Stafford Hospital- the scandal that shames the NHS PT1
The scandal at Stafford Hospital shames the National Health Service.Hundreds of hospital patients died needlessly. In the wards, people lay starving, thirsty and in soiled bedclothes, buzzers droning hopelessly as their cries for help went ignored. Some received the wrong medication; some, none at all.
Over 139 days, the public inquiry into the Stafford hospital scandal has heard testimony from scores of witnesses about how an institution which was supposed to care for the most vulnerable instead became a place of danger.
Decisions about which patients to treat were left to receptionists, inexperienced junior doctors put in charge of critically-ill patients, and nurses switched off equipment because they did not know how to use it.
By the time the hospital’s failings were exposed by regulators, in 2009, up to 1,200 patients had died needlessly between 2005 and 2008.
It happened in simple terms because managers attempted to cut costs and meet Labour’s central targets, so they could achieve the coveted “foundation status” for Mid Staffordshire NHS trust – enforcing 160 job cuts as they tried to succeed.
Now a public inquiry, which opened more than two years ago, is attempting to address fundamental two questions. How was it that the regulatory and supervisory systems which should protect all patients failed so catastrophically – and what is to stop it happening again?
Mr Francis and his team have heard from 290 witnesses, and considered more than one million pages of evidence, in an inquiry which has so far cost almost £13 million. Repeatedly, the evidence has led to one question – whether a “culture of fear” means that the demands of the NHS hierarchy take precedence over the most basic needs of patients.
The inquiry heard that at Stafford, NHS targets ruled supreme.
Orders were cascaded down the management hierarchy, from the executive board, to the operational managers, to the senior nurses and matrons; nurses and doctors who failed to meet them were threatened with the sack.
It led to junior nurses and doctors abandoning seriously ill patients to treat minor cases who were in danger of breaching the four hour Accident & Emergency (A&E) waiting time limit.
For the same reason, patients were often moved out of casualty soaked in urine or covered in faeces, because the target – to admit or discharge patients within four hours – was under threat.
Meanwhile, nurses were instructed by senior nurse colleagues to falsify waiting times, and to claim that patients had been seen more quickly than they were.
Often, patients who were approaching the time limit were put in a clinical decision unit – a “dumping ground” where they received inadequate care, but which allowed nurses to claim that the target had been achieved. An emergency assessment unit was frequently misused for the same reason, becoming so chaotic that staff nicknamed it “Beirut”.
NHS managers staffed the hospital so thinly that there were never enough consultants to properly supervise junior doctors, who took much of their instructions from the senior nurses and matrons who enforced the targets.
At nights it was worse. After 9pm, the most senior surgeon left in charge was often a junior doctor, with little experience of emergency surgery.
Many of the nurses had never been shown how to use basic life-saving equipment, such as cardiac monitors, which identify whether a patient is deteriorating; some turned them off.
When patients arrived at A&E, there were not enough nurses to assess them. In fact, the task was left to receptionists, who took decisions based on a “gut instinct”.
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