Hospital chief Christine Green quits after 'prevailing culture of failure' complaints

The chief executive of a scandal-hit hospital has resigned amid accusations that she presided over a "prevailing culture of failure".

Tameside Hospital NHS Foundation Trust, in Greater Manchester, announced today that Christine Green had "tended her resignation".

It is understood that the decision was agreed with the Trust's board last week but the decision was announced today - the day that three local MPs renewed their calls for her to step down following revelations about poor patient care.

It is also understood that medical director Tariq Mahmood has stepped down but his resignation was agreed in April.

Jonathan Reynolds, Andrew Gwynne and David Heyes, the three MPs whose constituents use Tameside as their main local hospital, issued a joint statement today urging Ms Green to go.

The standard of care delivered at the trust, in particular the poor performance of A&E and the impact that "poor management" is having on the delivery of health services at the hospital, was the key concern for the MPs.

But the hospital said it commissioned the reviews so it could "understand" more about its delivery and an action plan is already in place to address the concerns.

The MPs referred to two reviews of the hospital which detail operational deficiencies in how it delivers health services.

Sir Bruce Keogh's findings into standards of treatment at 14 hospitals, which according to the Guardian newspaper are expected to be highly critical, are also due to be published this month.

In their letter to the Keogh review, the MPs said: "We feel that the only way the prevailing culture of failure at the hospital can be changed is for the trust to explore reviewing its senior management team.

"We do accept that the chair has only been in post for less than two years and we have confidence that he would be able to help carry forward these changes and provide a level of continuity, however we have no confidence that the chief executive would be able to lead this change.

"Only by taking this specific action do we believe that both the staff and the wider public will have their confidence restored in the hospital."

In a joint statement issued today, the MPs said: "We have campaigned for many years to ensure Tameside Hospital delivers the level of care expected of an NHS hospital. These reports reflect our own concerns and the submission made by us to the Keogh review.

"Although the majority of care delivered by the hospital's frontline staff is praised by patients, we have had serious concerns about aspects of care and governance at the hospital for some time now, which the hospital trust are well aware of. We have always stood by our previous statement that new leadership is required.

"It is for these reasons that we all welcomed the review into the delivery of health services at the hospital trust by Sir Bruce Keogh. We believe this process will give us the chance to address the problems Tameside faces.

"There needs to be significant and sustained improvement across several different areas of care and management. We are confident this can be done, and in doing so local confidence in the hospital's ability to meet the needs of our community can be restored."

Health Secretary Jeremy Hunt said: "Substandard care in hospitals is completely unacceptable - patients should not face excessive waits for treatment and junior doctors must have the support they need from consultants to provide patients with that treatment.

"That is why we are making changes to the CQC's (Care Quality Commission) role, including the appointment of a new chief inspector of hospitals, to provide a better way to expose bad practice where it exists in the NHS and ensure it is dealt with swiftly and decisively. We have also begun discussions on changes to the consultant contract to ensure that trainee doctors have the support they need in the future.

"Prof Sir Bruce Keogh will be publishing his report on Tameside Hospital shortly - this will ensure that they have the support that they need to improve care for their patients."

According to the Guardian, the MPs' intervention comes as the CQC, which regulates NHS care, admitted its inspectors found problems at Tameside's A&E unit, which was heavily criticised and depicted as an overcrowded scene of chaos in the two reports.

A CQC spokesman told the Guardian it had instigated an inspection after Jackie Hayden, the postgraduate dean for Greater Manchester, passed on concerns first raised privately with her by a group of junior doctors working in several departments at Tameside.

A spokesman for Tameside Hospital said: "The trust takes the views and concerns of its staff very seriously, including those who work day in, day out under enormous pressure on the front line. That's why we specifically commissioned the reviews concerned, precisely so we could understand more about our delivery on the front line and how its quality can be maximised alongside support for our staff.

"As soon as the reports were received, we sought to substantiate any comments or observations contained in them, although some comments by individuals were not able to be substantiated.

"Within four weeks, we developed a specific action plan to address the concerns in the reviews. This was signed off by the board over a month ago, a copy sent to (health care regulator) Monitor and has been publicly available via our website since the beginning of June.

"We have a very close and good working relationship with our professional colleagues at the Greater Manchester Deanery and obviously work with them continually to address any concerns raised.

"There were some specific issues raised by the deanery in February. We have discussed them with them and, as we always do, addressed all issues raised.

"Our director of medical education always emphasises at trust induction the appropriate processes/opportunities available to all junior doctors to report any concerns and we assure them we will always address any concerns raised, as we have in these specific instances.

"We were surprised to hear for the first time via the Guardian of alleged comments made during proceedings of our local CCG (clinical commissioning group), with whom we have an excellent working relationship. We can confirm no such comments have been made to us."

In a further joint statement, the three MPs said: "Although we are still awaiting formal confirmation from Tameside Hospital, we would welcome the departure of chief executive, Christine Green, and medical director, Tariq Mahmood from their positions at Tameside Hospital.

"We have all said on numerous occasions that Tameside Hospital needs a change of leadership, and we are glad that change finally appears to be under way.

"Although there are numerous concerns about problems at the hospital we know from both speaking to our constituents and from personal experience that there is a lot of good care delivered by the hospital's staff too. However, the problems that do exist at Tameside have not been sufficiently addressed and we believe that the senior management have to answer for this

"The hospital trust now needs to find a successor who is capable of implementing the change that our hospital needs. Whoever takes that responsibility will have their work cut out for them, and we look forward to developing a strong working relationship with them.

"Hopefully, this will be a turning point, and patients, staff and the wider public will now be able to rebuild their confidence in Tameside Hospital."

A spokesman for health regulator Monitor said: "Tameside NHSFT has been under close scrutiny within Monitor's regulatory regime for more than two years, and is currently in breach of its licence on financial and governance grounds.

"We have used our powers to secure legal undertakings that the trust will deliver cost savings to eradicate its deficit, and require the trust to develop an adequate long-term strategic plan. If we receive evidence of any other breaches of the licence, we will not hesitate to take further regulatory action on behalf of patients.

"When we were made aware of the findings of the internal reports, we requested the CQC to undertake a review of the quality of care at the Trust. The inspection team went in during May and we are currently awaiting their report. Meanwhile, we are also awaiting the findings of Bruce Keogh's rapid responsive review, and will take further regulatory action if necessary in due course.

"Following the resignation of the chief executive, Monitor will work with the Trust to ensure there is stable leadership going forward."

PA