NHS inquiry: Shaming of health service as care crisis is laid bare
The shocking conditions in Britain’s hospitals have been laid bare by an official report which disclosed that failings uncovered in NHS wards were so bad that inspectors felt compelled to abandon their impartial roles and step in to alleviate patient suffering.
By Laura Donnelly, and Patrick Sawer
Eleven NHS trusts were put into “special measures” after an investigation found thousands of patients died needlessly because of poor care.
The report blamed poor staffing levels and lack of oversight, and said that staff did not address the needs of patients. It concluded the hospitals investigated were “trapped in mediocrity”.
In a row that quickly became political, David Cameron said responsibility lay with the previous Labour government, which he accused of “covering up” the NHS failings that stretched back to 2005.
Jeremy Hunt, the Health Secretary, said the findings exposed by the investigation into 14 NHS trusts were Labour’s “darkest moment”.
He said ministers owed it to patients to “tackle and confront abuse, incompetence and weak leadership head-on”.
Labour’s shadow health secretary, Andy Burnham, left, and Jeremy Hunt, the Health Secretary (PA)
Labour’s shadow health secretary, Andy Burnham, hit back, saying that the crisis in the NHS had worsened under the Coalition.
The review, ordered by the Prime Minister, began in February following the public inquiry into the scandal at Mid Staffordshire Hospital Foundation Trust, where up to 1,200 people died amid “appalling” failings in care.
Inspectors visited 21 hospitals, run by 14 NHS trusts, which had the highest recent mortality rates in England. They found that some of the risks to patients were so severe that they were forced to step in immediately.
During the visits, decisions were taken urgently to close operating theatres, suspend unsafe “out of hours” services for critically ill patients, order changes to staffing levels and to force hospitals to tackle major backlogs of scans and X-rays that had gone unexamined.
During one inspection, a senior nursing official was so dismayed by the shortage of staff that she stepped in to comfort one patient physically because they had been ignored by staff.
Ruth May, nurse director for NHS Midlands and East, said: “In some hospitals, in some ward areas there was inadequate staffing — we heard from patients about call bells going off for longer periods than they should have been. I held the hand of a patient — just to comfort them — because the nurses did not have sufficient time to do that.”
The review, led by Sir Bruce Keogh, the NHS Medical Director, found that all had “ingredients” of the Mid Staffs scandal.
The report said: “Where we found areas of concern, we acted immediately.
“We didn’t wait for a disaster so that we could be absolutely certain.”
Sir Bruce’s report uncovered disturbing examples of hospital staff failing to treat patients with compassion, while basic safety was put at risk.
Clear links were found between shortages of staff and the high death rates that had triggered the investigation.
At Buckinghamshire Healthcare NHS Trust, junior doctors described a “frightening” workload which left them responsible for up to 250 patients at weekends. Elderly patients were left on the lavatory with the door open, while others were left on trolleys for hours on end. At one of the trust’s community hospitals, nurses were forced to call 999 because there were not enough doctors.
At Blackpool Teaching Hospitals Foundation Trust, patients’ families had to feed other patients because nurses were busy while other vulnerable elderly people were left in soiled conditions. At Northern Lincolnshire and Goole NHS Foundation Trust, relatives said they were not only washing and dressing patients but turning them to prevent bed sores. Receptionists were left to take decisions about how quickly patients were seen in A&E, as happened in Mid Staffs.
Sir Bruce said: “For me this is in many ways a difficult day for the NHS — because we are laying bare some truths. On the other hand, the transparency with which this review has been conducted, I hope will be a turning point for the NHS.”
Dirt and dust was found to be “ingrained” on the wards at North Cumbria University Hospitals NHS Trust and two operating theatres were shut immediately due to poor hygiene.
Figures showed up to 13,000 excess deaths since 2005 at the 14 trusts investigated, advisers to the review said.
“No statistics are perfect but mortality rates suggest that since 2005 thousands more people may have died that would normally be expected at the 14 trusts reviewed,” Mr Hunt told the Commons.
At Basildon and Thurrock University Hospitals NHS Foundation Trust, up to 1,600 people more than expected may have died during the period. Inspectors found patients stayed up to two weeks in temporary areas without shower facilities. Others were left in ambulances “stacked” outside A&E departments, or waiting hours on trolleys.
At East Lancashire Hospitals NHS Trust, high numbers of stillbirths at the maternity unit — eight in March — were never investigated, nor reported to the trust’s board. An elderly woman was discharged at 3am and told she had “no choice”, inspectors found.
Patients at George Eliot Hospital waited up to 10 days to see a senior doctor. Nurses were not trained to treat bedsores, leaving patients in crippling pain. At Sherwood Forest Hospital NHS Foundation Trust, inspectors found significant backlogs of scans and X-rays which had never been examined, and complaints which dated back three years.
At Tameside Hospital NHS Foundation Trust, whose chief executive and medical director resigned this month, wards had no doctors in charge at nights, while patients were shifted from ward to ward.
At United Lincolnshire Hospitals NHS Trust there were 12 “never events” — incidents so serious, such as operations on the wrong part of the body, or surgical instruments left inside a patient, that they should never occur — in three years. Patients felt too frightened to complain in case it led to worse care, the report found.
The Government blamed Labour for the failings, which it said patients had endured for years, despite Labour more than doubling spending on the NHS. However, last night the Royal College of Nursing said there were 6,000 fewer nurses than at the time of the general election in 2010.
Mr Hunt said 11 of the trusts would be put into “special measures” for “fundamental breaches of care” and external experts would be sent in to improve patient care. All 14 trusts have been ordered to make changes.