Salford Royal Hospital was once the jewel in England’s NHS crown.
Politicians used to flock there when they had an announcement to make. We even have archive footage of a junior health minister visiting – now he is Prime Minister.
They are not posing in front of the cameras anymore, though. That’s because the hospital – and the massive NHS trust it is part of – is in crisis.
Just for a bit of background: in 2017, Salford merged with a number of other hospitals in Greater Manchester and became the Northern Care Alliance (NCA). It is now one of the biggest trusts in England, which staff say is partly to blame for its problems.
It has gone from being highly rated, to having an enforcement notice issued by NHS England – and that means it is either not meeting its statutory duties or that it cannot ensure “that no further patients may suffer harm”.
Across departments
Concerns into the spinal unit were previously investigated after disgraced surgeon John Bradley Williamson botched numerous operations.
But in a joint investigation with the Independent, Channel 4 News can now reveal accusations of patients being harmed, of incidents being downgraded so they are not properly investigated, and of chronic staff shortages.
And we have been told issues span the trust’s departments, including renal, neuro, maternity, gynaecology and emergency care.
One clinician told us that, in Salford’s emergency department, corridor care was the norm.
‘Unsafe, inhumane’
Speaking anonymously, she described people “dying, deteriorating, or just elderly people lying on a corridor on a hard trolley because you can’t put beds there”.
“I mean, the longest we’ve ever had somebody wait for a bed is four days on a corridor,” she told us.
“It’s unsafe and it’s inhumane.”
She also told us that complaints had been made to management by a group of clinical staff but, she said, they had been asked to shut it down. We are told the consultants refused.
During our investigation, nearly a dozen members of staff wanted to talk both on and off the record – so serious were their concerns.
In November, a survey of 400 consultants from across the trust and from different departments – now leaked to us – showed nearly 81% said patient safety was worse than in pre-Covid times and 75% did not believe the trust was well led.
In April, the chief executive Dr Owen Williams announced he was leaving. Yet still staff complaints persist.
‘Patients harmed’
A system called Datix is used by staff to record incidents – some minor, others more serious. During this investigation, we have repeatedly been told of management downgrading them, asking that they be closed, or closing them with no action.
Vanessa Lawton, pictured above, was a consultant gynaecologist at Salford until she resigned in April. She told us that many incidents were not investigated at all or were closed down.
Even patients had been harmed, she said, because the reviews were not thorough.
In a letter sent to the Care Quality Commission before she left the trust, she told the healthcare watchdog that she was retiring earlier than planned because she felt unable to continue working in a department that was “unstable and chaotic with poor cultures, lacking safety for patients and psychological safety for staff”.
She added that, if she had needed treatment herself, she “could not countenance being referred as a patient to my own department”.
One of the issues, she said, was the introduction of shorter appointment times to clear backlogs, but that meant cancers were missed.
“A patient came with postmenopausal bleeding to one of these weekend clinics with the short appointments. She had quite heavy and persistent bleeding, which is quite unusual for postmenopausal bleeding.
“The pathway that we normally use to document that process was not completed, she was not clinically examined, which is always part of the process,” Dr Lawton told us.
“The GP referred her back immediately and I think the second consultant made assumptions about what had happened and he didn’t examine her either.
“And then she came in with advanced cancer about four to five months later, and died. She was in her early 50s. So that was probably a preventable death.
“The investigation does not cover the important features of that or consider the short appointment effect and why did people not do what they normally do?”
‘Tickbox’ exercises
The problems at NCA have been escalated – even as far as the Greater Manchester Integrated Care Partnership Board, a statutory NHS organisation responsible for managing the local NHS budget, planning health services, and improving public health which was, until recently, co-chaired by Andy Burnham.
One email sent to his office said: “Trust-wide systems which permitted so many patients to be harmed for decades within the current NCA are probably unlikely to be due to an individual ‘rotten apple’ or confined to just one department.”
Glyn Smurthwaite, pictured below, was a consultant at Salford until his retirement in 2023. He said the investigations into patient harm incidents were treated as a tick box exercise.
“I’m in very close contact with many, many consultant colleagues on a daily or weekly basis. I know many areas that are affected. It is absolutely not just spinal surgery. I know areas across the patch, across several of the NCA sites, where ongoing harm is happening in the here and now,” he said.
‘Deliberate or incompetent?’
“A clinical case that I have some detailed knowledge about generated adverse incidents after I’d left and they were investigated again in the same malevolent way of trying to defocus from the prime problem.
“It’s like picking the low-hanging fruit. What’s an easy option for the trust to investigate? Well, investigate the easy option because it deviates from the problem. Whether this is malevolent or deliberate or just incompetent, I actually don’t know.”
When we asked the Northern Care Alliance for a comment, it said it was facing challenges and was working to address concerns colleagues had raised and also staff sickness absence.
The NCA said: “We have clear processes to investigate incidents and learning from these is an area we need to prioritise. By doing this, we can drive forward improvements and maintain our focus on safety.”
A statement that effectively says we hold our hands up – but without saying how this once illustrious trust found itself in such trouble.
The Greater Manchester Combined Authority said the former Manchester mayor first received an email from a group of NCA employees in July 2024.
“The email was focused on NCA’s membership of the Greater Manchester Good Employment Charter, requesting that this be revoked,” it said in a statement.
“As a result of the email, the Mayor asked officers to make further enquiries, involving both the GM Good Employment Charter team and the leadership of the Integrated Care Board.
“The NCA no longer has member status of the Good Employment Charter.”
Additional reporting by Rebecca Thomas
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