ProNurse

By Jeremy Laurance

Patients were ‘routinely neglected’, says most savage indictment of NHS trust How hundreds died after basic care was ignored

The worst hospital scandal in more than a decade has triggered the biggest review of safety in the NHS since the Labour government came to power.

Andy Burnham, the Health Secretary, announced an unprecedented five separate reviews of measures to protect patients yesterday, in response to an independent inquiry into failings at the Mid- Staffordshire Foundation Trust which concluded that it “routinely neglected” patients.

It is the biggest shake-up in the monitoring of the NHS since the Bristol children’s heart surgery scandal of the mid-1990s, in which babies lost their lives because doctors were not being properly checked. That scandal led to the establishment of regulatory mechanisms to protect patients which the catastrophe at Mid- Staffordshire has now shown to have comprehensively failed.

Gordon Brown said the failings were “completely unacceptable”. He told the Commons: “We understand both the sadness and the sorrow of all the relatives who lost loved ones in the Mid-Staffordshire hospital trust.”

The report of the inquiry, chaired by Robert Francis, QC, has convulsed the Department of Health which has scrambled to produce a response that would reassure patients barely two months ahead of an election. The reviews announced by Mr Burnham yesterday will examine how the regulatory bodies failed to spot what was going wrong at Stafford hospital (to be chaired by Mr Francis), the use of death rates to highlight problems in the NHS, alleged misconduct by doctors and nurses, a new system to regulate managers (who may be “struck off” like failing doctors), and protection for whistleblowers.

In addition, more than 300 cases where patients or relatives have concerns about the treatment they received at the trust are being reviewed by independent medical panels, a number of which are expected to lead to malpractice claims.

But the measures were not enough for the Tories who demanded a full public inquiry. Andrew Lansley, the shadow Health Secretary, said patients would be worried that the Government was “still not doing all it can” to prevent a repeat of “these awful events”.

Patients admitted to Stafford Hospital received care that was so lacking in the basic essentials that lives were sacrificed as a result. Mr Francis refused to put a figure on the number who had died but said it was “undeniably higher” than in other hospitals. Last March, an investigation by the NHS watchdog, the Healthcare Commission estimated there were between 400 and 1,200 excess deaths among emergency patients treated at the hospital between 2005 and 2008.

The inquiry re-iterated the earlier findings by the Healthcare Commission that patients were left lying in soiled sheets or on commodes, sometimes for hours, frightened and ashamed, as calls for help to use the bathroom were ignored. Some were left unwashed for up to a month, and others were left in pain, without drugs, and with food and drink out of reach. Staff failed to make basic observations and patients were often discharged before it was appropriate, with in at least one case alleged fatal results.

The report, which runs to 900 pages and is based on evidence from more than 900 patients and 80 current and former staff, is the most devastating indictment of an NHS organisation in memory.

There was a culture of low morale and a tolerance for poor standards fostered by a management board focused on financial targets rather than patient welfare. It persisted even after the Healthcare Commission exposed the hospital’s failings last March, with some staff and managers dismissing the findings and alleging the commission had blown matters out of proportion.

In answer to one of the biggest puzzles – how staff allowed the appalling care to persist for so long – the report found those who spoke out were ignored and there was “strong evidence” that many were deterred from doing so through fear and bullying.

Accepting all the recommendations, Mr Burnham said: “This was an appalling failure at every level of the hospital to ensure patients received the care and compassion they deserved. There can be no excuses for this.”

The former chairwoman of the trust, Toni Brisby, resigned last March. The former chief executive, Martin Yeates, stepped down from his post in March and resigned in May.

Under the microscope – Staffordshire inquiries

* March 2009: Healthcare Commission finds “appalling” standards of care and up to 1,200 excess deaths over three years.

* May 2009: Death rates for every hospital in England published.

* May 2009: Investigation into treatment at Mid-Staffordshire trust between 2005 and 2008 found patient complaints had been ignored.

* May 2009: Investigation into emergency care found “significant” improvements had been made.

* February 2010: Independent inquiry finds patients were “routinely neglected”.

* February 2010: Five more reviews announced by the Health Secretary.

Originally published by By Jeremy Laurance HEALTH EDITOR.

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