NHS: Teams sent to hospitals after high death rates

Sir Bruce Keogh said 'we are laying bare some truths'. Picture: Greg Macvean
Sir Bruce Keogh said 'we are laying bare some truths'. Picture: Greg Macvean
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Health officials were forced to step in to stop patients from being harmed at hospital trusts in England investigated over high mortality rates, it has emerged.

The review team said they identified issues that had to be “tackled immediately in order to avoid causing harm to patients”.

They identified a series of failings, including staff pushed to breaking point, inadequate numbers of staff and basic safety checks not being carried out.

They said they witnessed a “lack of compassion” among staff so busy they were unable to deliver compassionate care to patients. One of the review team described holding the hand of a patient because nurses were stretched so thin they were unable to do so.

The investigation, led by NHS medical director Professor Sir Bruce Keogh, found that none of the hospitals investigated was providing “consistently high-quality care to patients” and all 14 trusts have been ordered to act on recommendations set out by health officials.

Health Secretary Jeremy Hunt said that 11 of the trusts would be put into “special measures” for “fundamental breaches of care” and external experts will be sent in to help improve patient care.

Mr Hunt told MPs: “No statistics are perfect but mortality rates suggest that since 2005 thousands more people may have died than would normally be expected at the 14 trusts reviewed.

“Worryingly, in half of those trusts, the Care Quality Commission – the regulator specifically responsible for patient safety and care – failed to spot any real cause for concern, rating them as ‘compliant’ with basic standards.”

Sir Bruce said: “This is a very difficult day for the NHS because we are laying bare some truths.

“On the other hand I think the transparency with which these reviews have been conducted, I hope will be a turning point for the NHS.

“We had to take immediate action in a number of areas; there were issues with unsafe shift patterns, we had to close two operating theatres because the ultra-clean air conditioning wasn’t working and in one place we found a large backlog of complaints that simply weren’t being dealt with.”

NHS England’s regional director of nursing in the Midlands and the East, Ruth May, who sat on the review panel, said: “In some hospitals and in some ward areas there was inadequate staffing levels.

“I held a hand of a patient just comforting them because the nurses did not have sufficient time to do that.

“I observed some aspects of care that did lack compassion. I would argue that we saw at the same time as seeing that poor levels of staffing.”

Sir Bruce’s review found examples across many of the hospitals of professional and geographic isolation, failure to act on information that showed cause for concern and an absence of a “culture of openness”.

Specific examples included patients being left on trolleys, unmonitored for “excessive periods” and then being “talked down” to by consultants.

Patients were often moved repeatedly between wards without being told why, his review found. Other areas of concern highlighted included staff working 12 days in a row without a break and low levels of clinical cover, especially out-of-hours.

Review teams also found that some patients were “inappropriately exposed” where there were both male and female patients present as well as a large number of “never events” – care failings which are never supposed to occur in the NHS – at some trusts.

At East Lancashire NHS Trust, one of the 11 put into “special measures” the review teams found there had been a “high level” of stillborn babies in March this year – but the trust had failed to investigate.

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