In a letter to the trust, NHSE highlights a ‘series of escalating quality concerns over the previous 18 months'.

The letter states: ‘The Licensee is currently unable to provide assurance, as described in the independent review of quality governance by the GGI, that the organisation has a clear and consistent quality governance structure across the whole organisation that will ensure no further patients may suffer harm. The Licensee does not have effective systems and processes to identify and address risks affecting the quality and safety of the surgical wards.'

Dr Owen Williams, chief executive at the Northern Care Alliance NHS Foundation Trust, said: ‘We recognise the seriousness of the concerns raised by NHS England.

‘Over the past 18 months, we have worked with NHS England to improve services, respond to Care Quality Commission concerns and strengthen governance across the organisation.'

While noting the concerns include spinal, gynaecology and other surgical care, Dr Williams acknowledged the undertakings are about wider organisational improvement.

The chief executive said ‘real improvement has already been made, and we are committed to building on it'.

He said a new organisation structure had been introduced to move decision-making closer to patients and progress had been made in some areas, including gynaecology, but more needed to be done to make improvement consistent and lasting.

‘Our focus now is on delivering safe, consistent care and continuing to build on the progress already made,' Dr Williams said.