“We need to escalate our concerns to NHS England [and then health secretary], Wes Streeting.”
The words most NHS chiefs would dread came from a group of dozens of doctors working at Northern Care Alliance NHS Trust, who were forced to convene a secret meeting over fears for patients’ safety.
Concerns raised at the meeting in November included doctors describing wards as “like war zones” where corridor care is normalised, low staffing levels, last-minute appointment cancellations, and a culture of “bullying and fear”.
Leaked documents, obtained by The Independent, reveal NCA leaders have not only faced a mutiny from doctors but hundreds of admin staff, who mounted a collective grievance, warning that “unachievable workloads” were creating unsafe backlogs in patients’ care. Meanwhile, critical care nurses have taken to picket lines over pay and conditions.
Now, the trust has this week been hit with formal enforcement action by NHS England, which fears patients are not safe from harm, and faces fines or losing its licence if it does not improve.
The unrest came to a head in January, when doctors threatened to hold a vote of no confidence in the trust’s chief executive, Owen Williams, and medical director, Dr Rafik Badir, if leaders did not act on the concerns raised.
In April, Mr Williams announced he was stepping down from his role, and since then, several senior executives have left.
The news comes after an investigation by this publication revealed the trust was forced to review the care of hundreds of women at its Salford Royal Hospital gynaecology unit, which found dozens of women, including cancer patients, had been harmed after their diagnosis and treatment was delayed due to “admin failures”.
Whistleblowers have come forward from across the trust, alleging that the current executive leaders are not listening when safety concerns are raised.
One clinician, speaking on the condition of anonymity, warned: “Vacant posts are not being filled after staff leave to save money – this includes clinical posts. Staff are leaving in droves due to unsafe workloads.”
Another senior staff member said their service was seeing “chaotic last-minute scheduling of surgery” and warned there was a “high number of serious surgical complications” in their department.
The trust’s leadership is now being reviewed by the care watchdog, the Care Quality Commission (CQC), and NHS England to determine whether it is well-led. CQC inspectors have separately launched inspections of its gynaecology and surgery departments.
The inspection of surgical services comes after The Independent revealed the CQC had issued a formal warning after inspectors found patients were being left without vital pain medication due to staffing shortages at Salford Royal Hospital.
Reports of unrest across the trust come three years after a report in The Sunday Times revealed allegations that the trust failed to act over concerns that orthopaedic surgeon Bradley Williamson had harmed dozens of patients.
Local MP Rebecca Long-Bailey is now calling for a review of how whistleblowing concerns are handled.
She said: “I continue to hear from staff across the trust who say they do not feel safe or supported when raising patient safety concerns. No member of NHS staff should ever feel fearful of speaking up in the public interest.
“A culture where whistleblowers feel marginalised or ignored is not only wrong for those individuals, it is dangerous for patients.
“There must now be a transparent review of how whistleblowing concerns are handled across the trust, including whether Freedom to Speak Up processes are working as intended in practice, not just on paper.”
‘Fearful, toxic and silencing’
During the crunch November meeting, dozens of consultants cited “systemic failings across the organisation” that they claimed have led to “unsafe conditions” for patients and a culture that is “fearful, toxic and silencing”.
Minutes of that meeting, seen by The Independent, included allegations by doctors that:
- Medics aren’t listened to when they identify patient safety risks
- Doctors are seeing “unsafe practices” and deteriorating working conditions
- Clinicians are working in environments with low staffing levels
- Staff morale is at an all-time low, amid bed and staffing shortages
- There has been a “significant loss of trust and confidence in executive leadership”, who were described as “absent, dismissive, and disconnected”
The document adds: “The consultant body expressed a severe loss of confidence in current leadership, deep concerns for patient safety, a deteriorated culture, and a call for urgent structural and behavioural change…We find ourselves in a failing organisation, and we do not feel equipped to deal with this.”
Some doctors warned “the grass isn’t always greener”, claiming other NHS trusts have similar issues, with one saying: “The described ‘panacea’ of how things used to be at Salford is not a reality.”
A poll conducted in November of around 426 consultants working across the trust’s four hospitals, in Bury, Rochdale, Salford, and Oldham – the majority of whom work at Salford Royal – revealed the scale of concern among medics, with more than 200 warning they do not believe the trust is being well-led.
More than a third suggested they believed their hospitals were not safe.
One doctor replied to the survey saying they had resigned “because of the poor and unsafe care our patients received and an unaddressed culture of bullying and fear”, while another said Salford hospital faced “one of its most challenging positions in its history, having fallen from a place of excellence to one of disarray”.
One worker said they didn’t feel comfortable speaking up about safety issues and alleged “things are brushed under the carpet”. Another damning comment claimed it had become “acceptable for us to work in substandard conditions where patient safety is compromised on a daily basis”.
Multiple respondents compared the trust to Mid Staffordshire, which was closed in 2014 following a scandal that saw between 400 and 1,200 avoidable patient deaths due to poor care, between 2005 and 2009.
One medic wrote: “One quote at a divisional meeting recently from a senior doctor says it all – ‘we are not at a MidStaffs level yet, but we are not far off. Terrifying.”
Other doctors claimed the trust was putting finances before safety, saying “money trumps safety”, and that the trust cannot afford to buy “basic” protective equipment or staff wards.
Following the meeting, consultants wrote to the trust’s board, threatening a vote of no confidence if there was no change within three months.
Sheena McDonnell, NCA chair said the board was “sorry to hear” of the concerns raised.
She said she had met with consultant representatives and the board had taken their complaints seriously and wants to listen.
She added: “As an organisation, we place great importance on colleagues being able to speak up about patient safety and quality issues.
“Our consultant colleagues are key to the improvements we want to make for our patients and our communities, and we remain committed to working with them on that.”
‘Unachievable workloads’
Months before the consultants’ secret meeting, the trust received a grievance in June 2025, raising concerns from hundreds of admin staff.
The letter was signed by representatives of 14 major unions, including Unison, the Royal College of Nursing, the Royal College of Midwives and Unite.
The trust executives held a meeting with staff representatives in October 2025 and according to a summary of that meeting, seen by The Independent, medical secretaries warned they were “on the verge of resigning” as they felt their “well-being disregarded due to levels of stress/burnout”.
It said there was a backlog in letters needing to be typed for patients of between four and 10 weeks and added: “There are also backlogs of investigations, which are a patient safety risk.”
The letter warned that staff “have great concern” they couldn’t complete tasks due to short staffing and delays meant some patients ending up needing treatments they might not have needed if they were seen sooner, such as dialysis.
Staff also claimed they were being advised to stop submitting safety reports, because “management did not have time to deal with them.”
A source close to the matter said the grievance from admin staff was escalated to a formal hearing in May, but the outcome was yet to be decided.
Critical care nurses took industrial action twice this year, after the trust told nurses they could no longer work overtime.
Sarah Hall, the trust’s deputy chief delivery officer, insisted the trust was listening to concerns.
She said: “After concerns were raised, we took action to strengthen support for colleagues, improve key processes, and reinforce that safety incidents must always be reported. We recognise the importance of colleague wellbeing and continue to put measures in place to support this.”
“Patient safety remains our highest priority, and we continue to monitor services closely. Although there is a temporary pause on recruiting to some nonclinical roles, posts can still be approved once they have been reviewed through our Vacancy Control Panel.”
On Wednesday, following NHS England’s action, the trust executives told staff they were committed to “putting things right.”
However, despite the promises, staff in surgical theatres are still set to strike next week, while doctors have told The Independent they remain furious.
One doctor said: “I can tell you already the mood is one of anger and disbelief: the same people who have allowed Salford’s spectacular fall from grace over the last few years through underfunding, understaffing and a refusal to listen to the shopfloor workers’ views, are now sending us emails saying that they acknowledge NHSE’s and the CQC’s concerns, that significant progress has already been made and that we still need to get better.”
