During 2019 the Trust began to investigate concerns which had been raised regarding the urology service. As a result of the initial enquiries, it asked NHS England/Improvement to commission an independent external investigation into the service and the allegations that had been made.
NHS England/Improvement then asked Niche Health and Social Care Consulting to carry out this investigation.
The full Urology investigation report was published on 24 November 2021. The report made it very clear that the Trust and the entire health system had taken significant action over a period of time to tackle various concerns that arose. However, it is also clear that the actions that were taken were not detailed or robust enough to ensure the improvements were sustainable and embedded, and more should have been done.
You can view the full Urology investigation report on NHS England’s website. The Trust’s response to the urology report at the time of the publication can be found on our website.
On 29 June 2023, NHS England published an assurance review summarising progress towards 48 recommendations made in the report, An independent investigation into Urology services at University Hospitals of Morecambe Bay NHS Foundation Trust, first published in November 2021.
The assurance review highlights progress to date along with areas requiring further development.
Key achievements highlighted in the report include:
- Progress has been made in relation to all recommendations
- The team from Niche congratulated the Urology Department on progress to date
- Particular progress has been made in key clinical areas that presented patient safety risks, including:
- Improved professional relationships within the Urology department through a facilitated cultural development programme
- Introduction of a stent register to ensure that stents are removed or replaced within agreed time frames
- Training has also been provided to all Urology medical and nursing staff on fluid balance recording as part of a wider selection of measures focused on nutrition and hydration
- Focus by the Trust on the Mental Capacity Act and ensuring that care is given in line with the best interests of patients who do not have the mental capacity to make decisions for themselves, including those with dementia or learning disabilities.
- Updated policies and procedures for recording consent, along with the trialling of e-consenting across the Trust, including by some Urology consultants
- High levels of compliance in physiological observations and escalation through the National Early Warning Score (NEWS2)
This progress is positive news, but the Trust is clear that it needs to do more. Feedback received from Niche states that the Trust needs to maintain momentum to achieve further improvements. In particular, the review highlights areas for improvement in areas of governance and leadership that we are working to address.
The Trust acknowledges that governance was not good enough in the past and issues raised were not addressed. The priority now is making further progress and ensuring the recommendations are met in a robust and sustainable way. This work will improve the care offered to all patients across the Trust, not just in Urology services.
You can read the full Assurance review on NHS England’s website.