A retired consultant doctor has issued an urgent warning that more patients at Northern Care Alliance NHS Foundation Trust (NCA) hospitals will die avoidable deaths unless major changes are made. Dr Glyn Smurthwaite, 65, who worked as a consultant at Salford Royal from 1995 to 2024, described the trust as 'utterly unsafe' and 'toxic'.
It comes as dozens of patients have died or come to harm at NCA hospitals due to treatment delays and staffing errors, according to the trust's own reports, with a workforce under extreme pressure and facing high levels of staff absences over sickness. The NCA manages hospitals in Salford, Bury, Oldham and Rochdale, treating more than a million patients.
'Crumbling and toxic'
Dr Smurthwaite said: "I was appointed in 1995 and I left because the place was crumbling and toxic in 2023 early 2024. I've been a campaigner ever since because the place is utterly unsafe, and it's led by an utterly incompetent out of touch board who don't have a clue what's happening on the shop floor. It was failing miserably before the NCA was envisaged. It started to go wrong I would say 2008 or 2009, at this point around 2010 certainly things were getting worse."
The retired consultant said there was a 'system of governance that utterly failed and was incompetent' and called for the removal of the current board of directors. He also criticised the Datix patient safety reporting system, saying: "One of the questions when you fill the form in is if you want feedback, I always ask for feedback, I filled in hundreds and I honestly can tell you not a single one has ever resulted in anything meaningful. It's completely ineffective. It's not an ineffective system, it's ineffective because the people who run it are ineffective."
Locum appointments questioned
Dr Smurthwaite alleged that some consultant doctors are being appointed at NCA hospitals as 'locums', staff appointed on a temporary basis without needing to be on the General Medical Council's specialist register. He said: "The specialist register is a GMC [General Medical Council] document, so if you are a fully trained specialist you end up on the specialist register. There is a piece of statute, it is written into law, you cannot appoint a consultant in the medical fraternity who is not on the specialist register, that's driven to protect the public. There's a caveat to that, you can appoint a locum who isn't on the specialist register, a locum being a temporary post, but you can only appoint a locum to fill a gap, such as maternity leave. Rochdale and Oldham and Bury have got dozens of doctors who were appointed almost certainly as locums, who have morphed into permanent jobs. This is a failure of HR."
Asked if there could be more avoidable deaths at NCA hospitals without urgent changes, Dr Smurthwaite said: "Undoubtedly." He added: "You've got a huge tranche of non-clinical managers, they've grown like rabbits, and you've got a board generally run by people who are just managers with no insight at all about what the actual shop floor does."
Asked what needs to be done to improve, he said: "The board needs to be removed and whichever new board is imported needs to genuinely start showing interest and finding out what are the problems on the shop floor. That is the problem, the disengage between the people managing the organisation and what the organisation actually does. It is terrifying, I wouldn't go to any NCA sites as a patient, I mean any of them. And I worked there for 30 years, I am acutely embarrassed about the state of the NCA."
Patient experiences
The Manchester Evening News (M.E.N) has spoken to patients treated at NCA hospitals, with experiences of people 'screaming in pain' while staff were 'too busy' to help, and a 76-year-old who spent 36 hours on a trolley in A&E and claimed she became 'really poorly' after experiencing the NCA's standards of care. Lengthy delays at NCA hospitals were linked with '28 deaths' and 56 issues of 'severe harm', while problems diagnosing illness led to ten deaths last year.
Joshua, who asked not to give his surname, said he spent around 16 weeks in hospital on and off after developing a "life-threatening" infection following a non-urgent knee surgery at Fairfield General Hospital. He was admitted to Salford Royal with septic arthritis around a week after undergoing keyhole surgery on his knee. He subsequently underwent several procedures and courses of antibiotics, but said the infection repeatedly returned - and he eventually required a through-knee amputation.
Joshua described instances when basic care was delayed or missed on the hospital's trauma and orthopedic ward, including meals, water and medication. He also described "one of the worst incidents", when he claims he was left bleeding heavily after a "considerable surgery" and was forced to shout for help for 15 minutes. "As soon as I stood up after [ward staff] left, it started bleeding everywhere," Joshua told the M.E.N. "I wasn't mobile and I was trying to get hold of someone. I was shouting 'help' out of the door. It took about 15 minutes for someone to acknowledge I was shouting for help. They came rushing in and there was blood everywhere."
Another woman, who will remain anonymous, said her 76-year-old mother was sent to the hospital's emergency department by her GP in January after dangerously low blood pressure readings. She said her mother, who has heart failure, spent around 30 hours on a trolley in an A&E corridor and was not given a pillow or blanket. She claims her mother was eventually discharged by an A&E nurse with tablets, which she later believed were the wrong strength of medication. During a separate hospital visit weeks later, the woman said her mother spent another 36 hours on a trolley in A&E. Following admission to the cardiology ward, she claims issues with medication persisted, with her mother given doses she believed were incorrect or insufficient.
Political and official responses
Salford MP Rebecca Long-Bailey said: "I have been raising patient safety and whistleblowing concerns at the NCA for some time, working with patients, families and staff affected by the John Bradley Williamson case, challenging the Trust over Salford gynaecology, and taking concerns directly to Government. These latest allegations strengthen the case I have already been making: staff must be able to speak up safely, concerns must be properly investigated, and there must be independent scrutiny where the Trust has failed to act. This is not about undermining the many dedicated staff working across the NCA. It is about ensuring they are properly supported, that they can raise concerns without fear, and that patient safety is always put first. I will continue pressing the NCA, NHS England and Ministers until patients and staff can have confidence that these issues are being addressed."
Elsie Blundell, MP for Heywood and Middleton North, said: "Like others locally, I rely on the services of the Northern Care Alliance. I gave birth to my daughter in the Royal Oldham, and my family continues to use that hospital when needed. I am therefore very concerned to read about the issues within the NCA and, on behalf of local residents, have written to the chief executive to demand an update in person. The vast majority of people will only have positive things to say about the wonderful staff in our NHS, but we depend on these hospitals to keep us in good health and care for us in emergencies. Something has clearly gone wrong and situations like this erode the trust of patients. We need swift action to reassure us that the health service we deserve is being provided. I will also raise this issue with the health secretary."
Salford, Bury and Oldham councils have issued similar statements about the issues at the NCA, explaining that they are aware of the concerns. A Salford City Council spokesperson said: "Patient safety must always be the highest priority across the NHS, and it is important that any concerns raised by staff are investigated thoroughly and transparently through the appropriate processes. Salford City Council has been made aware of the concerns being raised about patient safety and services provided by the Northern Care Alliance. It would not be appropriate for us to comment any further until those investigations have been completed. The people of Salford deserve the very best care and hospital treatment, anything less is unacceptable."
The Northern Care Alliance said in a statement: "It's always incredibly sad to hear a patient or a loved one hasn't been satisfied with their care or treatment. Every patient deserves safe, high-quality care. We absolutely encourage patients and their families who have concerns to contact our Patient Advice and Liaison Service (PALS). PALS can investigate matters thoroughly and work with those involved to better understand their experience and help address any concerns they may have. Every patient deserves safe, high-quality care and our colleagues are absolutely key to delivering this. In April 2026, we purposefully changed the way we run our organisation, putting more clinicians into leadership positions and giving them a direct role in making decisions and driving improvements within frontline teams. Like many NHS organisations, we're facing challenges. We're clear about what those challenges are and recognise the concerns colleagues have raised. We are working to address those concerns and will continue to listen when colleagues tell us we haven't got something right, so that we can keep learning and improving. We have clear processes to investigate incidents and learning from these is an area we need to prioritise. By doing this, we can drive forward improvements and maintain our focus on safety. We'll continue to work with our partners, including our local authorities and Integrated Care Board, as part of our ongoing commitment to making improvements."
A Department of Health and Social Care spokesperson said: "The safety of patients is paramount, and every NHS trust must provide safe, high-quality and timely care. Clearly this wasn't the case at the Royal Salford Hospital and patients were severely let down. NHS England is working at pace with the trust and Greater Manchester ICB to support rapid improvement , strengthen oversight and accountability. We are also prioritising gynaecology services in surgical hubs, at Community Diagnostic Centres, and in pathways for NHS Online. We know there is much more to do but we are determined to make sure the NHS is the safest in the world."
A spokesperson for NHS England in the North West said: "Patient safety is our top priority, and where we have concerns about a trust's ability to deliver safe, effective care, we take decisive action. The Northern Care Alliance NHS Foundation Trust is already subject to enhanced national and regional oversight, with a coordinated programme of intensive support underway that includes formal undertakings on quality of care and quality governance agreed with the trust. We are working closely with the Trust's leadership to ensure the necessary changes are made, and will continue to monitor progress closely."
