The now notorious Shrewsbury and Telford Hospitals Trust, which is facing more criminal investigations and enforcement actions than any other trust in England, has been heavily criticised again in a letter from the chief inspector of hospitals leaked to the Independent.

The last CQC inspection report in January found the trust to be “inadequate” overall and on fur of the five specific criteria, with a “requires improvement” rating for “are services caring”.

Trust bosses have had 90 specific conditions imposed in five CQC inspections since 2018, but as Professor Ted Baker’s latest letter, demanding an urgent meeting with NHS England to discuss the next steps, reveals they have failed to change a management culture which has led to “a lack of professional accountability and professional curiosity amongst staff to recognise, challenge and address poor care.”

Toxic

So toxic is the system that even with far more generous than average staffing levels services continue to raise “significant safety concerns”.

“This culture and underpinning normalisation of poor care is the environment in which future health professionals are being trained. We are concerned that unless this is addressed at pace by a sufficiently capable team, this will be compounded by those providing care to patients [at the trust] in the future not knowing what good truly looks like.”

A year ago the trust’s Chief Executive Simon Wright announced he was stepping down. According to the trust he was to “take up a role working with sustainability and transformation partnerships”, although this was quickly thrown into doubt.

His replacement Paula Clarke was acting chief until February, when the trust’s current chief executive Louise Barnett joined the hospital – but it seems that the underlying problems have not been tackled.

A frustrated Prof Baker says frontline staff have reported “lack of visibility and diminishing confidence in the executive leadership team’s ability to acknowledge and address any concerns raised. This has been a consistent theme throughout our inspections.”

Investigations

1,500 cases of alleged poor care at the trust going back decades are being investigated.

To make matters worse the trust is in the process of driving through a controversial reconfiguration that will strip emergency services and specialist services from Telford Hospital to “centralise” in Shrewsbury, which has risen in projected cost from £312m to £498m.

Before the first bricks are laid, the trust could be taken over by a Trust Special Administrator, a process which culminated in a major report in December 2013 that broke up the Mid Staffordshire Hospitals Trust, and moved services to Stoke and Wolverhampton. For the sparsely scattered population of Shropshire any similar result could be yet another disaster after a decade of sub-standard care.

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