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| Jeremy Hunt: inspectors found evidence of poor care at NHS hospitals | Jeremy Hunt: inspectors found evidence of poor care at NHS hospitals |
| (1 day later) | |
| Inspectors sent into hospitals with higher-than-expected death rates found evidence of poor practice such as too few staff, inadequate infection control, patients left unmonitored on trolleys for long periods and badly maintained operating theatres, Jeremy Hunt has said. | Inspectors sent into hospitals with higher-than-expected death rates found evidence of poor practice such as too few staff, inadequate infection control, patients left unmonitored on trolleys for long periods and badly maintained operating theatres, Jeremy Hunt has said. |
| The health secretary cited the problems uncovered by an inspection team led by the NHS medical director, Prof Sir Bruce Keogh, into mortality rates at 14 hospitals in England, as he confirmed that 11 of them were being put into "special measures" to push through urgent improvements to patient care. | The health secretary cited the problems uncovered by an inspection team led by the NHS medical director, Prof Sir Bruce Keogh, into mortality rates at 14 hospitals in England, as he confirmed that 11 of them were being put into "special measures" to push through urgent improvements to patient care. |
| But the concerns flagged up by the in-depth review fell far short of the damning indictment of the NHS that had been predicted. The picture drawn by Keogh and his team was of mediocre hospitals, geographically, professionally or academically isolated, struggling and failing to improve without the help and support they needed. | But the concerns flagged up by the in-depth review fell far short of the damning indictment of the NHS that had been predicted. The picture drawn by Keogh and his team was of mediocre hospitals, geographically, professionally or academically isolated, struggling and failing to improve without the help and support they needed. |
| The review was triggered by high death rates, which had led to speculation in the press that 13,000 patients may have needlessly died since 2005 on the basis of figures from Sir Brian Jarman of Imperial College. But the report categorically rejected that interpretation. | The review was triggered by high death rates, which had led to speculation in the press that 13,000 patients may have needlessly died since 2005 on the basis of figures from Sir Brian Jarman of Imperial College. But the report categorically rejected that interpretation. |
| Hunt in his statement said that "mortality rates suggest that since 2005 thousands more people may have died than would normally be expected at the 14 trusts reviewed by Sir Bruce" - careful wording which allows for the conclusion that the deaths may not have been avoidable, as Keogh in his later briefing suggested. | Hunt in his statement said that "mortality rates suggest that since 2005 thousands more people may have died than would normally be expected at the 14 trusts reviewed by Sir Bruce" - careful wording which allows for the conclusion that the deaths may not have been avoidable, as Keogh in his later briefing suggested. |
| The report itself took a tougher line. "However tempting it may be, it is clinically meaningless and academically reckless to use such statistical measures to quantify actual numbers of avoidable deaths," it said. | The report itself took a tougher line. "However tempting it may be, it is clinically meaningless and academically reckless to use such statistical measures to quantify actual numbers of avoidable deaths," it said. |
| Keogh has asked Lord Darzi of Imperial College, the surgeon and former health minister, and Nick Black, professor of health services research at the London School of Hygiene and Tropical medicine, to carry out a study reviewing the case notes of patients who have died to establish the true relationship between excess mortality and avoidable deaths. | |
| Hunt told the House of Commons that inadequate staffing was a key issue found by the review, which investigated the quality of care the hospitals provide now, rather than historically. Inspectors found concern about staffing levels at many of the trusts, either in particular units or more generally, including difficulty getting enough staff to fill overnight shift rotas in some places. | Hunt told the House of Commons that inadequate staffing was a key issue found by the review, which investigated the quality of care the hospitals provide now, rather than historically. Inspectors found concern about staffing levels at many of the trusts, either in particular units or more generally, including difficulty getting enough staff to fill overnight shift rotas in some places. |
| In some places "trust boards were shockingly unaware of problems discovered by the review teams in their own hospitals". | In some places "trust boards were shockingly unaware of problems discovered by the review teams in their own hospitals". |
| Citing what he called "some very concerning examples of poor practice", Hunt said that at Tameside general hospital in Manchester, for example, "patients spoke of being left on unmonitored trolleys for excessive periods and the [Keogh] panel found a general culture of 'accepting sub-optimal care'". | Citing what he called "some very concerning examples of poor practice", Hunt said that at Tameside general hospital in Manchester, for example, "patients spoke of being left on unmonitored trolleys for excessive periods and the [Keogh] panel found a general culture of 'accepting sub-optimal care'". |
| At North Cumbria university hospitals trust, which runs hospitals in Carlisle and Whitehaven, "the panel found evidence of poor maintenance in two operating theatres, which were closed immediately". Twelve "never events" - serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented –occurred at the United Lincolnshire Hospitals NHS trust in the space of three years, while Basildon and Thurrock University Hospitals NHS trust had seven "never events" in three years, as well as problems involving infection control and overnight staffing levels. | At North Cumbria university hospitals trust, which runs hospitals in Carlisle and Whitehaven, "the panel found evidence of poor maintenance in two operating theatres, which were closed immediately". Twelve "never events" - serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented –occurred at the United Lincolnshire Hospitals NHS trust in the space of three years, while Basildon and Thurrock University Hospitals NHS trust had seven "never events" in three years, as well as problems involving infection control and overnight staffing levels. |
| External teams will be sent into the 11 to ensure changes are made; the performance of the bosses of the hospitals concerned will be subject to close scrutiny and each of the trusts will be partnered with high-performing trusts to help them improve both quality of care and safety standards. | External teams will be sent into the 11 to ensure changes are made; the performance of the bosses of the hospitals concerned will be subject to close scrutiny and each of the trusts will be partnered with high-performing trusts to help them improve both quality of care and safety standards. |
| Hunt announced the move as he briefed MPs on the findings of Keogh's five-month investigation into the 14, which was triggered by the damning official report in February into the Mid Staffordshire hospital care scandal. | Hunt announced the move as he briefed MPs on the findings of Keogh's five-month investigation into the 14, which was triggered by the damning official report in February into the Mid Staffordshire hospital care scandal. |
| Although some of the 14 have improved their performance and have made major changes to their management, "failure or mediocrity is so deeply entrenched at others that they have continued to decline, making the additional measures I announce today necessary", Hunt said. | Although some of the 14 have improved their performance and have made major changes to their management, "failure or mediocrity is so deeply entrenched at others that they have continued to decline, making the additional measures I announce today necessary", Hunt said. |
| The Commons witnessed furious exchanges between Hunt and Andy Burnham, the shadow health secretary who was the Labour government's health secretary in 2009-10. Hunt claimed that Labour had "left the NHS with a system that covered up weak hospital leadership and failed to prioritise compassionate care. The system's reputation mattered more than individual patients; targets mattered more than people." | The Commons witnessed furious exchanges between Hunt and Andy Burnham, the shadow health secretary who was the Labour government's health secretary in 2009-10. Hunt claimed that Labour had "left the NHS with a system that covered up weak hospital leadership and failed to prioritise compassionate care. The system's reputation mattered more than individual patients; targets mattered more than people." |
| Burnham rejected as "outrageous" and unfounded Hunt's claim that Labour ministers had pressurised the Care Quality Commission (CQC), the regulator of NHS care in England since April 2009, to suppress findings of bad care. Burnham quoted Robert Francis QC's report into Mid Staffs to underline his point. | Burnham rejected as "outrageous" and unfounded Hunt's claim that Labour ministers had pressurised the Care Quality Commission (CQC), the regulator of NHS care in England since April 2009, to suppress findings of bad care. Burnham quoted Robert Francis QC's report into Mid Staffs to underline his point. |
| The 14 trusts under review | The 14 trusts under review |
| 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 | Buckinghamshire Healthcare NHS trust |
| 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 | East Lancashire Hospitals NHS trust |
| George Eliot Hospital NHS trust | George Eliot Hospital NHS trust |
| Medway NHS foundation trust | Medway NHS foundation trust |
| North Cumbria University Hospitals NHS trust | North Cumbria University Hospitals NHS trust |
| Northern Lincolnshire and Goole Hospitals NHS foundation trust | Northern Lincolnshire and Goole Hospitals NHS foundation trust |
| 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 |
| • This article was amended on 17 July 2013 to correct a description of Lord Darzi as a heart surgeon. |