28/11/2011 Inside Out North East and Cumbria

This sounds like a system that is close to breakdown. Patients would

be horrified. But the bosses insist we are safe

on their wards. This is a good hospital, we are not

about to reduce the level and range of services.

30 years on, and can an amateur Tyneside photographer track down

the stars of his show? Thigh did not take names, I don't

know why. It is a real detective hunt.

Stories from the heart of the North East and Cumbria. This is Inside

Out. Shortages of beds and staff, morale at rock bottom and a

financial crisis. That's what we've been told is the situation at

Cumberland Infirmary here in Carlisle and the West Cumberland

Infirmary in Carlisle, together with the West Cumberland Hospital

in Whitehaven, make up the North Cumbria University Hospitals Trust.

Forced to pay back millions in Private Finance Initiative payments

for this new hospital, and with a savings target of 15 million this

year, the Trust says it provides safe, high-quality care. But we

have been passed information which hospital staff say is evidence

that's not what patients are always getting. Lets start at Cumberland

Infirmary. For five months up to April this year staff in A&E kept a

log of incidents. They wanted their own record of the problems they

were dealing with. It makes shocking reading. This is an entry

from October 2010: "Patient with suspected meningitis unmonitored in

"psych" cubicle". "lady with PV bleed assessed in corridor and

collapsed prior to being put on trolley." So, just let me explain

what this means. The first case appears to refer to a patient with

suspected meningitis, a potentially fatal infection, who is left, with

no supervision, in a cubicle. The second refers to a woman with a PV

bleed, that's a vaginal bleed, who is close to collapse, and is

assessed in a corridor! So what's going on? To find out I've spoken

to staff at most levels in the hospitals. Many fear being

disciplined for talking to us, so actors speak their words.

haven't got enough nurses on the shift to cover everywhere. We can

have potentially three people in resus, three people having heart

attacks, strokes, breathing difficulties. People are being left

in cubicles because we can't keep an eye on them. We're not ignoring

them. But the priority has to be the people in resus. That would be

worrying if it was a rare event, but it appears, it wasn't. The log,

filled in by the A&E nurses, lists page after page of shortages,

delays and risks. Here's a flavour: January: dangerous nursing

conditions in A&E. Two patients with chest pain on back corridor.

February: department unsafe, none of children handed over as none

triaged. One quite unwell, encephalitis? Temperature of 38.8.

April: patient in red category waited 3 hours 40 minutes to see

doctor. Number of patients exceeded number of trolleys. Ambulance crews

waiting in corridor. At times, we've been told, A&E at Carlisle

resembled a hospital during a major incident. Basically, if they're

going to be alive for the next five minutes you're going to look at the

next person. Like in london when there was a bomb. It's that sort of

fight or flight response. You're just looking at people the bare

minimum and then look at something else. The nurses' union was so

worried it handed the log to the Trust earlier this year. We were

informed that they would ask the chief operating officer to conduct

an internal investigation to some of the situations you've described.

Unfortunately we've had no further feedback. When we asked them

they've gone very quiet. So we don't believe that that internal

investigation has taken place and that's very disappointing. That's

disturbing. From the information we have that log was kept before my

arrival. I will need to investigate to see what happened in terms of

addressing their concerns. The RCN say they were told that the chief

operating officer would investigate and they've heard nothing? Well,

the chief operating officer is no longer here. With the revised

online systems that we've introduced there's been an increase

now in reporting of concerns from staff and we think that's positive.

But according to the nurses they're still not being listened to - and

worse. Nurses are regularly telling us that they're filling in incident

forms in and they're not having a response to those forms. And some

staff genuinely feel that they're being bullied and told not to fill

the forms in when they've not got sufficient staff or if they've not

been able to give care to patients. I don't believe that whatsoever. We

have very open well established reporting systems and we receive

information all the time about potential safety and quality issues.

There are concerns raised with us that staff feel under pressure not

to report incidents and in one case felt they were even being bullied

into this. I don't have any evidence for that and if i did i

would be very unhappy if that was the case. So if this is brought to

your attention in detail you will act? Absolutely. Many of the staff

say the real problem, and the reason for the shortage of beds and

staff is a programme called Closer to Home that aimed to treat more

people out of hospital and so reduce the need for beds. It really

hasn't worked in Cumbria. It's had catastrophic effects on the two

hospitals. Starving them of funding. The numbers have gone back up again

and the complexity of cases has gone up. Some numbers have fallen

and some have not in our experience. And we'll be discussing our results

of closer to home with the commissioners for the health

service in Cumbria. So is there a shortage of staff and beds then if

the numbers are greater than you expected? No. There's no issue with

staff numbers or beds? No. That's not what the nursing staff tell us.

They say they're now frightened to open wards when patients are stuck

in corridors and cubicles. It's a blame game. If the duty matron

opens beds, especially over the weekend, they're hauled over the

coals by the business managers on Monday morning. There is that fear

of managers. It's more intimidated, harangued and harassed. Why did you

do that? Why did you open these beds? Why didn't you staff it

properly? We do open and close beds as demand requires it. So I don't

see a problem with that. I would be disappointed if staff were told off

for opening beds. It's about proper use of resources to meet demands in

patient care. The staff tell us other departments, not just A&E in

Carlisle and Whitehaven, are also feeling the strain. Like

Outpatients. If somebody needs to be admitted more often than not

they'll have to wait sometimes most of the day on an examination couch

until the bed becomes available. We don't have the nursing staff spare.

If somebody needs their pain sorting out it will have to wait

until they're seen on the ward. Now operating theatre nurses, on-

call for emergencies, are helping on wards. They say they don't have

the skills, and are given patients That pager goes off for an

emergency I can't say to a patient you stay there, unsteady on your

feet, fall, break your hip, I've got to go. Luckily nothing's

happened yet. We have had near misses.

Is that really an effective way of using the staff? As you present it

no, but I'm sure that the staff themselves and their managers will

be advising very strongly on safety and quality grounds about how best

to organise that service. Hospital bosses have hit back

angrily at claims that patient care will suffer. Recently the Trust

announced it's in a financial crisis and must make more cuts. So

can senior staff guarantee there won't be serious implications?

not at all, particularly in the A&E departments. We're quite short on

numbers of consultants normally compared to other comparative units.

We're much more vulnerable, and patients are much more vulnerable

to any further cuts than say an average district general hospital.

And I know, again, Whitehaven A&E, they feel they really are right on

the edge of consultant and middle grade medical cover in particular

as they are now, never mind with any further cuts. This sounds like

a system that is close to breakdown? Yeah, I can't deny that.

Patients would be horrified to hear you say that. Yes.

What's on everyone's mind is the situation at Mid Staffs Trust,

where up to 1,200 people may have lost their lives because they put

cost-cutting and targets before patient care. The clinicians say

they're not there yet. We could possibly be in a situation

that mid staffs were in in the run- up to that where clinicians and

nurses were flagging up their concerns through the proper

channels. And great concern was being expressed and clearly Mid

Staffs got it wrong, they didn't listen to those responses.

So, It isn't Mid Staffs NOW. And the consultants believe they still

provide high quality care - but it's exceptional for a consultant,

who speaks for medical staff at Carlisle, to voice his concerns in

public like this. But the Trust doesn't appear to have heard.

They are not saying that. They did not say that to me last evening.

And I met with them. All of them. They didn't say that. And there was

no serious suggestion that what we have here are early signs of a Mid

Staffordshire situation. There's no evidence to say that we have safety

and quality concerns. We're a high performing hospital in those areas.

And there's a good relationship between the Trust board and the

consultant staff at the hospital. So how has all this affected

morale? Staff are on anti-depressants

because they are cracking up. The nursing staff will look after the

patients to the hilt, but it's starting to crack and you'll see

the cracks over the 6 to 12 months coming in our reports. The teams

are fragmenting and breaking up. If things really cannot be resolved,

yes, I will leave. To a post where i can work more effectively. It all

sounds like rats on a sinking ship. It is. That aspect is probably the

most worrying thing. We've recently lost two key consultants.

I think the staff survey, where presumably you got these results,

it's a snapshot of a moment in time. We have a process undergoing at the

moment where the Trust is being acquired. Some staff will feel

uncertain about that, some will choose to seek greater security

elsewhere. I think that's perfectly normal and that's their decision.

The Trust is in financial crisis. It's lost a chief executive and

other senior managers in the last few months. And it's looking for a

Foundation Trust to take it over. Perhaps the deluge of bad news

stories prompted it to try to reverse the trend. In an e-mail

entitled "Good News Stories" leaked to Inside Out 10 days ago it asks

senior nurses to list "anything new nurses are doing", "anything new"

in their departments. They want to issue "as many positive press

releases as we can" over the next two weeks.

It kind of smacks of desperation, of trying to take attention away

from the bad? Because the media is only interested in bad news. It's

what makes good television. It's what sells newspapers, you know.

There's a lot of good things going on in this Trust.

Staff tell us what lies at the bottom of all this is a longer term

problem involving money and how it's spent. It's claimed the

Carlisle and Whitehaven hospitals have been starved of cash by NHS

Cumbria, the Primary Care Trust, while it lavishes money on other

services. They say between 2007 and this financial year North Cumbria

Trust's spending fell by almost 9% to around �155 million. At the same

time "other secondary care", which includes elderly care and

specialist services at other hospitals, rocketed by almost 50%

to �284 million. How on earth can you justify a 50%

increase in spending on other secondary care over the course of

four years while decreasing the spending to the local hospitals.

While they are spending they've increasing ED spending on

everything they fund apart from the acute hospitals. -- why are they

spending increasing amounts of money on everything. They've

received the normal tariff which they get for doing the work they do.

They have had additional supplements over the last three

years amounting to 70 million which the other trusts in the patch

haven't received. The biggest increase for us in I think it's

non-NHS spend has been the huge rise in continuing care allocations

and these are predominantly nursing care payments made to very frail

elderly patients with multiple needs and unfortunately that's a

national challenge and that's going to get worse, not better.

We showed our evidence to the MP whose constituency includes the

West Cumberland Infirmary. The pressures right now seem

absolutely intolerable. I know that this Trust is full of people

absolutely commited to the ideals of the NHS, absolutely committed to

top quality patient care. And right now they're really suffering, and

patient care looks like it's starting to be affected.

This is a good hospital. We provide high quality care. We have done for

many many years. We will continue to do so. We're not about to reduce

the level and range of services that are provided to you.

Tonight we've presented a disturbing picture of life inside

the North Cumbria University Hospitals Trust. A picture painted

by its own staff. They warn the service is approaching breaking

point. Today a survey listed North Cumbria as one of 19 trusts in

England with high mortality rates on two out of four basic measures.

The trust says it is reviewing this with two teams of consultants and

its medical director. Thirty years ago keen photographer Chris Mearns

was working on a community project in Newcastle's West End when he

decided to set up a makeshift photo booth so local people could take

their own self-portraits. Over the years he couldn't help wondering

what had become of those youngsters. It became his life-long ambition to

one day track them down, but it was only this year - three decades on -

that he seriously tried to find them. Would he succeed? Let's find

out. It's 1981. And it's tough on the

streets of Tyneside. The Specials release their melancholy Ghost Town.

It goes to number 1 in the charts. Steel works were mothballed, there

had been a new Conservative government, war looming.

But behind the stereotype of a run- down West End there was fun to be

had. Back then Chris Mearns was a community worker but with a passion

for photography, so he created a makeshift photo booth. 30 years on

he's back to his old haunts in Elswick Park.

30 years. Yes, it is this corner here. We had the subject at the far

end, light coming through the window, white sheets hanging. There

are many photographs of Newcastle depicting a kind of war-zone. I

would say, here is a rather old. When you squeeze it, that camera

will take pictures. -- rubber old. Essentially I was after pretty much

the look you see on the pictures, direct, not opinionated, just kids

looking back at the camera and decided -- deciding what they would

I said, take a picture, I am going to give you a moment, take your

time, and I would her -- hand them the camera angle would stand

outside. It is the stories which are the heart of the matter. It is

irresistible when you look at the pictures, and you know how old they

are, to wonder what people did. tracking them down three decades on

is a daunting task. Chris has virtually no clues. Did not take

names, don't know why. It is a real detective hunt. The clues are the

faces. I am I go on -- going around places in the same geographical

area, west Newcastle. I wonder if I could show you some

pictures. I know his face. He is still around. I am not sure.

might be a John. I don't know if it is the same person. It might not be.

That is interesting. I wonder if I can give you some posters and you

can get them around. Chris' quest even made the evening news. Perhaps

you are one of the people who was snapped by a Tyneside photographer

who wants to get back in touch and recreate the images 30 years later.

This his one-man on a mission which he is determined will not prove

impossible. -- and this is one man. If even a handful of those 100

faces do get in touch, does Chris have any idea what will be

revealed? I just don't know. I know some very sparky people who come

from those places and I am sure there will be some tough stuff,

some who are not alive now, who have problems, but I bet there are

a lot to have good lives and what would look -- I just want to find

out. What has changed since 1981 is technology. The internet and social

media site means word is out and the kids, now adults 30 years wiser,

are starting to get in touch. This is Martin I am coming to see

and I have great hopes for him. He knows a lot of people and this is

the first person I have met from the portraits. It is odd. I am

nervous. I don't know how it is going to go.

Evening. How are you doing? lovely to see you. You are the

first person I have seen. Know what is really funny? I have not really

thought about the photos in all that time. Then the thing came on

the news and I thought, I would love to see those photos. How has

the time passed? Without a care in the world. But life doesn't just

bring highs - there are lows too and Marty was lucky to survive a

car crash. A car came down the slip road, he hit me, I hit the outside

lane and an articulated lorry. I fractured my skull and my shoulder

and I was in a coma for a while. Who knows what tales the pictures

may hold. Fortunately Marty can identify quite a few of them. One

character does stand out because everyone knew him.

The great Jimmy. Like Chris, Jimmy Forsythe was a keen photographer

who documented the West End in the 1950s and '60s. His amateur snaps

have become an iconic archive of this part of the city. When he

found out Chris was doing his 1980s take on Elswick, well, he couldn't

resist joining in. Chris meanwhile is close to achieving his life's

ambition and he's put the word out for all those he'd contacted so far

to come to Times Square in Newcastle. But fate had one more

cruel twist in store. One that no- one could have predicted.

My dad went cycling and had a heart attack. He was airlifted to the

Freeman Hospital. Unfortunately, nothing could be done. He had held

on to these photographs for 30 years until he could do them

justice. It has been a massive part of his life over the past month and

he was incredibly excited about what would happen with them. A week

to go and everybody was coming up. An absolute tragedy. But by now the

project had a momentum all of its That is it, guys, fantastic. Chris'

family, friends, and the gang of 1981 all wanted to carry on with

The Centre for Life will be the setting for the new makeshift

photobooth and for the original subjects the present & the past are

becoming a blur. I knew I must have been going somewhere special

because I put the two favourite things on but I like. I showed a

friend these pictures, and she said, I have realised I could not be me

and I came out. I am gay. That is probably one of the high points of

my life, everybody supports me, they are not bothered, I am still

me. The reason I got involved with it is because it is a social

history thing, not really a photography thing. It is just one

of those projects that needs to be carried on all the everyday things

that it focuses on will be lost forever. For Amanda life's gone

full circle - growing up in the West End spurred her on to lead

urban regeneration projects, like this one in Southampton.

background I have, living in deprived areas, I have an

understanding of the community and the barriers that they face and

trying to improve themselves and hopefully I will help in some way

in the regeneration. The second one is reasonable. I remember quite

well and I still have the photo. For swimming instructor Trish it

also meant moving away It's a warning sign: I looked around and I

was a single parent then. And I realised that my life could be

better if I moved to Jersey. We went with backpacks, not knowing if

it would work or not, and it did work. I was nice, wasn't I? You

have not changed. I recognise you. You were so much younger. You look

just the same boat. -- the same, though. I was a bit of a tearaway

when I was younger. I left school at 12 and ran away to London at 13

and lived on the streets for quite a long time and became a drug

addict. I finally decided to sort my head out, got off the drugs and

decided I wanted to become an occupational therapist to help

people off drugs, so I went to university, got a BSc. For Chris,

this would have been a perfect day. They were just ordinary kids from

an ordinary town. I think they have ripened. It would be lovely to

photograph them again. But also I am very interested in their

children. I think another Self I think it is a really good idea.

It is just it -- a shame that Chris was not around to see the

combination. I think it is wonderful that he has kept this all

of these years, this small project he had going, and ABS -- actually

done something about it, which is really good. The family are

delighted. My dad would have been amazed by the turnout.

Thank you! Some of the people in the original

1981 pictures have not been found so the work continues. To find out