Labour’s NHS targets may have led to 1,200 deaths in Mid-Staffordshire
An astonishing litany of failings at Mid-Staffordshire Hospitals trust was uncovered by the Healthcare Commission in one of the most critical reports of NHS treatment ever published.
Last night there was concern from patient groups that managers who should have spotted the failings at the trust but failed to raise the alarm have now been promoted to key jobs in the NHS and healthcare regulation.
The investigation into care between 2005 and 2008 found overstretched and poorly trained nurses who turned off equipment because they did not know how to work it, newly qualified doctors left to care for patients recovering from surgery at night, patients left for hours in soiled bedclothes, and reception staff expected to judge the seriousness of the condition of patients arriving at A&E.;
Doctors were diverted away from seriously ill patients, in order to treat ones with minor problems, to make the trust look better because they were in danger of breaching the Government’s four hour waiting time target.
The trust – which was under pressure to save £10m from its annual budget – was more concerned with hitting targets, gaining Foundation Trust status and PR marketing and had “lost sight” of its responsibilities for patient care, the report said.
It is not clear how many patients died as a direct result of the failures but the Commission found that mortality rates in emergency care were between 27 per cent and 45 per cent higher than would be expected, equating to between 400 and 1,200 ‘excess’ deaths.
Sir Bruce Keogh, medical director of the NHS, described the failures as a “gross and terrible breach of trust” of patients.
Health Secretary Alan Johnson offered his apologies to patients and staff who suffered as a result and immediately ordered two more inquiries.
Patients of Mid-Staffordshire NHS Foundation Trust described one ward as a “war zone” and people were often left waiting in A&E; for hours covered in their own blood and without pain relief even though they had serious injuries.
Others were left without food or drink, some received the wrong medication – or none at all – and blood and faeces was left on lavatories and floors.
Trust chief executive Martin Yeates and chairman Toni Brisby both stepped down two weeks ago and Mr Yeates, who is paid a salary of £160,000, is suspended on full pay while an independent investigation is carried out.
But patient groups were angered that Cynthia Bower, who was chief executive of the West Midlands Strategic Health Authority – the organisation with responsibility for checking standards at the hospital – from July 2006, is to set to become the new head of the health super-regulator the Care Quality Commission.
Her predecessor David Nicholson at the forerunner of West Midlands Strategic Health Authority – which was Shropshire and South Staffordshire SHA – left in 2006 but is now the head of the NHS, as its chief executive.
Sir Ian Kennedy, chairman of the Healthcare Commission, said the report is a “shocking story” and that there were failures at almost every stage of care of emergency patients.
“There is no doubt that patients will have suffered and some of them will have died as a result,” he said. “Trusts must always put the safety of patients first. Targets or an application for foundation trust status do not lessen a board’s responsibility to its patients’ safety.”
The problems first emerged after the hospital was reported in 2007 to have high mortality rates among patients.
But the trust’s board of directors “fobbed off” NHS investigators by saying the rates were a result of statistical errors.
Yesterday the Healthcare Commission concluded this was not that case. The report stated that staff members claimed care of patients had become secondary to government-imposed targets.
The report said there was a “reluctance to acknowledge or even consider that the care of patients was poor”.
Nurses were threatened with the sack because of the number of breaches of the target to treat A&E; patients within four hours and felt they were “in the firing line”.
Patients in danger of breaching the target were put in a ‘clinical decision unit’ which was a “dumping ground” for patients in order to “stop the clock” on the waiting time.
Relatives came forward to report, nurses shouting at patients, staff failed to treat patients with compassion or dignity and respect, lack of help with meals or drinks, and failures to treat bed sores. One comapred the hospital treatment to the “Third World”.
A survey found two thirds of doctors would not be happy to have a relative of theirs treated at the hospital.
Director of the Patients Association Katherine Murphy said: “How can any patient have trust in the managers and systems that have allowed this disaster to run and run?
“It is not enough for the Chairman and Chief Executive to take the fall for this.
“Government targets have directly impaired safe clinical practice and money and greed for Foundation Trust benefits has taken priority over patients’ lives.”
Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN), said: “There is also something very wrong when trusts are achieving foundation status by putting the health of their budgets over the care of their patients as detailed in the accounts of trust board meetings.”
Eric Morton, the new chief executive of the Mid-Staffordshire NHS Foundation Trust, said: “We would like to take this opportunity to offer our very sincere apology. We would like to reassure the local community that our focus is, and will remain, on providing high quality, efficient and safe healthcare for the people of Staffordshire. “
Professor Sir George Alberti, national clinical director for urgent and emergency care will now lead an independent review of the trust’s current A&E; services.