with unprecedented circumstances. It is a desperately poor show.

“I feel I need to share this with you because similar circumstances may be coming in the direction of some of you.”

Liverpool University Hospitals Trust has been one of the hardest hit NHS trusts in recent weeks and is at the epicentre of the second wave of coronavirus after cases in Merseyside surged in September and October. The trust has reported a total of 700 deaths linked to coronavirus.

Dr Cope, who was appointed medical director in 2019, also revealed the trust had been threatened with enforcement action by the Care Quality Commission in a move which he said failed to appreciate “the extraordinary pressure” his hospital was facing.

He said the trust had received a draft letter from the CQC on Friday threatening enforcement action against the hospital.

Dr Cope said: “They didn’t identify any evidence of patient harm, but a number of low level issues such as documentation of risk assessments not being completed. Also concerns about segregation of Covid and non-Covid patients. None of this is a surprise to us, as our staff are incredibly stretched against the number of patients we have.

“We are effectively running at 100 per cent occupancy in terms of available staffed beds. No recognition of the extraordinary pressure we are working under in the letter.”

His message has been widely shared among NHS leaders in the northwest. One colleague of Dr Cope’s in a different trust said: “NHS England had lost the plot. They just want data dumps. They know it’s a shambles. They don’t know what to do.”

Another senior northwest NHS source added: “The NHS England leadership in the northwest have no credibility.”

Professor Ted Baker, chief inspector of hospitals for the CQC, said: “We carried out a focused inspection of Liverpool University Hospitals Trust on 28-29 October in response to serious concerns shared by staff and members of the public. Where we found evidence of risk we have instructed the trust to take immediate action. We will report on the full findings from the inspection in due course.”

A spokesperson for Liverpool University Hospitals Trust said: “The trust has been working closely with local partners and the regional NHS England team to agree plans that respond to the widely recognised demands on our services with more Covid patients in our hospitals today than at the peak of the first wave.

“Our dedicated and hard-working teams are treating and caring for a higher number of Covid patients alongside delivering Accident and Emergency, and other services whilst maintaining patient safety at the point of care.”

An NHS England spokesperson added: “The NHS in Liverpool is now treating more Covid patients than at the peak of the first wave and the NHS has rightly been doing everything possible to sustain services for other patients too. We have also been providing the trust external clinical support from elsewhere in the region including asking them to introduce asymptomatic staff testing to promote staff and patient safety.”