10:32am Wednesday 10th March 2010
By James Connell
THE disturbing and heartbreaking accounts of the lives of patients in Stafford Hospital conjure up a vision of hell rather than a hospital at the heart of the civilised world.
You need a strong stomach and steely nerves to wade through the at times revolting quagmire of neglect detailed in reports into the failings of this now infamous hospital, managed by the Mid-Staffordshire NHS Foundation Trust.
Estimates based on the now defunct Healthcare Commission’s report that sent shockwaves through the NHS suggest between 400 and 1,200 needless deaths at the hospital between 2005 and 2008.
A further damning report was published by barrister Robert Francis last month and it is a measure of the indignation, hurt and rage families still feel that many of them, some carrying pictures of their loved ones, branded it a whitewash the day it came out.
Many were angry that none of the doctors, nurses and managers suffered any formal sanction while Mr Francis left it up to the Secretary of State for Health to ask Monitor, the foundation trust regulator, to “de-authorise” Mid- Staffordshire as a foundation trust.
The list of what went wrong at Stafford (see panel, right) goes on across 367 pages of witness testimonies, covering the period from January 2005 to March 2009.
This shameful catalogue of suffering and death at a foundation trust hospital immediately begs a question: why are health bosses still so hungry to join the club?
Bosses at Worcestershire Acute Hospitals NHS Trust, which runs Worcestershire Royal Hospital in Worcester; Worcestershire Mental Health Partnership NHS Trust and the West Midlands Ambulance Service NHS Trust, are in the process of applying for their organisations to become foundation trusts.
The move gives them far more power to cut the apron strings of government and decide how they spend public money.
Before they’re granted foundation trust status, hospitals have to meet 13 key targets and standards, such as superbug screening, making sure cancer patients are treated within 31 days of diagnosis and ensuring 98 per cent of A&E patients are seen, treated or discharged within four hours.
But has this national obsession with targets, driven by government policy, made health chiefs lose sight of the big picture or are they vital quality control measures?
If foundation trust hospitals are supposed to be the leading lights of the NHS then the families of those who died have every right to be sceptical about the foundation trust label, pinned like an illdeserved medal to the pinstriped lapels of boardroom grandees.
But John Rostill, chief executive of Worcestershire’s hospitals, says pressing ahead with plans to make the organisation a foundation trust, which could be as soon as May, is the right move.
He said: “It’s a way of life in the NHS. We have to go to the next stage and become a foundation trust. The chief executive of the NHS has made it clear that he expects every current acute trust to become a foundation trust. The process is robust and it’s even more robust since the Mid-Staffordshire crisis. It is a very comprehensive review of all the relevant standards that we would apply to healthcare.
I would say, as an organisation, although it has been exhausting, it has also been exhaustive and we would say we’re a better organisation for it than before the process started.”
Mr Rostill hopes if the trust becomes a FT it will have more flexibility and accountability.
FTs can form alliances with the private sector and direct money into areas they consider to be of most benefit to local people (although they do run the risk of going bust like a failing business).
A new forum for patients’ views will be created called the Council of Governors. Some governors will be elected from the public membership.
The board meetings will also be in public to make the decisionmaking process as open as possible.
He said: “Let’s be absolutely clear – there is no rush by us to become a foundation trust. Half the acute trusts in the UK are already foundation trusts. We’re lagging behind. We have benefited from the extra pressure. Don’t forget that the Mid-Staffordshire report came at a time when Monitor was still learning. We are also operating in a new era now we have the Care Quality Commission.”
Ann Montague-Smith, chairman of Worcestershire LINk , a statutory patient group which represents the health and social care issues of the county, said: “The staff and management didn’t listen at Mid-Staffordshire. From my knowledge of the acute trust in Worcestershire, it is very different.
They do listen and they do care.”
The trust has appointed a medical director for patient safety, Dr Steve Graystone, who has said he wants to reduce ‘harm events’ which could lead to injury or death in patients by 40 per cent by 2012.
Trust leaders also go on walkabouts so they can spot aspects of care that need to be improved.
Dr Richard Taylor, MP for Wyre Forest, wants more power to be given to whistleblowers within hospital trusts as a result of what happened at Stafford Hospital.
He said: “I don’t think we will get the same thing happening at this trust as happened at Stafford.
Everybody has learned the lesson.
Safety and quality are the top priorities now.”
He is trying to introduce a Private Member’s Bill – the NHS Public Interest Disclosure Support Bill – which calls for independent support officers for NHS employees who wish to make certain disclosures in the public interest and to place a duty on NHS trusts and others to cooperate with these support officers.
The Bill is on the order paper for a second reading this Friday.
The key findings of the Francis report were that NHS bodies should learn from the report, develop early warning systems to prevent patients coming to harm, replacing the code of conduct for NHS managers with a new statement of professional ethics and consultation on a system of professional accreditation for senior NHS managers.
Mr Rostill is listening.
WHAT WENT WRONG IN STAFFORD
Among the incidents descrived in the report on Stafford Hospital are:
● An 85-year-old man with pneumonia left with no trousers on who fell 10 times
● A 67-year-old stroke patient found on the floor, covered in flies, who wasn’t fed for a week and later died
● A doctor who implied a stroke patient was drunk
● A patient whose husband had to bring her water bottles himself when nurses failed to, her underwear filling with blood after a biopsy because no one had bothered to apply a dressing
● Nurses failing to change soiled bedsheets
● A mugging victim with head wounds who had to make his own bed and waited four hours just to be assessed
● A nurse who said she could not help a patient because she had hurt herself having sex the night before
● A patient with gangrene who had pieces of his toe fall off which were then left lying on the floor for hours.
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