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Mid Staffs trust to be prosecuted over death of diabetic patient Mid Staffs trust to be prosecuted over death of diabetic patient
(21 days later)
The Mid Staffs NHS foundation trust, castigated for providing appalling care for years to patients, is to be prosecuted over a diabetic patient who died after falling into a diabetic coma – an unprecedented change in criminal accountability in the health service.The Mid Staffs NHS foundation trust, castigated for providing appalling care for years to patients, is to be prosecuted over a diabetic patient who died after falling into a diabetic coma – an unprecedented change in criminal accountability in the health service.
The Health and Safety Executive (HSE) said there was enough evidence to bring criminal proceedings against Mid Staffs over the death of Gillian Astbury, 66, in 2007.The Health and Safety Executive (HSE) said there was enough evidence to bring criminal proceedings against Mid Staffs over the death of Gillian Astbury, 66, in 2007.
The announcement comes after a fresh HSE inquiry this year into the patient's death following the conclusion of the public inquiry chaired by Robert Francis into events at the trust, which runs Stafford and Cannock Chase hospitals.The announcement comes after a fresh HSE inquiry this year into the patient's death following the conclusion of the public inquiry chaired by Robert Francis into events at the trust, which runs Stafford and Cannock Chase hospitals.
An inquest into Astbury's death recorded a narrative verdict, noting there had been a systemic failure to provide adequate nursing facilities and staffing, which contributed to her demise. The inquest jury ruled a failure to administer insulin amounted to a gross failure to provide basic care.An inquest into Astbury's death recorded a narrative verdict, noting there had been a systemic failure to provide adequate nursing facilities and staffing, which contributed to her demise. The inquest jury ruled a failure to administer insulin amounted to a gross failure to provide basic care.
When released in February, the Francis report looked in considerable detail at the Astbury case and criticised the HSE for having "to this day an inability … to decide whether it should prosecute the trust over the deficiencies shown up by the case".When released in February, the Francis report looked in considerable detail at the Astbury case and criticised the HSE for having "to this day an inability … to decide whether it should prosecute the trust over the deficiencies shown up by the case".
David Cameron has taken a keen interest in events at Stafford and said after the publication of the Francis report that it was unacceptable that no NHS staff had faced the "proper consequences" of their role in the Mid Staffs hospital scandal.David Cameron has taken a keen interest in events at Stafford and said after the publication of the Francis report that it was unacceptable that no NHS staff had faced the "proper consequences" of their role in the Mid Staffs hospital scandal.
In a statement, Peter Galsworthy, HSE head of operations in the West Midlands, said: "We have concluded our investigation into the death of Gillian Astbury at Stafford Hospital and have decided there is sufficient evidence and it is in the public interest to bring criminal proceedings in this case.In a statement, Peter Galsworthy, HSE head of operations in the West Midlands, said: "We have concluded our investigation into the death of Gillian Astbury at Stafford Hospital and have decided there is sufficient evidence and it is in the public interest to bring criminal proceedings in this case.
"HSE will be charging Mid Staffordshire NHS Foundation Trust under Section 3(1) of the Health and Safety at Work Act. Gillian Astbury died on April 11 2007, of diabetic ketoacidosis, when she was an inpatient at the hospital."HSE will be charging Mid Staffordshire NHS Foundation Trust under Section 3(1) of the Health and Safety at Work Act. Gillian Astbury died on April 11 2007, of diabetic ketoacidosis, when she was an inpatient at the hospital.
"The immediate cause of death was the failure to administer insulin to a known diabetic patient. Our case alleges that the trust failed to devise, implement or properly manage structured and effective systems of communication for sharing patient information, including in relation to shift handovers and record-keeping.""The immediate cause of death was the failure to administer insulin to a known diabetic patient. Our case alleges that the trust failed to devise, implement or properly manage structured and effective systems of communication for sharing patient information, including in relation to shift handovers and record-keeping."
The case's first hearing will be at Stafford magistrates court next month. The HSE successfully prosecuted the trust in 2003 over the death of a patient who had drowned in a pond at Cannock hospital.The case's first hearing will be at Stafford magistrates court next month. The HSE successfully prosecuted the trust in 2003 over the death of a patient who had drowned in a pond at Cannock hospital.
The Astbury case marks a turning point for the HSE since it is moving away from the traditional NHS role of holding trusts responsible for the physical state of infrastructure and ensuring it is safe to prosecuting and policing a hospital's clinical governance and administration of care.The Astbury case marks a turning point for the HSE since it is moving away from the traditional NHS role of holding trusts responsible for the physical state of infrastructure and ensuring it is safe to prosecuting and policing a hospital's clinical governance and administration of care.
Police investigated the circumstances surrounding the death, but the Crown Prosecution Service said there was insufficient evidence to bring a prosecution.Police investigated the circumstances surrounding the death, but the Crown Prosecution Service said there was insufficient evidence to bring a prosecution.
Last month, the Nursing and Midwifery Council found two nurses guilty of misconduct for failing to spot Astbury was diabetic. It ruled that Ann King and Jeannette Coulson had failed to look at or update her records or carry out blood tests.Last month, the Nursing and Midwifery Council found two nurses guilty of misconduct for failing to spot Astbury was diabetic. It ruled that Ann King and Jeannette Coulson had failed to look at or update her records or carry out blood tests.
In a separate move, a new inquest is to be held into the 2006 death of a 20-year-old man seen and discharged by Stafford hospital doctors hours before he died. A second hearing has been scheduled because of new evidence regarding the death of John Moore-Robinson. He died after Stafford hospital staff failed to diagnose a ruptured spleen and said he had bruised ribs. He died hours later.In a separate move, a new inquest is to be held into the 2006 death of a 20-year-old man seen and discharged by Stafford hospital doctors hours before he died. A second hearing has been scheduled because of new evidence regarding the death of John Moore-Robinson. He died after Stafford hospital staff failed to diagnose a ruptured spleen and said he had bruised ribs. He died hours later.
These events take place as Mid Staffs is being dismembered. The trust went into administration in April after a report concluded it was not "clinically or financially sustainable". Last year it needed an additional £21m of taxpayers' money to cover its running costs and in July administrators recommended the hospital should be stripped of key services and the trust dissolved.These events take place as Mid Staffs is being dismembered. The trust went into administration in April after a report concluded it was not "clinically or financially sustainable". Last year it needed an additional £21m of taxpayers' money to cover its running costs and in July administrators recommended the hospital should be stripped of key services and the trust dissolved.
Maggie Oldham, chief executive at the trust, said: "We accept the findings of the Health and Safety Executive's investigation.Maggie Oldham, chief executive at the trust, said: "We accept the findings of the Health and Safety Executive's investigation.
"Our thoughts remain with the family of Gillian Astbury and we apologise for the appalling care Ms Astbury received at our hospital in April 2007."Our thoughts remain with the family of Gillian Astbury and we apologise for the appalling care Ms Astbury received at our hospital in April 2007.
"Ms Astbury's death was reported as a serious untoward incident at the time and a full investigation into her care and treatment was carried out."Ms Astbury's death was reported as a serious untoward incident at the time and a full investigation into her care and treatment was carried out.
"The recommendations from that investigation were implemented. Actions included raising staff awareness about the care of diabetic patients and improving the information system for nurse handovers. In 2010 we reviewed Ms Astbury's dreadful care and, as a result, disciplinary action was taken.""The recommendations from that investigation were implemented. Actions included raising staff awareness about the care of diabetic patients and improving the information system for nurse handovers. In 2010 we reviewed Ms Astbury's dreadful care and, as a result, disciplinary action was taken."
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