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Eleven hospitals put on notice

Published on 17/07/13 at 08:35am
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There were angry exchanges in the House of Commons yesterday as health secretary Jeremy Hunt announced that 11 hospitals in England were to be put into ‘special measures’.

He was making a statement on hospital mortality rates in England in 14 NHS Trusts following the publication of a report on them by NHS medical director Professor Sir Bruce Keogh.

The report was commissioned by the government following the Francis report into failures at the Mid Staffordshire NHS Foundation Trust, and focused on hospitals with mortality rates which have been consistently high for two years or more. 

Hunt put the blame for scandals such as Mid Staffs squarely at the door of the previous Labour administration, including his current opposite number Andy Burnham, who was formerly health secretary.

Hunt was ‘cynical’ and ‘squalid’ in attempting to ‘besmirch’ and ‘smear’ Labour’s record on the NHS, according to various Labour MPs.

Former Labour home secretary Jack Straw said that the blame Hunt put on Labour ‘demeans his office’ and that it was “inappropriate to suggest that he and his party have a monopoly” on compassion - a charge that has frequently been used in reverse by Tory politicians in recent years.

Former Labour health secretary Alan Johnson said that Keogh’s report was of a ‘vastly superior quality’ to Hunt’s statement, while Labour’s Chris Bryant said: “In a quieter moment the secretary of state will probably think this has not been his proudest moment.”

But Conservative Bill Cash was in combative mood, telling the chamber that an investigation into Mid Staffs had been initially refused by Labour because they “were not prepared to have an inquiry and it was a cover-up”.

Hunt stuck to his guns, rebuffing Labour criticism and frequently returning to his theme.

The speaker John Bercow had to repeatedly call the house to order in a series of ill-tempered arguments - at one point stopping proceedings to warn whoever had shouted ‘a word that was unparliamentary’ to desist from doing so again.

There was also concern over the figure of 13,000 avoidable deaths which has been in recent media reports - it does not appear in Keogh’s report and the government denies leaking it.

However, Keogh did find that there were a variety of problems in the 14 trusts, many of which had not been disclosed before, saying: “Not one of these trusts has been given a clean bill of health by my review teams.”

General issues include: failure to act on data that showed cause for concern, lack of openness, no willingness to learn from mistakes and ineffectual governance and assurance processes.

“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,” Keogh said.

Specific problems identified in the report included: patients being left on trolleys, ‘unmonitored for excessive periods’, arrogant consultants, poor maintenance in operating theatres, staff working for 12 days in a row without a break and low levels of clinical cover, especially out of hours.

Keogh described his role as providing “a clear diagnosis, to write the prescription, and, most importantly, to identify what help these organisations might need to support their recovery or accelerate improvement”.

He has set out, he believes, an “achievable ambition which will help these hospitals improve dramatically over the next two years”.

The 14 hospitals will be inspected again within the next year by the new chief inspector of hospitals, Professor Sir Mike Richards, who took up his post this week.

The NHS as a whole will be expected to make “demonstrable progress to reducing avoidable deaths” while doctors and managers will no longer be isolated from one another, the government insists.

Nurse staffing levels will ‘appropriately reflect the caseload’ and be transparently reported by Trust boards.

“Patients will not just feel like they have been listened to but will be able to see how their feedback is impacting on their own care and the care of others,” it concludes.

Adam Hill

 

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