Hospital scandal: missed warnings

The shocking extent of the failures at an NHS hospital where hundreds of patients died unnecessarily can be disclosed today.
Senior managers at Stafford Hospital were told repeatedly that the standard of care they were delivering was not good enough but each time the warnings were ignored.

The disclosures follow the publication last week of a damning report by the NHS regulator, the Healthcare Commission, that found that hundreds of patients died at the hospital because of the “appalling” treatment they received.

Today, The Sunday Telegraph can disclose that executives at Stafford Hospital were warned as early as 2002 by the commission’s predecessor that it had problems with the standard of its emergency care services and that it was not adequately staffed. However, they failed to act on the warnings.

In 2006, a former government adviser warned the hospital about the standards of hygiene in A&E. Again, the warning was ignored.

It was only when alerts were issued over the high mortality rate at the hospital that alarm bells rang.

At that stage an investigation by the Healthcare Commission began, resulting in the publication of last week’s report and the suspension on full pay of Mid Staffordshire NHS Foundation Trust’s chief executive, Martin Yeates, and the resignation of its chairman, Toni Brisby.

The Sunday Telegraph launches a campaign today for a series of measures to ensure that the crisis in Staffordshire is never repeated in the NHS. The Heal Our Hospitals campaign demands the establishment of an independent inquiry into the regulation and supervision of NHS hospitals.

This has been endorsed by the Patients Association and the Cure the NHS campaign group, which worked to expose the crisis at Stafford Hospital. The two groups today launch a petition demanding an inquiry.

Richard Branson, the vice-president of the Patients Association, said: “The most important thing is that patients are happy and safe. I’ve signed the petition because I think patients need to have confidence that they will be. Inquiries are not about laying blame, they are about finding answers to important questions.”

This newspaper is also calling for:

Þ A review of hospital targets to ensure that they work to improve quality of care.

Þ Nurses to focus on patient care — not form-filling — as their central duty.

Þ Routine publication of comprehensive death rates for hospitals.

Þ Patients to be given a stronger voice in the running of hospitals.

Þ Assurance that senior hospital staff will not be rewarded for failure.

In an interview with The Sunday Telegraph yesterday, the chairman of the Healthcare Commission condemned the board at Mid Staffordshire NHS Foundation Trust and bosses at the strategic health authority for failing to act.

Sir Ian Kennedy said it was clear that serious problems at the hospital were evident as far back as 2002, yet no action was taken by managers.

Sir Ian said board members and managers who had not already left should “examine their consciences”.

“Anybody who had any responsibility for leadership and management must ask how they allowed this place to get into the state where patients were dying,” he said.

Terry Deighton, an expert in risk assessment who carried out the inspection of A&E in February 2006 that led to another warning for Stafford Hospital, described the conditions as “absolutely disgusting”. He found blood encrusted on seats, puddles of urine on the lavatory floors and doctors and nurses washing their hands in sinks encrusted with grime.

Mr Deighton’s report said standards of cleanliness risked placing patients in danger of infection but Mr Yeates insisted that Stafford Hospital was “very clean” and refused to meet Mr Deighton for over a year.

The commission has also criticised standards of care at Birmingham Children’s Hospital NHS Foundation Trust (BCH) after it struggled to meet rising demands.

The commission is also investigating allegations that West London Mental Health Trust did not do enough to prevent patients harming themselves and other people.

The disclosures have led to concern about standards of care in the NHS and calls for a change in the target-driven culture that many emergency care specialists believe is distorting clinical priorities within A&E departments.

The Sunday Telegraph’s campaign has received the backing of health experts and practitioners.

Claire Rayner, the president of the Patients Association, said: “The target culture has led to a dreadful waste of professional time and extra layers of management.”

John Heyworth, the president of the College of Emergency Medicine, said: “The lack of doctors and nurses identified in Stafford is a dramatic example of what can happen when the focus on care in departments is lifted.”

Dr Peter Carter, the chief executive of the Royal College of Nursing, said: “Many of the catastrophic failings identified at the Mid Staffordshire trust could have been avoided if there were simply enough nurses to care for patients.”

The Conservatives will set out their own plan to put patient safety first this week. It includes giving patients power to hold failing hospitals to account, an end to the target culture and tougher inspections to root out failure. Andrew Lansley, the shadow health secretary, said: “I welcome The Sunday Telegraph’s campaign. We need to make sure that patients are listened to and give responsibility to doctors and nurses.”

A survey for Channel 4’s Dispatches programme to be broadcast tomorrow indicates that many nurses believe that the lives of patients were being placed in danger by a lack of training, staff shortages and long hours. It also indicates that more than a third (37 per cent) think that patient care in the NHS has become worse in the past five years. Mr Yeates refused to comment but his replacement, Eric Morton, said: “Care standards fell below those that our patients had a right to expect of their hospital and we regret this. We would like to offer our very sincere apology.

“We would like to reassure the local community that our focus is, and will remain, on providing high-quality, efficient and safe health care for the people of Staffordshire.

“We have put in place effective governance structures to address the key issues.”

The Department of Health responded to the launch of The Sunday Telegraph campaign by insisting that the problems in Mid Staffordshire were down to “a complete failure of management” at a local level, which had been revealed through a “meticulous” inquiry by the Healthcare Commission.

A spokesman said the system of regulation and management would be reviewed; trusts were expected to monitor mortality rates, and there was no secrecy over the figures; and the system of targets set minimum standards which patients would expect.

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