One of the NHS’s biggest and most prestigious hospitals has been put into special measures after inspectors said failings including serious staff shortages were putting patients’ safety at risk.

Addenbrooke’s hospital in Cambridge, renowned for providing high-quality care including excellence in organ transplant medicine, has become the 26th NHS trust in England to be placed into the NHS’s improvement regime.

Problems recruiting enough staff and the sheer demand for care meant that planned operations were often cancelled and the maternity unit had to close regularly. In addition, patients were waiting longer than the maximum 18 weeks for elective care and up to 51 weeks for an outpatient appointment for eye care.

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While the Care Quality Commission (CQC) praised Addenbrooke’s staff as hard-working, passionate and caring, it rated the overall services it provides as inadequate, and recommended it enter the special measures process.

CQC inspectors demanded improvements after highlighting a series of serious concerns at the 1,000-bed hospital. They included:

A significant shortage of staff in a number of key areas, including critical care.



Staff being moved from ward to ward to cover gaps in rotas, even though some lacked the necessary training to do so.



Too few midwives to cover the number of births in the Rosie birth centre adjoining Addenbrooke’s.



Senior managers knowing for two years about high levels of nitrous oxide – laughing gas used for pain relief during childbirth – circulating in the birth centre, but doing too little to tackle it.



High use of agency and bank staff to try to maintain adequate staffing.



It found particular evidence of poor practice at the birth centre. Good practice medical guidelines were not being followed, for example, on continuously monitoring babies’ heart rates during labour with a fetal heart monitor.

Last winter, Addenbrooke’s incurred some of the worst breaches of the four-hour target for treating A&E patients and was one of almost 20 hospitals to declare a major incident in January when it struggled to cope with the weight of demand.

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Dr Keith McNeil, its chief executive at the time, pointed out that a key part of its problems was due to 200 of its beds being taken up with patients who could not leave because social care was not in place to support them when they did.

McNeil announced last week that he was leaving the trust after almost three years in the job, so that a successor could address “a number of very serious challenges here in Cambridge, including a growing financial deficit”. The trust is losing £1.2m a week.

After his announcement, McNeil took the unusual step of criticising the CQC’s negative appraisal of the trust, branding it wrong. Many of the trust’s doctors have rallied to support him, with calls for his reinstatement.

Addenbrooke’s was phenomenal, he told the BBC. “People’s lives are saved every day by that hospital,” he said. “I cannot see why anybody would want to describe it as inadequate.”

He added that there was not “any sane or rational interpretation of the word ‘inadequate’ that would describe any aspect of the operations at Addenbrooke’s”.

But explaining his decision to recommend the trust goes into special measures, Prof Sir Mike Richards, the CQC’s chief inspector of hospitals, said: “We were concerned that in some services staff were caring for people in areas unfamiliar to them, meaning patient safety and welfare was placed at risk.”

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Richards told BBC Radio 4’s Today programme on Tuesday that beds being taken up by patients because of of social care needs not being met fast enough was a problem throughout the country. “It is a question then how well the hospital is working with its community, its local authority and CCG [clinical commissioning groups] to make sure these things are expedited as far as possible. The fact is, it’s not just the local authority’s problem, it’s the hospital’s problem.

“Sometimes hospitals think it’s all outside their control but it’s actually not. We go to all the hospitals in the country and we see variation in how hospitals respond to the challenges, which are broadly similar across the country. What’s different is how they are responding and that’s about the management of the hospital.”

The CQC rated the hospital as outstanding for caring but handed down its overall judgment of inadequate on grounds of its poor safety and leadership.

The Cambridge University hospitals NHS foundation trust chair, Jane Ramsey, said she accepted the report and apologised to patients and local residents. “We are absolutely on the case and have not waited since the inspection in April. On outcomes, we have some of the best in England, and in Europe, with survival rates for cancer, really low hospital infection rates and low mortality rates. I want to reassure patients this a good hospital to come to.”

East Sussex healthcare NHS trust is also to go into special measures after the CQC uncovered problems there. They included understaffing in surgery, maternity and pharmacy services, patient records not being securely stored and, on two wards of the Conquest hospital – near Hastings in East Sussex – medicines stored at the wrong temperature. It also frequently breached national rules on providing separate accommodation for male and female patients.

The two trusts are the 23rd and 24th to be put into special measures since Robert Francis QC’s landmark report in early 2013 into the Mid Staffs care scandal.