Former Stockton North MP Alex Cunningham and ex North Tees and Hartlepool NHS Foundation Trust chief executive Julie Gillon were two of several signatories to a letter which has been sent to Health Secretary Wes Streeting criticising a “deterioration of services and staff morale”. The letter also referenced a lengthy legal battle which led to a judge ordering redacted elements of a previous report into governance at the trust commissioned by NHS England to be published.
A number of non-executive directors at North Tees previously resigned their positions, reportedly over a move to appoint a joint chief executive covering both North and South Tees hospitals. Both organisations have since agreed closer working arrangements with a new strategic grouping ‘University Hospital Tees’ being established and a joint CEO appointed, Stacey Hunter.
A regional spokesman for NHS England, which had prompted the changes and is responsible for managing the NHS in England, said: “Greater co-operation between North and South Tees is in the best interests of patients and supports the sustainability and safety of services.
“It is being progressed through good local leadership.”
The letter, also signed by former non-executive directors at North Tees Jonathan Erskine, Steve Hall and Rita Taylor, said: “We won’t labour the historical successes of the North Tees and Hartlepool NHS Foundation Trust, but are content in the knowledge that it was once one of the best performing trusts in the country – but sadly no more. The recent national staff survey paints a disappointing picture of worsening morale, and performance data suggest that improvement has stalled or declined.”
It included claims of deterioration of some services.
In response, Ms Hunter said the report – which criticised joint chairman Professor Derek Bell for not handling the arrangements for a joint CEO effectively – at no point suggested the strategic alliance should not have been created. She also said “performance across urgent and emergency care across our sites are consistently ranked in the top two trusts performing emergency departments in the region and in the top six across the country”.
Ms Hunter said: “In common with all trusts across England, North Tees and Hartlepool NHS Foundation Trust is making good progress on reducing waiting times, as we continue our elective recovery from the impact of the covid-19 pandemic.”
She acknowledged that there were always improvements to be made and said staff themselves had scored the extent to which they were engaged with highly, along with the trust’s compassion and inclusivity values. Ms Hunter said: “We value the fact that colleagues make their voices heard.
“Their openness and honesty helps us to make the right changes to how our group operates.”
The CEO said lead clinicians were delivering the aims of a group strategy for patients, giving the example of a new community diagnostic centre established in Stockton which was supporting hospitals and GPs in the surrounding area.
How did we get here?
In April 2021 NHS Improvement, now part of NHS England, made a decision that North Tees should work with South Tees Hospitals to accelerate strategic integration in order to secure a sustainable future for key services.
Prof Bell, a former president of the Royal College of Physicians who has advised several Government programmes and was awarded an OBE in 2018 for his work in the NHS, was appointed in September that year as joint chairman of the two trusts and went onto chair a joint partnership board set up to develop closer ties between the organisations.
Prof Bell was said to have identified that it was likely to be challenging to get the boards of both trusts to work in a more joined-up manner around contentious issues without a single chief executive alongside him. There were disagreements about the pace and approach being taken with five non-executive directors at North Tees subsequently resigning their positions in February 2022.
Prof Bell was criticised by Mr Cunningham, who stood down as Stockton North MP prior to last year’s General Election, who accused him of “driving a wedge” between the two trusts. Mr Cunningham also repeatedly aired concerns about a potential merger which he said would be a “millstone around the neck” of North Tees which was successful and financially sound in contrast to its South Tees counterpart.
An investigation into events was undertaken by NHS Improvement with a subsequent report stating that there had been an “inability to find a mutually agreeable path”. It said “as tensions rose evidence suggests that the level of conduct by some individuals within the trust non-executive directors group was not consistent with accepted standards of professional business conduct”.
Formal regulatory intervention was considered and while the North Tees trust was assessed as a “relatively operationally sound NHS provider”, there remained ongoing concerns about the longer-term clinical sustainability of the organisation.
However the findings of the investigation were never fully published. A month or so later chief executive Julie Gillon then announced plans to quit, describing her departure as a “difficult decision”.
Mr Cunningham at the time said that there had been a “failure to acknowledge the actions and behaviour of the chair and regional office to push through a proposal for a joint chief executive to cover the North and South Tees trusts”. He also said the outcome had been an “attack on non-executive directors who were only doing their job challenging the proposals for change which they believed could have a detrimental effect on the way the trust was run and ultimately on patient care”.
Mr Cunningham and Mr Erskine made a series of Freedom of Information requests in a bid to get the full findings released with Mr Cunningham even raising the affair in Parliament and, while a redacted version was issued, it took a decision of a judge-led appeal tribunal to uncover the redactions.
Prof Bell, was described as new and inexperienced in his role with “overall, poor communications, some hasty actions, and position-taking appea[ing] to characterise this dispute, leading to high levels of personal stress for all those involved”. The investigation said Prof Bell, who remains in post, disagreed with the conclusions, which he believed was “unwarranted and unsubstantiated by evidence”.
The letter now sent to Mr Streeting said: “NHS England’s regional office commissioned the governance investigation report clearly with the belief that the outcome would principally criticise the non-executive director group and ensure major changes to the structure of the board.
“When the report demonstrated instead that failings of leadership and accountability were mainly laid at the doors of the joint chair and the NHS England regional director, it was quashed, and an inaccurate, cherry-picked summary was instead presented to the North Tees hospital board. They were effectively denied important information at a point in time when this was crucial when considering the way forward.”
In February last year both trusts, which employ about 15,000 staff, signed a formal partnership agreement, changes having been made to the constitution of both trusts to align them as much as possible. A new group board was set up to oversee the development and delivery of a joint clinical strategy and a series of appointments made to new group executive roles, including that of Ms Hunter, while some senior managers departed.
Speaking in May last year, Prof Bell said: “This is not a merger, rather a collaboration to ensure the best possible outcomes for our patients and communities.”
Meanwhile, in a separate national development, the Government announced last month NHS England was to be abolished as an example of “overregulation and duplication of bureaucracy” with the health service brought back under the control of ministers within the Department of Health and Social Care.
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