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”.