Inadequate overall rating for Bart’s Health NHS Trust 23 Mar 2015

 

I have this morning read the Care Quality Commission Report into the quality of care afforded at Whipps Cross Hospital. It is shocking. Every department has scored inadequate save critical care and maternity & gynaecology which ‘require improvement’.

This is a terrible situation for the NHS Trust.

Whips Cross University Hospital is only one of 6 hospitals run by Barts Health NHS Trust and this is the largest NHS Trust in this country. The Trust serves a wide population of at least if not more than 350,000 people extending to Waltham Forest, Redbridge, Epping Forest and further. In Waltham Forest alone it is suggested that deprivation is high with 16,000 children living in poverty stricken circumstances, in Redbridge this was slightly reduced in that 13,900 children were living in poverty and 3,600 in Epping. In year 6, 603 children were noted to be obese in Waltham Forest as appose to 713 in Redbridge and 155 in Epping. These statistics in Waltham Forest and Redbridge are very high.

Given the above statistics, it is expected perhaps that people living in Waltham Forest and Redbridge would seek medical/surgical advice and assistance from Whipps Cross Hospital more often due to higher risk of health problems. Whipps Cross Hospital should therefore, be equipped to meet the demands of its local population.

A team of 45 specialists including consultants in A & E, obstetrics & gynaecology, palliative care, anaesthetics, paediatrics, surgery, medicine, outpatient’s managers, nurses, child safeguarding and other experts including a Care Quality Commission non-executive had to ask five questions of every service to get to the root of the problems at Whipps Cross.

The questions the inspection team had to ask were:

• ‘Is it safe?
• Is it effective?
• Is it caring?
• It is responsive to people’s needs?
• Is it well-led?’

In addition other organisations were asked what they knew about the NHS Trust and were asked to give their feedback. Unannounced visits to the NHS Trust took place over a 3 days period in November 2014 and two visits on Sundays a week apart. During these unannounced visits patients and relatives were spoken to and staff was spoken to in focus groups and there were also ‘drop in ‘sessions to allow members of staff to talk with a member of the inspection team.

I am acting for a family who have through no fault of their own become victims of the failings at Whipps Cross Hospital. Their relative died in tragic circumstances following failure to correctly diagnose and treat a simple medical condition that became life threatening but was left untreated. Words cannot explain the tragic situation this family has been faced with and the ripple effect the death has had on everyone.

The bottom line is that the death could have been prevented, if the care provided had been to at least an acceptable standard. Basic errors were made and incorrect decisions were made at a crucial time of the patient’s illness.

The detailed findings of the Care Quality Commission report highlight that zero ‘never’ incidents were reported at the hospital between 1 January 2014 – 9 January 2015. Never incidents being

“serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented”

I do find this hard to believe when there were 208 serious incidents reported during the same period made up of

• ‘138 incidents related to pressure sores grade 3; 16 to pressure sores to grade 4 ;4 to slips trips and falls
• 16 maternity related incidents; 2 intrauterine deaths; 1 maternal death; 3 unplanned admissions to ITU; 9 unplanned admissions to NICU and 1 unexpected neonatal death.
• 3 incidents relating to child death; 2 relating to unexpected deaths
• Allegations against health care professionals accounted for 6 incidents reported
• 6 incidents relating to sub-optimal care of the deteriorating patient
• 5 delayed diagnosis incidents were recorded
• 12 incidents relating to various types of incidents were reported.’

Interestingly out of 835 staff, 582 nursing and 253 other staff, 9% were reported to be bank/agency staff, which is higher than the national average. This would suggest that staff are leaving and the hospital are unable to attract new permanent staff to suitable positions and so are having to rely on agency/bank staff who are often no au fait with the hospital as a whole, procedures/protocols and they are also expensive for the trust to employ as agency staff attract agency fees and charge an enhanced hourly rate.

The Care Quality Commission report is dated 17 March 2015. Almost a month before it was published, on 19 February 2015, a media statement was released by the NHS Trust to confirm that Peter Morris, Chief Executive at Barts Health NHS Trust had announced his intention to step down. 

I wonder why?

His resignation and that of a senior nurse Professor Kay Riley, came two weeks after the NHS Trust announced on 5 February that it’s deficit was £93m rather than £44m that it had predicted.
Peter Morris was quoted as saying:

“As Bart’s Health moves towards foundation trust status there is a need for senior management continuity to provide leadership for the next five years, and beyond. That is a long-term commitment that I am not able to make and so I feel the time is right for me to hand over to a new chief executive, and start the next chapter in my own career.”

“I will look to take my extensive learning and experience in the healthcare sector to help others develop and deliver their own strategic plans,”

The NHS trust confirmed that Professor Riley would be transferring to Health Education North West London until October 2015 when she retires;

“to pass on her wealth of experience to the next generation of nurses”.

Professor Riley was quoted as saying:

“I have thoroughly enjoyed my time at Barts. Having joined an institution with such a proud and distinguished history in the development of nursing dating back centuries, it has been a privilege and a pleasure to use the opportunity given to me as chief nurse to take forward and develop the ethos of innovative and compassionate nursing.”

Whatever, the reasons for the resignations Whipps Cross Hospital needs to be managed, and many significant changes need to be made to bring it up to standard and to prevent unnecessary risk, damage and death to patients in their care.

If you think that you have suffered substandard medical care or treatment, you can contact Osbornes Medical Negligence department for a free and confidential conversation on 020 7681 8671. Alternatively, you can email either, Stephanie Prior, Partner and Head of Clinical Negligence at stephanieprior@oosborneslaw.com or Ewelina Ochab at

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