The findings of the report into Blackpool Victoria hospital are as shocking as they are damning: a culture of bullying, racial discrimination and harassment that has contributed to a staff exodus with a direct impact on patients. The treatment of chronic disease, including Parkinson\u2019s, were just some of the areas blighted by what appears to be a toxic culture.<\/p>\n
But the Royal College of Physicians report, leaked to the Guardian, exposes much broader challenges for the NHS<\/a> \u2013 and particularly for hospitals in the most deprived corners of Britain.<\/p>\n Clinicians in places such as Blackpool are overwhelmed by generational ill health and entrenched poverty, a crisis that is deepening<\/a> in many parts of the country. Their ability to respond is often hampered by their struggle to attract the best staff.<\/p>\n The issues are complex. Hospitals in poorer areas are flooded with people who have chronic health problems, including higher rates of depression, chronic obstructive pulmonary disease (COPD) and other respiratory conditions worsened by living in damp homes.<\/p>\n The worst-performing NHS trusts in the league table broadly tally with levels of deprivation.<\/p>\n League table of NHS Trusts<\/a><\/p>\n Blackpool teaching hospitals NHS foundation trust, and University hospitals Birmingham NHS foundation trust were in the 10 worst-performing trusts, with Hull University teaching hospitals NHS trust in 11th from bottom.<\/p>\n In the 2025 indices of multiple deprivation, seven neighbourhoods in Blackpool ranked among the top 10 most deprived in England<\/a>. Kingston upon Hull and Birmingham were among the local authorities with the highest proportions of neighbourhoods among the most deprived in England.<\/p>\n The problem is exacerbated by inequalities in primary care. The current formula for distributing GP funding, known as the Carr-Hill formula, uses expected workload of GP practices to determine distribution of funding, but it is based on outdated figures and has left people in deprived areas and coastal towns with the fewest GPs.<\/p>\n