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Trust acts after BAME staff report ‘systematic bullying’

NHS leaders are being encouraged to have ‘difficult discussions’ about inequalities, after a trust found its BAME staff reported being ‘systematically… bullied and harassed’, along with other signs of discrimination.

A report published by Newcastle Hospitals Foundation Trust found the trust’s black, Asian and minority ethnic staff are more likely than white staff to be bullied or harassed by colleagues, less likely to reach top jobs, and experience higher rates of discrimination from managers.

It claims to be the first in-depth review into pay gaps and career progression among BAME workforce at a single trust.

The new report revealed that, in a trust survey carried out last year, some BAME staff described being subjected to verbal abuse and racial slurs by colleagues; had left departments after being given no chance of progression; and been “systematically… bullied and harassed”.

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Source: HSJ, 22 September 2020

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‘Secretive’ safety findings set to be revealed direct to CQC

The Care Quality Commission may in future be notified when ‘secretive’ external reviews have looked at patient safety issues within trusts.

Last summer, HSJ revealed guidance for trusts to publish summaries of royal colleges’ reviews was being widely ignored, with some even failing to inform the CQC.

A recent BBC Panorama programme has again raised the issue, with Academy of Medical Royal Colleges chair Helen Stokes-Lampard saying she was “dismayed” the body’s guidance was not being followed.

But she has now told HSJ of “advanced discussions” with the CQC about changes which would see the royal colleges routinely inform the regulator when reviews raise patient safety issues.

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Source: HSJ, 3 June 2021

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Major trust records fifth never event at troubled department

A fifth patient has been given the wrong blood at a major teaching hospital’s haematology department where patient safety concerns were raised by clinicians last year.

The incident, at University Hospitals Birmingham Foundation Trust, is the fifth never event involving patients being transfused with the wrong blood at the trust since April 2020.

Only 15 such never events have been recorded in England in the last two financial years, which means UHB accounted for a third of the total in 2020-21 and 2021-22.

HSJ revealed last year that several clinicians had raised safety concerns at the trust’s haematology specialty after most of its services at Heartlands Hospital were moved to Queen Elizabeth Hospital as part of the trust’s pandemic response.

The latest never event, which occurred in March, saw a patient being given an “unintentional transfusion of ABO-incompatible blood components” – according to papers provided to the trust’s council of governors.

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Source: HSJ, 14 June 2022

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NHS accused of “burying” damning child cancer report

NHS bosses have been accused of “burying” a damning report into child cancer services commissioned following complaints that patients were “dying in agony”. Completed in 2015, the document highlights failings at the Royal Marsden NHS Foundation Trust, one of the UK’s flagship cancer organisations. It found that, despite being supposedly a centre of excellence, children admitted for cancer treatment were routinely transferred between hospitals to get the care they needed.

Compiled by Professor Mike Stephens, the report was commissioned after a coroner found “astonishing” failures in the care of a two-year-old girl, Alice Mason, leading to her suffering irreversible brain damage and dying in 2011. It recommended a radical shake-up of the Marsden’s services. The document was never made public, however, and former NHS medical director for London, Dr Andy Mitchell, accused the head of NHS England, Simon Stevens, and Cally Palmer, England’s National Cancer Director and Chief Executive of the Royal Marsden, of suppressing its publication.

Dr Mitchell told the Health Service Journal (HJS): “I can’t imagine any other individuals having the power and influence to be able to stop this report moving forward.”

NHS England has denied that its then Medical Director, Sir Bruce Keogh, was improperly leaned on and said the report remained unpublished because it made “implausible suggestions” which would have forced children with cancer to travel further for care. But Gareth Mason, Alice’s father, said: “To write a report, shelve it and not debate it, that is a cover-up [and] it has left children since Alice and danger, and the Marsden won’t acknowledge that.”

The controversy surrounds the performance of a so-called “shared care system”, with the Marsden’s Sutton site forming part of a network for South London, Surrey, Sussex and Kent.

Critics say the format meant children were transferred between sites more regularly than they should have been and were put in danger because information was not properly shared.

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Source: The Telegraph, 19 June 2019  

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Alert over hospital air devices after 120 ‘never events’

NHS trusts are to be told to remove devices linked to more than 120 never events caused by ‘unconscious errors’.

A national patient safety alert from NHS England which urges trusts to remove all air flowmeters from wall medical gas outlets. It is likely to be published next month.

The alert comes after 121 never events in the last three years involved staff members accidentally connecting patients to air instead of oxygen. This number is close to 10% of all never events recorded during that period.

These types of never events have been recorded by 57 NHS organisations during 2018-19, 2019-20 and 2020-21.

The incidents took place mostly on medical wards and in emergency departments. They occurred despite NHSE issuing a patient safety alert in 2016, which recommended removing the flowmeters from wall outlets when not in active use.

According to NHSE documents - seen by HSJ - the never events often went undetected “for some time”, even when other staff responded to deteriorating patients or took over their care. The regulator concluded this makes it more likely that there have been other unreported incidents.

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Source: HSJ, 17 May 2021

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Patients harmed after doctors ‘failed to respond’ to nurse concerns

Two patients at a hospital in West Lancashire came to “avoidable harm” after medical staff failed to act on concerns raised by nurses, according to a health watchdog.

The issue was highlighted by the Care Quality Commission (CQC) following an inspection of children and young people’s services at Ormskirk Hospital in July and August.

In there report CQC stated: “In children and young people’s services we found evidence that there had been occasions when medical staff had not responded to nursing concerns, which led to avoidable harm occurring to two patients.”

The document added that the two serious incidents, which had both been reported by staff, were "relating to babies".

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Source: The Nursing Times, 3 December 2019

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Launch of Patient Safety Learning’s 'the hub'

After many months of development and several user workshops, we are delighted and proud to present the hub at Patient Safety Congress 2019.

the hub is one of the actions proposed by Patient Safety Learning's A Blueprint for Action. The report identifies six foundations of safe care: shared learning, leadership, professionalising patient safety, patient engagement, data and insight, and culture, and proposes a range of actions to address these foundations. the hub is Patient Safety Learning's share online learning platform, which encourages and facilitates knowledge sharing, collaboration and conversation in patient safety across the whole of health and social care. It is a platform for health and social professionals, patients and their families to share and learn from one another.

the hub is free for everyone to use. Have a browse and you will find the latest news, research, resources and events in patient safety, and lively conversations and debates. Members can share content, comment on posts and start conversations in our communities. Please use the hub, share content and let us know what you think and how we can continue to develop it.

We would like to take the opportunity to thank everyone who has contributed this far in the development of the hub. Your thoughts, ideas and critique have been invaluable. the hub is still in development and we continue to seek out user testing and feedback. Please contact us at feedback@pslhub.org with your ideas or if you would like to be a part of our user testing group.  

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NHSE director calls out trust over ‘speak English’ rule

An ‘outstanding’ London trust has come under fire for asking staff to communicate ‘only in English’ when around other people.

A document published under the ‘trust values’ section of Homerton University Hospital Foundation Trust’s website, says: “I will only communicate in English in the presence of others.”

The document has been widely shared on social media in the last 24 hours, with many criticising the trust for its wording. The document itself is dated 2014, but was reposted by the trust in 2019, and remained on its website as of midday today.

NHS England’s director of equality – medical workforce, Partha Kar, who is also NHSE’s diabetes lead, questioned the document on Twitter. He also said: “I am not aware of any NHS England ‘diktat’ suggesting we must all only speak in English to uphold NHS values.”

It follows a separate notice being posted on Twitter yesterday signed simply by “Matron”, by a doctor who claimed her friend saw it at her “hospital placement”. It seemingly threatened staff with “disciplinary action” if they spoke any other language other than English.

It reads: “English is the only language to be spoken in the ward area – this includes the kitchen. Disciplinary action will be taken against staff who do not comply, including agency and bank.”

The documents have prompted a backlash on Twitter, with many criticising them and raising concerns about racism and inclusivity of staff. NHSE’s chief nursing officer, Ruth May, has publicly queried where the document is from.

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Source: HSJ, 16 March 2022

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Hundreds recalled as consultant accused of ‘unnecessary’ surgery

A surgeon has been accused of carrying out “unnecessary” shoulder operations on several NHS patients at a private hospital linked to the Ian Paterson scandal, with 217 patients recalled.

HSJ has been told at least five patients, all commissioned by the NHS, have instructed solicitors to take legal action against Habib Rahman, a consultant orthopaedic surgeon at Spire Parkway Hospital in Solihull.

Mr Rahman is accused of undertaking “unnecessary or inappropriate surgical procedures at Spire Healthcare hospitals” . Spire has confirmed it has recalled 217 patients over the concerns.

The allegations come weeks before the findings are due from an independent inquiry into disgraced surgeon Ian Paterson – who was found guilty of wounding with intent after giving hundreds of patients unnecessary breast surgeries in Spire hospitals across the Midlands.

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Source: HSJ, 24 January 2020

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California approves bill to punish doctors who spread false information

Trying to strike a balance between free speech and public health, California’s Legislature on Monday approved a bill that would allow regulators to punish doctors for spreading false information about Covid-19 vaccinations and treatments.

The legislation, if signed by Gov. Gavin Newsom, would make the state the first to try to legislate a remedy to a problem that the American Medical Association, among other medical groups and experts, says has worsened the impact of the pandemic, resulting in thousands of unnecessary hospitalisations and deaths.

The law would designate spreading false or misleading medical information to patients as “unprofessional conduct,” subject to punishment by the agency that licenses doctors, the Medical Board of California. That could include suspending or revoking a doctor’s license to practice medicine in the state.

While the legislation has raised concerns over freedom of speech, the bill’s sponsors said the extensive harm caused by false information required holding incompetent or ill-intentioned doctors accountable.

“In order for a patient to give informed consent, they have to be well informed,” said State Senator Richard Pan, a Democrat from Sacramento and a co-author of the bill. A paediatrician himself and a prominent proponent of stronger vaccination requirements, he said the law was intended to address “the most egregious cases” of deliberately misleading patients.

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Source: New York Times, 29 August 2022

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NHS trust pays £30m to boy branded “naughty” after behaviour is linked to birth injury

A 7-year-old boy who has spent most of his life being branded naughty and disruptive has won a settlement of more than £30m after it was discovered that he had sustained a brain injury after negligent delays in his delivery at University College Hospital in London.

The settlement is thought to be one of only a handful of NHS clinical negligence payouts to exceed £30m.

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Source: BMJ, 1 November 2019

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Survey shows 60% of health visiting teams affected by Covid-19 redeployment

The redeployment of health visitors to support the national coronavirus response has left remaining staff with increased workloads, worsened mental health and fears that the needs of children are being missed, a new survey has revealed.

In the wake of Covid-19, University College London (UCL) gathered the views of 663 health visitors in England to find out how the pandemic had affected their work. Overall, 60% of respondents reported that at least one member of their team had been redeployed between 19 March and 3 June. Of teams that had lost staff, 41% reported that between six and 50 colleagues had been moved elsewhere during that period.

The combination of increased caseloads and limited face-to-face contacts left “widespread concern” among health visitors that the needs of many children would be missed in the peak of the outbreak, found the survey. Study authors raised concerns about the “significant negative impacts” that increased workload and pressures had on staff wellbeing and mental health.

Read the full article here.

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CQC chief sceptical about need for ‘patient safety commissioner’

The Care Quality Commission's chief executive Ian Trenholm has said he is sceptical about the need to appoint an NHS patient safety commissioner, one of the key recommendations of the recently published Cumberlege review.

In a wide-ranging interview with HSJ, Mr Trenholm also revealed that he wants the Care Quality Commission to review the collaboration of every health system in England.

Mr Trenholm told HSJ he is “not sure” a patient safety commissioner was needed and that it would need to perform a “role that was different from what’s already in place” for it to add value.

He said: “If you look at the work we’re doing on patient safety, the work that HSIB are doing on patient safety, and then we’ve got people within the NHS itself doing work on patient safety, I think there are enough people playing. The question is, are we all working together as effectively as we possibly could be.

“If another player helps that work [then] great, but I’m not sure that’s something that is necessary.”

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Source: HSJ, 24 August 2020

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Bath surgeon sacked after raising safety concerns

A senior surgeon has raised concerns about the way whistleblowers are dealt with, claiming he was sacked after speaking out.

Serryth Colbert told the BBC that following attempts to "stop wrongdoing", he was investigated by the trust at Bath's Royal United Hospital.

As a result, he said he was dismissed for gross misconduct in October 2023.

The RUH said it has "never dismissed anybody for raising concerns and never will".

It added that Mr Colbert's dismissal related to "significant concerns about bullying" and its investigation into his conduct was "thorough" and "robust".

Mr Colbert said he raised safety concerns without regard for the impact it might have on his career.

"It was never a question in my mind. This is wrong. I'm stopping the wrongdoing. I stand for justice. I stand to protect patients," he said.

The BBC has seen no evidence his most serious concern was ever investigated and Mr Colbert is now taking the RUH to an employment tribunal.

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Source: BBC News, 9 February 2024

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‘Appalled’ NHSE director orders safety review at all providers

The NHS’ mental health director has branded abuse exposed at a city inpatient unit as “heartbreaking and shameful” and ordered a national review of safety across all providers.

In a letter to all leaders of mental health, learning disability and autism providers, shared with HSJ, Claire Murdoch responded to BBC Panorama’s exposure of patient abuse at the Edenfield Centre run by Greater Manchester Mental Health FT by warning trusts they should leave “no stone unturned” in seeking to eradicate and prevent poor care.

An investigation by the programme found a “toxic culture of humiliation, verbal abuse and bullying” at the medium-secure inpatient unit in Prestwich near Manchester.

In response, Ms Murdoch said the mindset that “it could happen here” must be at the front and centre of national and local approaches, adding that trusts which already adopt this outlook are most likely to identify and prevent toxic and closed cultures.

She also urged all boards to urgently review safeguarding of care in their organisations and identify any immediate issues requiring action now, such as freedom to speak up arrangements, complaints, and care and treatment reviews. A separate national probe into the quality of inpatient care is due to launch imminently.

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Source: HSJ, 30 September 2022

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Shrewsbury maternity scandal: NHS used report to create ‘false narrative’ on maternity services

NHS bosses have been accused of using a 2013 report to “maintain a false narrative” about maternity services in Shropshire, which meant poor practices and conditions went unchallenged for years.

The Independent has obtained a 2013 report, commissioned by NHS managers in Shropshire, which concluded maternity services at the Shrewsbury and Telford Hospital Trust were “safe”, of “good quality”, and “delivered in a learning organisation”.

The report, written by rheumatologist Dr Josh Dixey (now high sheriff of Shropshire), delivered a glowing assessment of the care given to women and babies and appeared to gloss over hints of deeper problems within the service.

Sources within the Shropshire and Telford clinical commissioning groups (CCGs), which paid £60,000 for the report, said since it was written it had been “proven to be wrong, inaccurate and to have come to the wrong conclusions and recommendations”, but also stressed it was based on the information received from the trust at the time.

A leaked report last month revealed dozens of mothers and babies had died at the Shrewsbury and Telford Hospital Trust, with incidents of poor care stretching over four decades, due to repeated failures to learn from mistakes.

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Source: The Independent, 4 December 2019

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Kettering Hospital ward accused of traumatising children may close

Children's services could be forced to close at a hospital that is accused of leaving young patients traumatised and sick through poor care.

The care regulator said it had taken action to "ensure people are safe" on Skylark ward at Kettering General Hospital (KGH) in Northamptonshire.

Thirteen parents with serious concerns after their children died or became seriously ill have spoken to the BBC.

A BBC Look East investigation has heard allegations spanning more than 20 years about the treatment of patients on Skylark ward, a 26-bed children's unit.

The BBC discovered:

  • An independent report found staff left a 12-year-old boy - who died at KGH in December 2019 - for four hours suffering seizures, and suggests little effort was made to obtain critical care support.
  • In April 2019, nurses allegedly dragged a "traumatised" four-year-old girl down a corridor in agony, insisting that she could walk. Medics are accused of refusing to carry out an MRI scan, which would have detected a dangerous cyst on her spine.
  • Mothers claim to have been threatened with safeguarding referrals, with one stating a referral was made against her after she complained her son was struggling to breathe, while another likened it to blackmail.

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Source: BBC News, 20 February 2023

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Extra 10,000 dementia deaths in England and Wales in April

There were almost 10,000 unexplained extra deaths among people with dementia in England and Wales in April, according to official figures that have prompted alarm about the severe impact of social isolation on people with the condition.

The data, from the Office for National Statistics, reveals that, beyond deaths directly linked to COVID-19, there were 83% more deaths from dementia than usual in April, with charities warning that a reduction in essential medical care and family visits were taking a devastating toll.

“It’s horrendous that people with dementia have been dying in their thousands,” said Kate Lee, chief executive officer at Alzheimer’s Society. “We’ve already seen the devastating effect of coronavirus on people with dementia who catch it, but our [research] reveals that the threat of the virus extends far beyond that.”

The charity thinks the increased numbers of deaths from dementia are resulting partly from increased cognitive impairment caused by isolation, the reduction in essential care as family carers cannot visit, and the onset of depression as people with dementia do not understand why loved ones are no longer visiting, causing them to lose skills and independence, such as the ability to speak or even stopping eating and drinking.

Another factor may be interruptions to usual health services, with more than three-quarters of care homes reporting that GPs have been reluctant to visit residents.

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Source: The Guardian, 5 June 2020

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NHS staff coronavirus inquests told not to look at PPE shortages

Inquests into coronavirus deaths among NHS workers should avoid examining systemic failures in provision of personal protective equipment (PPE), coroners have been told, in a move described by Labour as “very worrying”.

The chief coroner for England and Wales, Mark Lucraft QC, has issued guidance that “an inquest would not be a satisfactory means of deciding whether adequate general policies and arrangements were in place for provision of PPE to healthcare workers”.

Lucraft said that “if there were reason to suspect that some human failure contributed to the person being infected with the virus”, an inquest may be required. The coroner “may need to consider whether any failures of precautions in a particular workplace caused the deceased to contract the virus and so contributed to death”.

But he added: “An inquest is not the right forum for addressing concerns about high-level government or public policy.”

Labour warned the advice could limit the scope of investigations into the impact of PPE shortages on frontline staff who have died from COVID-19.

“I am very worried that an impression is being given that coroners will never investigate whether a failure to provide PPE led to the death of a key worker,” said Lord Falconer, the shadow attorney general. “This guidance may have an unduly restricting effect on the width of inquests arising out of Covid-19-related deaths.”

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Source: The Guardian, 29 April 2020

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'Crumbling hospitals’ are putting patient safety and care at risk

Hospitals throughout the NHS are in such a poor state of repair that patient safety and care is being put at risk, according to an investigation by the Labour Party. A freedom of information requests sent to every hospital trust in England highlighted problems such as sewage and water leaking on to hospital wards, broken lifts and ceilings collapsing. The incidents have affected patient care, often leading to the cancellation of appointments and leaving people waiting longer for vital treatment. It is speculated that these issues are not just confined to secondary care.

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Source: Nursing Notes, 5 July 2019

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Latest HSIB report highlights ‘devastating’ impact of delays and pressure on national glaucoma services

Delays to follow-up appointments for glaucoma patients leaves them at risk of sight loss, the Healthcare Investigation Safety Branch (HSIB) warns in their new report.

The report highlights the case of a 34-year old woman who lost her sight as a result of 13 months of delays to follow-up appointments.

Lack of timely follow-up for glaucoma patients is a recognised national issue across the NHS. Research suggests that around 22 patients a month will suffer severe or permanent sight loss as a result of the delays. In HSIB’s reference case, the patient saw seven different ophthalmologists and the time between her initial referral to hospital eye services (HES) and laser eye surgery was 11 months. By this time her sight had deteriorated so badly, she was registered as severely sight impaired.

The investigation identified that there is inadequate HES capacity to meet demand for glaucoma services, and that better, smarter ways of working should be implemented to maximise the current capacity. The report makes several safety recommendations focused on the management and prioritisation of appointments. 

Helen Lee, RNIB Policy and Campaigns Manager, said: “This report has brought vital attention to a serious and dangerous lack of specialist staff and space in NHS ophthalmology services across the country. We know that thousands of patients in England are experiencing delays in time-critical eye care appointments, which is leading to irreversible sight loss for some."

“Without immediate action, the situation will only continue to deteriorate as the demand for appointments increases. RNIB urges full and immediate implementation of the recommendations set out in this report to improve the capacity, efficiency and effectiveness of ophthalmology services.”

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Source: HSIB, 9 January 2020

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Police prepare for investigation into mental health unit following alleged mistreatment of patients

Police are preparing to investigate alleged mistreatment of patients at a mental health unit. The Edenfield Centre based in the grounds of the former Prestwich Hospital in Bury is at the centre of the claims.

The unit cares for adult patients. The Manchester Evening News understands that action was taken after the BBC Panorama programme embedded a reporter undercover in the unit and then presented the NHS Trust which runs it with their evidence.

A spokesperson for Greater Manchester Police said: "We are aware of the allegations and are liaising with partner agencies to safeguard vulnerable individuals and obtain all information required to open an investigation."

A spokesperson for Greater Manchester Mental Health NHS Foundation Trust said: "We can confirm that BBC Panorama has contacted the Trust, following research it conducted into the Edenfield Centre. We would like to reassure patients, carers, staff, and the public that we are taking the matters raised by the BBC very seriously".

"Immediate action has been taken to address the issues raised and to ensure patient safety, which is our utmost priority. We are liaising with partner agencies and stakeholders, including Greater Manchester Police. We are not able to comment any further on these matters at this stage."

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Source: Manchester Evening News, 14 September 2022

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Long Covid: Who is more likely to get it?

Old age and having a wide range of initial symptoms increase the risk of "long Covid", say scientists. 

The study estimates one in 20 people are sick for least eight weeks. The research at King's College London also showed being female, excess weight and asthma raised the risk.

The aim is to develop an early warning signal that can identify patients who need extra care or who might benefit from early treatment.

The findings come from an analysis of people entering their symptoms and test results into the COVID Symptom Study app.

Scientists scoured the data for patterns that could predict who would get long-lasting illness.

"Having more than five different symptoms in the first week was one of the key risk factors," Dr Claire Steves, from Kings College London, told BBC News.

COVID-19 is more than just a cough - and the virus that causes it can affect organs throughout the body. Somebody who had a cough, fatigue, headache and diarrhoea, and lost their sense of smell, which are all potential symptoms,- would be at higher risk than somebody who had a cough alone. The risk also rises with age, particularly over 50, as did being female.

Dr Steves said: "We've seen from the early data coming out that men were at much more risk of very severe disease and sadly of dying from Covid, it appears that women are more at risk of long Covid."

No previous medical conditions were linked to long Covid except asthma and lung disease.

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Source: BBC News, 21 October 2020

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“We have been totally abandoned” people left struggling for weeks as they recover from COVID at home

Initial survey findings show the long road to recovery for people who have faced COVID at home without going into hospital

New survey findings from over 1,000 people show that those recovering from mild-moderate COVID are struggling for weeks with symptoms, raising concerns that there is not adequate support for people who have not been in hospital with the illness.

The ongoing survey is being run by Asthma UK and the British Lung Foundation, through their post-COVID HUB, which they set up, alongside a helpline and WhatsApp service, to support anyone left with breathing difficulties after COVID.

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Investigation launched after seven ‘never events’ in two years at leading trust

An external review has been launched at a leading children’s hospital after a series of “never events”.

According to local commissioners, a review by the Association for Perioperative Practitioners will look into seven incidents at Alder Hey Children’s Foundation Trust over the last two years. The probe had been delayed by the pandemic and began this month.  

Great Ormond Street Hospital for Children FT and Sheffield Children’s FT, the two other dedicated children’s trusts in England, reported one and four never events respectively, between April 2018 and July 2020, according to national data.

In a statement, Alder Hey claimed it could not provide further details of the incidents. But most have been described in its board papers over the past year. They include a 15-year-old who had the wrong tooth removed by the surgical division, a patient who had the wrong eye operated on, a swab that was left inside a patient having their adenoids and tonsils removed, and an incorrect implant being inserted into an orthopaedics patient.

Liverpool Clinical Commissioning’s group’s board papers for September said: “The trust has had a series of seven never events and there is a plan to undertake an external review that has been delayed due to the pandemic response. The trust has approached the Association for Perioperative Practitioners and have agreed the process."

“The trust also plans to work with Imperial College London on a peer review and bespoke human factors training to include simulation training and coaching. The trust also plans to produce an overarching action plan to bring together the themes and learning from the seven never events. This work is still underway and NHSE/I and CCG had requested a copy of this plan.”

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Source: HSJ, 24 September 2020

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