A ‘leading’ cancer service has reported a series of safety incidents which contributed to patients being severely harmed or dying, HSJ has reported.
An internal report at Liverpool University Hospitals Foundation Trust suggests the incidents within the pancreatic cancer specialty were partly linked to patient pathways being ill-defined following the merger of its two major hospitals.
The report lists seven incidents involving severe harm or death, and five involving moderate harm. It is not clear how many of the patients died.
The trust was formed in 2019 through the merger of the Royal Liverpool and Aintree acute sites, with the consolidation of clinical services an integral part of the plans. However, there were no formal plans to change the configuration of pancreatic cancer services, which already operated under a “hub and spoke” model.
In one finding relevant to all 12 incidents, the report said: “Patient ownership and clinician accountability (local vs specialist) have not been defined following the merger of the legacy trusts and subsequent service reconfigurations.
“This has contributed to system failures in the provision of timely quality care, particularly in patients with time-critical clinical uncertainty.”
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Source: HSJ, 5 October 2022