MP demands action after concerns raised at NHS trust

An MP has called for urgent action to be taken after one of the north-west of England's biggest healthcare trusts was placed under an NHS enforcement notice.

The Northern Care Alliance (NCA) runs four hospitals in Greater Manchester: Salford Royal, the Royal Oldham, Rochdale Infirmary and Fairfield General in Bury.

The NHS England notice demands improved safety standards in surgical wards, tackling backlogs in spinal and gynaecology services and an assurance that patients are "no longer at risk".

Salford MP Rebecca Long-Bailey has called the situation "incredibly concerning". The Trust said patient and staff safety was its top priority and added that changes were being made.

The NCA was created in 2021 when Salford Royal NHS Foundation Trust was combined with three of the four hospitals from the former Pennine Acute Hospitals NHS Trust. The two trusts had been run together since 2017.

At the time, Salford Royal was widely recognised as one of the best acute hospital trusts in England - one of only two to twice be rated "Outstanding" by the government's health watchdog the Care Quality Commission (CQC).

By contrast, Pennine Acute had been judged "Inadequate" in 2016 after a series of scandals and failings at the Royal Oldham and North Manchester General sites.

North Manchester General was absorbed by the Manchester University NHS Foundation Trust.

It was hoped the good practice shown at Salford Royal would also enable the other three hospitals to rapidly improve.

This NHS Enforcement Undertaking relates largely to issues at Salford Royal, however.

Problems began in 2022 when the CQC dramatically downgraded the hospital, saying it needed improving.

The trust as a whole was also rated "Requires Improvement".

In 2023 and 2024 two reports were published into harm suffered by patients at the spinal unit and how the trust dealt with the concerns being raised about the work of one surgeon, John Bradley Williamson, at Salford Royal Hospital.

At the time, clinicians said their attempts to get answers had been brushed aside.

Earlier this month the Independent discovered that an issue with patient backlogs in gynaecology services in 2024 had led to some women - including cancer patients - having delayed treatment.

Finally, in September 2025, the CQC issued a warning notice on surgical services, again at Salford Royal, saying they "believed significant improvement was required to reduce the risk of harm to people who used the service".

Some of their concerns related to staffing levels, an issue currently forming part of strike action by workers in both the critical care units and operating theatres across the trust.

The main issue is overtime, which the Unison union said was set at a lower rate than regular pay.

But regional organiser Kevin Dolan said unfilled vacancies were leading to staff burnout.

"The workforce are at the end of their tether," he said. "They're under severe pressure under very, very difficult circumstances.

"You've got workers going through the door where before they even get in, they know they're going to be understaffed, they know they're going to be under-resourced. The morale is low."

The investigation by The Independent reported that administrative staff raised a grievance last year about a large backlog of patient letters.

They too cited understaffing and burnout.

It also stated that in January a group of consultants threatened to hold a vote of no confidence unless significant changes were made. The trust does not dispute either of these claims.

Speaking anonymously, one consultant told the BBC morale was at rock bottom.

"I think low is an understatement because we have given up," they said, adding that if staff tried to raise concerns they were either "shut down or not listened to. Or they say they will get back to it but never do".

The trust said it "actively encourage(s)" staff to speak up and "any concerns raised are taken seriously and acted upon".

Long-Bailey has also voiced concerns about culture within the trust.

The Labour MP met consultants and trust executives in October after being contacted by some staff.

"They didn't feel they could speak up," she said. "A lot of staff members wanted to report issues anonymously. They didn't feel safe even doing that.

"It seems that the issues have worsened since then. It's an incredibly concerning situation particularly regarding patient safety and staff workloads."

On Friday, Long-Bailey will meet all 14 unions representing staff at the trust.

She said she wanted to see meaningful change.

In a statement, NCA deputy chief executive Suzanne Robinson said: "Patient and colleague safety and wellbeing is our top priority.

"We recognise there have been challenges, and we have already taken action to strengthen governance, improve our processes and support our teams and we remain focused on the ongoing improvements that are still needed.

"Our colleagues play a vital role in this, and by listening and responding to their concerns, we can continue to make meaningful changes that benefit both our teams, services and the patients we care for."

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