NHS inquiry results in 11 trusts placed under ‘special measures’

The furore is continuing over the alarmingly high death rates at 14 hospitals, following the publication of NHS England medical director Professor Sir Bruce Keogh’s review, who described the situation at the 14 hospitals as “trapped in mediocrity”, saying that had often disregarded concerns raised by either patients or staff.

The report highlighted staffing levels behind many of the issues and lack of oversight, adding that staff regularly did not attend to the needs and requirements of patients.

Shockingly, a member of Sir Bruce’s review panel even stated that there may be other hospitals across the country that have more appalling care and conditions than those at the 14 hospitals involved in the investigation.

Health secretary Jeremy Hunt also revealed yesterday that 11 of the NHS trusts are being placed under “special measures”, saying “we can no longer ignore mediocre treatment.” The 11 in the spotlight will be subjected to intense on-going scrutinisation for the immediate future, including “hit squads” of external experts being sent in to oversee the urgent improvements.

Speaking in the commons, Mr Hunt told fellow 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.”

Some of the 11 hospitals facing intense monitoring include Tameside Hospital NHS Foundation Trust, in Greater Manchester, where Sir Bruce’s teams discovered some patients were being left unattended for several hours on trolleys and Burton Hospitals NHS Foundation Trust, with many staff being found to have worked for 12 hour stretches.

Sir Bruce’s report highlighted countless other examples of poor care at the 11 worst hospitals, such as patients being repeatedly transferred between wards without being given an explanation why, blood being taken from patients in open view of fellow patients on wards, and low levels of clinical cover – out of hours times in particular.

Sir Bruce said: “Higher mortality rates do not always point to deaths which could have been avoided but they do act as a ‘smoke alarm’ indicator that there could be issues with the quality of care. Not one of these trusts has been given a clean bill of health by my review teams. These reviews have been highly rigorous and uncovered previously undisclosed problems. Mediocrity is simply not good enough and, based on the findings from this review I have set out an achievable ambition which will help these hospitals improve dramatically over the next two years.”

The row has quickly gotten political in the commons, with several heated exchanges taking place this week as the Conservatives and Labour were quick to point the finger at each other for the NHS failings.

Mr Hunt tried to blame the failings within Sir Bruce’s report on the previous Labour Government, saying Andy Burnham, the Shadow Health Secretary, had not acted on warnings of poor care quality when he was in office and of “muzzling” regulators.

He also claimed that since 2005 “thousands more people may have died than would normally be expected” across the 14 hospitals with high mortality rates.

But Sir Bruce was quick to disregard Mr Hunt’s accusations however, saying that any effort to use statistical measures to “quantify actual numbers of avoidable deaths” was “clinically meaningless and academically reckless”.

After the publication of findings at the 14 hospitals, the NHS now has to comply with eight ‘ambitions’ by Sir Bruce in the report:

1. Reduce avoidable deaths with early warning systems for deteriorating patients and introduce more accurate statistical measurement of mortality rates.
2. Expertise and data on how to deliver high quality care to be more effectively shared between NHS trusts.
3. Patients, carers and the public should be more involved, and should be able to give real-time feedback.
4. Patients should have more confidence in the regulator the Care Quality Commission, with wider participation of patients, nurses, and junior doctors on review teams.
5. Hospitals in remote areas should not be left isolated, with staff from better-performing hospitals used to train and inspect others.
6. Nurse staffing levels and mix of skills should be appropriate to the patients being cared for on any given ward.
7. Medical directors should “tap into the latent energy of junior doctors” and include them in review panels.
8. NHS employers should make efforts to ensure staff are “happy and engaged”.

NHS mistakes increase as more patients are needlessly dying

Damming statistics have been released that show errors by NHS staff are increasing each year, needless deaths are occurring due to misdiagnosis, and hospitals are full to the extent that nurses and doctors are struggling to maintain the safety and quality of patient care resulting in almost 3,000 deaths each year and 7,500 being wrongly diagnosed, administered with wrong drugs or poorly cared for.

Titled ‘How Safe Is Your Hospital?’, a documentary was screened last night on BBC1 at 8.30pm for  Panorama showing just how huge pressure from increasing demand, limited finances and the biggest reorganisation in its history, is leaving thousands of patients at huge risk.

BBC Reporter Declan Lawn was documented exploring numerous serious problems in trusts across England and the latest figures of death rates will be seen.  In particularly, during 2011/12 it has been revealed that a shocking 2,864 patients died after mistakes were made by NHS staff. During 2010/11 there were 2,726 deaths due to similar reasons, representing a 5% increase. Viewers last night were shocked to learn that some of the mistakes made included elderly patients being misdiagnosed as having cancer when they in fact had heart failure, and thus receiving unnecessary and pointless treatment as their health declined.

Other errors that have been made include nurses failing to notice chest infections in new-born babies that may have been cured with adequate treatment such as antibiotics.

Health Secretary Jeremy Hunt reacted to the worrying statistics and acknowledged that there could be ‘pockets’ of poor care, similar to that seen during the 2008 Stafford Hospital scandal which erupted after an investigation by the Healthcare Commission following the Commission receiving news that there was ‘apparently high mortality rates in patients admitted as emergencies’ between January 2005 and March 2009. Approximately 1,200 patients were believed to have died as a result of varying examples of incompetence and mainly due to the scandal, the mortality rates of every NHS hospital are now able to be viewed online.

In a statement given for the Panorama documentary, the Health Secretary said: “Whilst failings in care at Mid-Staffordshire  NHS Foundation Trust have shocked many, we cannot say with confidence that some of those failings do not exist in pockets elsewhere in the NHS. Whilst the majority of patients receive excellent care from the NHS, we still have much to do to ensure quality of care is considered as important as quality of treatment throughout the system.”

Dr Mike Williams, of the University of Exeter, has conducted recent studies regarding hospital safety and says: “Doctors, nurses, and managers do not realise the level of harm that’s going on hospitals. Most hospitals are now having more and more patients coming through the front door. The money is at standstill, if not reducing. The number of staff are therefore at the same level, they’re having to do more work – and work harder and faster. The research is very clear that where staff have to work extremely hard they are much more likely to make mistakes.”

The BBC documentary into the NHS comes in the same week it has been revealed that hospitals are fully crammed with patients, leading to a decline in the quality of care that is available. Healthcare information firm Dr Foster – partially owned by the government – shows that bed occupancy rates are well over 85% on many occasions. This is the limit that is recommended in order for patients to receive good care and also not exposed to health risks.

The NHS themselves have previously stated that 85% or above puts them in a difficult position to provide high-quality care and keeping the rate below this can help to limit the chances of patients  contracting an infection within the hospital as well as ensuring that staff do not make any errors when dealing with patient’s medication.

Worryingly, it seems the problems could get a lot worse. More and more hospitals are on ‘red alert’, meaning they do not have many beds to spare. Others are even worse off though, declaring themselves on ‘black alert’, having to refuse any new admissions and direct patients elsewhere.