Shocking details of incidents that should never have happened at hospitals in Carlisle and Whitehaven have been uncovered by The Cumberland News.

They include an anaesthetic block being administered to the wrong leg before surgery, the wrong eye being injected, the wrong tooth being extracted - and a swab that was accidentally left inside a patient's wound for six months following surgery.

The details come from a leaked theatre safety report carried out by the Royal College of Surgeons (RCS) in the aftermath of the six so-called "never events", between July 2015 and February 2016.

It concluded that although appropriate action had been taken to prevent further incidents, there were still a number of "significant concerns" - both in terms of the culture within theatres and pressures facing staff at the Cumberland Infirmary and West Cumberland Hospital.

The Cumberland News last year revealed that there had been a total of six never events at the North Cumbria University Hospitals NHS Trust, five of which were in theatres.

Details of the incidents were never made public - but we can now reveal the extent of the events.

They include:

* One case where a large swab, measuring nine by nine inches, was left inside a patient's wound - and not discovered for more than six months;

* Another saw the wrong part placed into a patient's knee during surgery because vital checks weren't carried out;

* A patient who had the wrong leg anaesthetised prior to surgery.

Last year The Cumberland News also uncovered a briefing letter sent by bosses threatening staff with disciplinary action over the errors.

At the time unions criticised trust managers for blaming individuals, rather than ensuring there were sufficient staff and resources.

The RCS agreed that the letter was counter-productive and "could be perceived as threatening".

It added that it "reinforced divisions between senior management and staff".

The RCS was invited to conduct an independent review in the wake of the never events - which were across a wide range of specialties.

A team visited the hospitals on July 19 and 20 last year, reviewing each incident, interviewing staff and looking at what has happened since.

It published its findings and recommendations just before Christmas.

Overall the RCS concluded that historic "cultural problems" were a key reason for the never events, with staff omitting key safety checks, along with increased pressures.

It said the trust's investigation into the causes of the never events and measures taken afterwards - including enhanced staff training - were robust and appropriate, and senior management are committed to addressing problems at the core.

But it also highlighted a number of concerns, describing the environment within the trust as "firefighting".

Rod Harpin, trust medical director, explained that the trust requested the review as part of its improvement work, and was acting on the recommendations to improve culture.

But the RCS report also raised questions about the safety of centralising more services in Carlisle - as is currently planned.

It said: "Centralisation of services at the Cumberland Infirmary has presented significant operational challenge for senior management.

"Issues such as moving equipment and staff over large distances also necessitate a focus on day-to-day running of theatre services."

It also raises concerns about staff morale.

"Many staff on the ground feel demoralised and blamed for never events. Goodwill towards the management had evaporated a long time ago and many staff do not feel supported in their roles," the report said.

Controversial plans put forward by the Government's Success Regime would see bed numbers drop across the Carlisle and Whitehaven hospitals - a move strongly opposed locally.

And the RCS report would appear to fuel concerns, stating: "Pressures which are placed on staff, most notably in respect of beds, staffing and equipment issues on the day of theatre, are causing significant distractions which could contribute to the occurrence of never events."

The report found that some staff did not take some safety policies seriously, viewing them as a "tick box" exercise or refusing to take ownership. It also questioned behaviour in theatres, with some operating lists starting late because staff were still on breaks.

Wider cultural issues included a historic east/west divide between the hospitals and operating lists that constantly overrun due to bed and equipment issues, particularly in Carlisle.

High levels of sickness also meant staff were constantly being moved to fill gaps, affecting continuity.

However it was reported that attitudes are improving and that training had helped.

Junior staff in Whitehaven told the review team they now felt they could raise concerns with senior colleagues when before they would be reluctant, though in Carlisle they were less confident.

Dr Harpin said that improvements are being made.

He added: "The report has been widely circulated to clinical staff as part of our improved approach to creating an open and positive learning culture.

“Following this review an overall improvement plan has been developed and is currently being implemented with all staff working in surgery.

"Surgical services were also inspected by the Care Quality Commission in September 2016 and the subsequent report recognised the efforts staff have gone to in order to improve safety in surgery and to prevent incidents from occurring.”