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| Version 5 | Version 6 |
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| Care failings probed at 'worst' hospitals | Care failings probed at 'worst' hospitals |
| (about 1 hour later) | |
| Failings in care and problems with staffing at the 14 hospital trusts with the worst death rates in England are to be exposed. | Failings in care and problems with staffing at the 14 hospital trusts with the worst death rates in England are to be exposed. |
| The investigation was launched earlier this year following the public inquiry into the Stafford Hospital scandal. | The investigation was launched earlier this year following the public inquiry into the Stafford Hospital scandal. |
| The probe has been led by NHS England's medical director Prof Sir Bruce Keogh. | The probe has been led by NHS England's medical director Prof Sir Bruce Keogh. |
| It has focused on whether the figures indicate sustained failings in the quality of care and treatment at the trusts. | It has focused on whether the figures indicate sustained failings in the quality of care and treatment at the trusts. |
| Investigators have been looking at whether existing action by the trusts to improve quality is adequate or whether they are in need of any "additional external support". | Investigators have been looking at whether existing action by the trusts to improve quality is adequate or whether they are in need of any "additional external support". |
| The report was ordered amid concern that failing hospitals were not being held to account following the criticisms of the Francis Inquiry into Stafford Hospital, which said the public had been betrayed by a system which put "corporate self-interest" ahead of patients. | The report was ordered amid concern that failing hospitals were not being held to account following the criticisms of the Francis Inquiry into Stafford Hospital, which said the public had been betrayed by a system which put "corporate self-interest" ahead of patients. |
| Its understood the Keogh report - as well as flagging up management failings - will also point to concerns over nurse staffing levels in the 14 hospitals under investigation. | Its understood the Keogh report - as well as flagging up management failings - will also point to concerns over nurse staffing levels in the 14 hospitals under investigation. |
| The report will suggest there is a link between inadequate staffing levels and poor standards of care. | The report will suggest there is a link between inadequate staffing levels and poor standards of care. |
| Its expected the report will say: "When the review teams visited the hospitals, they found frequent examples of inadequate numbers of nursing staff in some ward areas." | Its expected the report will say: "When the review teams visited the hospitals, they found frequent examples of inadequate numbers of nursing staff in some ward areas." |
| Sir Bruce Keogh's report will say all 14 hospitals are undertaking an urgent review of "safe staffing levels." | Sir Bruce Keogh's report will say all 14 hospitals are undertaking an urgent review of "safe staffing levels." |
| On staff morale it says - "It was clear that staff did not feel as engaged as they wanted or needed to be: yet academic research shows that the disposition of staff has a direct influence on mortality rates." | On staff morale it says - "It was clear that staff did not feel as engaged as they wanted or needed to be: yet academic research shows that the disposition of staff has a direct influence on mortality rates." |
| Prof Sir Brian Jarman, an expert on mortality rates who contributed to the report, told the BBC that his data showed that over a period of seven years there were about 13,300 more deaths than would have been expected. | Prof Sir Brian Jarman, an expert on mortality rates who contributed to the report, told the BBC that his data showed that over a period of seven years there were about 13,300 more deaths than would have been expected. |
| He agreed it was closely linked to staffing levels. | He agreed it was closely linked to staffing levels. |
| "Doctors make mistakes if they are overworked," he said. "If you don't have enough trained nurses, as with doctors, you get higher death rates." | "Doctors make mistakes if they are overworked," he said. "If you don't have enough trained nurses, as with doctors, you get higher death rates." |
| The trusts investigated, which run a total of 19 acute hospitals, are the ones with the highest death rates in 2010-11 and 2011-12. They are: | The trusts investigated, which run a total of 19 acute hospitals, are the ones with the highest death rates in 2010-11 and 2011-12. They are: |
| • Basildon and Thurrock University Hospitals NHS Foundation Trust | • Basildon and Thurrock University Hospitals NHS Foundation Trust |
| • Blackpool Teaching Hospitals NHS Foundation Trust | • Blackpool Teaching Hospitals NHS Foundation Trust |
| • Buckinghamshire Healthcare NHS Trust (Two hospitals - Stoke Mandeville and Wycombe) | • Buckinghamshire Healthcare NHS Trust (Two hospitals - Stoke Mandeville and Wycombe) |
| • Burton Hospitals NHS Foundation Trust | • Burton Hospitals NHS Foundation Trust |
| • Colchester Hospital University NHS Foundation Trust | • Colchester Hospital University NHS Foundation Trust |
| • The Dudley Group NHS Foundation Trust | • The Dudley Group NHS Foundation Trust |
| • East Lancashire Hospitals NHS Trust (Two hospitals - Burnley General and Royal Blackburn) | • East Lancashire Hospitals NHS Trust (Two hospitals - Burnley General and Royal Blackburn) |
| • George Eliot Hospital NHS Trust | • George Eliot Hospital NHS Trust |
| • Medway NHS Foundation Trust | • Medway NHS Foundation Trust |
| • North Cumbria University Hospitals NHS Trust (Two hospitals - Cumberland Infirmary and West Cumberland) | • North Cumbria University Hospitals NHS Trust (Two hospitals - Cumberland Infirmary and West Cumberland) |
| • Northern Lincolnshire and Goole Hospitals NHS Foundation Trust (Three hospitals - Diana, Princess of Wales Hospital, Goole and District Hospital and Scunthorpe General) | • Northern Lincolnshire and Goole Hospitals NHS Foundation Trust (Three hospitals - Diana, Princess of Wales Hospital, Goole and District Hospital and Scunthorpe General) |
| • Sherwood Forest Hospitals NHS Foundation Trust | • Sherwood Forest Hospitals NHS Foundation Trust |
| • Tameside Hospital NHS Foundation Trust | • Tameside Hospital NHS Foundation Trust |
| • United Lincolnshire Hospitals NHS Trust | • United Lincolnshire Hospitals NHS Trust |
| At the moment, regulatory action is being taken against six of the trusts, but none is facing the ultimate sanctions of fines, closure of individual units or administration of the entire organisation. | At the moment, regulatory action is being taken against six of the trusts, but none is facing the ultimate sanctions of fines, closure of individual units or administration of the entire organisation. |
| Key questions | Key questions |
| Action Against Medical Accidents chief executive Peter Walsh said: "These investigations are welcome but well overdue. The problems at these trusts were known to the authorities well before any decision to look into them. | Action Against Medical Accidents chief executive Peter Walsh said: "These investigations are welcome but well overdue. The problems at these trusts were known to the authorities well before any decision to look into them. |
| "What patients most want to know are answers to some key questions. Are these hospitals safe now? Is the regulatory system now robust enough to detect problems when they arise and intervene quickly to protect patients? Will those responsible for allowing these avoidable deaths to go on be held to account?" | "What patients most want to know are answers to some key questions. Are these hospitals safe now? Is the regulatory system now robust enough to detect problems when they arise and intervene quickly to protect patients? Will those responsible for allowing these avoidable deaths to go on be held to account?" |
| Roger Taylor, of Dr Foster, a research company that has pioneered the use of mortality data, said: "In the past, there has been a culture in the NHS, which at best aims to reassure the public and at worst seeks to conceal failings. | Roger Taylor, of Dr Foster, a research company that has pioneered the use of mortality data, said: "In the past, there has been a culture in the NHS, which at best aims to reassure the public and at worst seeks to conceal failings. |
| "That culture has had its day. The reluctance to speak plainly about the risks to patients has meant that, too often, poor care has been allowed to continue. The desire to support organisations struggling to provide a high standard of care in difficult circumstances has cost patients their lives." | "That culture has had its day. The reluctance to speak plainly about the risks to patients has meant that, too often, poor care has been allowed to continue. The desire to support organisations struggling to provide a high standard of care in difficult circumstances has cost patients their lives." |
| The Stafford Hospital inquiry was launched after data showed there had been between 400 and 1,200 more deaths than would have been expected. | The Stafford Hospital inquiry was launched after data showed there had been between 400 and 1,200 more deaths than would have been expected. |
| It is impossible to say all of these patients would have survived if they had received better treatment, but evidence made it clear many were let down by a culture that put cost-cutting and target-chasing ahead of the quality of care. | It is impossible to say all of these patients would have survived if they had received better treatment, but evidence made it clear many were let down by a culture that put cost-cutting and target-chasing ahead of the quality of care. |
| Examples included patients being so thirsty that they had to drink water from vases and receptionists left to decide which patients to treat in A&E. | Examples included patients being so thirsty that they had to drink water from vases and receptionists left to decide which patients to treat in A&E. |