CQC to reveal NHS cover up names

England’s NHS regulator will name some officials accused of covering up a failure to investigate deaths of babies at a Cumbria hospital.CQC to reveal NHS cover up namesPressure is mounting on the Care Quality Commission to name managers who apparently blocked publication of a critical report.

The Information Commissioner said the Data Protection Act does not overide public interest in releasing the names.

The CQC said no decision had yet been formally reached. However it has said it is exploring all legal means possible to see if names can be made public.

However, Health Minister Lord Howe said those involved will be named.

Speaking in the House of Lords, he said his “understanding” was that the CQC would reveal the identities of some of the officials involved later today.

However, the CQC said no official decision has yet been made.  Before the meeting, CQC chief executive David Behan confirmed he was reviewing legal advice not to reveal the names of those involved.

It follows growing pressure to publicly name those involved.

Information Commissioner Christopher Graham in the meantime has told the BBC that senior managers could not “hide behind the Data Protection Act”.

More than 30 families have taken legal action against the hospital in relation to baby and maternal deaths and injuries from 2008.

Consultants Grant Thornton were asked by the health regulator to investigate its own failure to spot the problems: in 2010, Morecambe Bay NHS Trust, which ran the hospital, had been given a clean bill of health.

Grant Thornton found that, a year after this, with more concerns emerging, an internal review had been ordered into how the problems had gone unnoticed.

In March 2012 it was decided the findings should not be made public because the review was highly critical of the regulator.

That order is said to have come from a senior manager who has not been named and who denies the allegations.

The latest report said this “might well have constituted a deliberate cover-up”.

Information Commissioner Mr Graham told BBC Breakfast: “What appeared to be going on yesterday was a sort of general duck-out saying ‘oh, data protection, sorry can’t help you’ – that’s all too common and in this case it certainly looked as if data protection really wasn’t the issue.”

He said he could not order the CQC to reverse its decision but said he was glad it was looking at the issue.

“So far as the Data Protection Act is concerned, we all have a right to the protection of our personal privacy but if you are a senior official then there are issues about the point at which your privacy is set aside because of over-riding public interest. That’s really the issue at stake here,” he said.

The 1998 Data Protection Act details how personal information is used by organisations, businesses and government. It demands that information is used fairly and legally, is accurate, used for specifically stated purposes and is kept secure.

There have been numerous occasions where data protection has been wrongly cited as a reason something should not happen.

In 2010 the Information Commissioner was forced to warn schools that they could not use it to ban parents from taking pictures of their children in nativity plays.

NHS cover up is unacceptable wanrs Health Secretary

A cover up by England’s NHS regulatory body after a series of baby deaths at a Cumbria hospital is unacceptable warns the Health Secretary.NHS cover up is unacceptable wanrs Health SecretaryJeremy Hunt was speaking after a review of the Care Quality Commission’s (CQC) response to complaints about several deaths at Furness General Hospital.

The review has shown a senior manager may have ordered the deletion of a report critical of the CQC last year.

Mr Hunt promised there would be “no hiding place” for those responsible.

In a statement to the House of Commons, he said the CQC was already introducing a tougher inspection regime and had just appointed a chief inspector of hospitals.

Meanwhile, he said the government was introducing measures to make the NHS more transparent, including a duty of candour to compel the health service to be open and honest about mistakes.

But Mr Hunt said the attempt to cover up as described in the report was “completely unacceptable” and the truth must come out.

“There should be no anonymity, no hiding place, no opportunity to get off Scot-free for anyone at all who was responsible for this. What happened at Morecambe Bay is above all a terrible personal tragedy for all the families involved. I want to apologise on behalf of the government and the NHS for all the appalling suffering they have endured.”

The CQC asked consultants Grant Thornton to investigate its failure to spot the problems – Morecambe Bay NHS Trust, which ran the hospital, had been given a clean bill of health in 2010.

The consultants found a year after this, with more concerns emerging, an internal review had been ordered into how the problems had gone unnoticed.

But in March 2012 it was decided the findings should not be made public as the review was so critical of the CQC. The order is said to have come from a senior manager who has not been named for data protection reasons. The individual denies the allegations.

Dementia care patchy- quango finds

The standard of care provided for people with dementia is “patchy”, the National Institute for Curbing Expenditure (NICE) has said. Dementia care patchy- quango findsSome people with the condition were not getting even basic levels of care, it added.

The warning came as NICE unveiled new standards for dementia care in England, covering issues such as housing and access to leisure services.

Care services were playing “catch-up” on dementia, it said.

The guidance is the first to be produced by NICE under its new extended remit.

To date, the organisation has focused on issuing recommendations about NHS treatments and encouraging healthy lifestyles.

But under the shake-up of the NHS, it now has responsibility for providing guidance on care and support provided by the likes of councils and care homes.

NICE’s dementia guidance includes 10 standards it wants the care sector to follow.

One calls for people with dementia to live in housing that meets their needs, while another says they should be given the support they need to access leisure activities.

Others focus on keeping patients involved in community life and ensuring they get access to services such as dentists and opticians.

NICE deputy chief executive Prof Gillian Leng said: “The general picture is that care is patchy.  We know that it is really good in places but it’s not consistent.  My personal view is that we are all playing catch-up because the number of people with dementia has been increasing so dramatically.”

Currently about 670,000 people in England are living with dementia but one in three over the age of 65 are expected to develop the condition.

George McNamara, of the Alzheimer’s Society, said people with the condition were being denied the quality of life they deserved.

“These standards will be a useful tool for the care sector and show what people with dementia and carers should be able to expect,” he said.  “But, as they are not mandatory, it’s a case of ‘wait and see’ as to whether this guidance will drive real change or just sit on the shelf.”

NHS whistleblower Gary Walker faced bullying culture

Former NHS trust executive Gary Walker claimed he was put under pressure to meet non emergency targets.NHS whistleblower Gary Walker faced bullying cultureThe former boss of a hospital which is being investigated over high death rates has told MPs there was a culture of “sheer bullying” in the NHS.

Gary Walker, former United Lincolnshire Hospitals Trust chief, said he was sacked because of a row over an 18-week non emergency waiting list target.

He said he was threatened by the East Midlands Strategic Health Authority when he flagged up capacity problems.

The NHS said he was sacked for allegedly swearing in a meeting and denied Mr Walker’s claims he was “gagged” by a compromise agreement for raising concerns about patient safety.

Gary Walker described in vivid detail the pressures facing Lincolnshire’s hospitals back in 2008 and 2009.

Mr Walker said he personally witnessed hospital trolleys lined up together in an assessment ward – such was the demand for beds.

He claimed that when he tried to raise concerns he was “bullied”, threatened with his position and told that “everyone else is coping”.

Speaking for the first time in public, Mr Walker told the health select committee staff had been forced to cancel 700 operations when hospitals were full of emergency cases in 2009.

He said he had to put Lincoln County Hospital on an emergency footing, or red alert, but felt pressurised by health executives.

He said the response from the health authority was “this is your problem – you need to meet the targets whatever the demand”.

“It is a very dangerous thing to be trying to push through targets when hospitals are dangerously overfull,” he said.

Mr Walker told the committee: “I got a phone call from Dame Barbara Hakin former chief executive of the East Midlands Strategic Health Authority saying ‘we’re about to approve £11 million of funding for your trust and that’s going to be very difficult while you’re on red alert’.

“I don’t personally see the link between £11 million of largely capital funding to build facilities and being on red alert, the two are separate.

“One is about operationally running a hospital safely and the other one is about longer term plans.”

Mr Walker said he prepared a presentation for the Department of Health about problems with hitting targets but was ordered to remove any reference to him calling for a capacity review.

Mr Walker, who was sacked in 2010 for “gross professional misconduct” over alleged swearing at a meeting, said he was forced to quit after refusing to meet Whitehall targets for non-emergency patients and was gagged from speaking out as part of a settlement deal.

Man with no shame- Sir David Nicholson- calls to resign after misleading MPs

Calls for the resignation of Sir David Nicholson- the chief executive of the NHS, were growing after it emerged he misled MPs over how he dealt with a ‘whistleblower’.Man with no shame- Sir David Nicholson- calls to resign after misleading MPsSir David was forced to issue a correction over evidence he gave to the Public Accounts Committee (PAC), after part of it was revealed to be untrue.

He had claimed that Gary Walker, former head of United Lincolnshire NHS Trust, had not identified himself as a whistleblower in a July 2009 letter to him. Sir David also told MPs that Mr Walker had not raised concerns about patient safety in the letter.

However, Mr Walker produced the letter in his own evidence to the Health Select Committee, which flatly contradicted Sir David’s account.

He told the MPs that he had “asked for protection as a whistleblower” in the letter, which also warned that patient safety could be compromised because he was “being forced to comply with targets”.

The letter, seen by the Telegraph, concludes: “I assume the Department of Health has a policy on whistle-blowing and would therefore like this letter to be considered in that context and not freely copied to the SHA [strategic health authority] or the local PCT [primary care trust].”

Mr Walker was sacked from his post in February 2010, for allegedly swearing in meetings.

He has always maintained the real reason was his refusal to bend to pressure from East Midlands Strategic Health Authority (SHA) to prioritise hitting waiting list targets. Mr Walker argued this would have endangered the safety of emergency patients.

He eventually received a £325,000 pay-off from the trust, on the condition he never talked about the dispute. Last month he broke the terms of that ‘gagging order’, resulting in him being invited to the Health Select Committee.

In the letter to Sir David, Mr Walker also claimed that he and David Bowles, the former chairman of the trust, had been the subject of “bullying and harassment” by the SHA.

Referring to the scandal at Mid Staffordshire NHS Foundation Trust, which at the time was just unfolding, he added: “This is the behaviour that gave this country a mid-Staffordshire.”

The matter is important because Sir David is fighting to maintain his reputation in the fallout of the Stafford hospital scandal, in which up to 1,200 people died due to appalling care.

A culture of bullying, not admitting mistakes and slavish adherence to targets is now widely accepted to have led to the tragedy.

Mr Walker argues he was trying to bring to Sir David’s attention similar problems at United Lincolnshire and East Midlands Strategic Health Authority ( SHA), which oversaw it. At the time the SHA was run by Dame Barbara Hakin, who Sir David has just appointed as his deputy.

From: http://www.telegraph.co.uk/Sir-David-Nicholson-calls-to-resign-after-misleading-MPs

Man with no shame Sir David Nicholson is partly to blame for Mid Staffs- Jeremy Hunt

The man with no shame- Sir David Nicholson does “bear some responsibility” over the scandal at Mid Staffs hospital according to  Jeremy Hunt.Man with no shame Sir David Nicholson is partly to blame for Mid StaffsSpeaking in the Commons during a debate on NHS accountability, Mr Hunt, the Health Secretary, became the most senior Government figure to admit that Sir David, the NHS chief executive, was partly at fault for the failings that led to Mid Staffs, where up to 1,200 patients died needlessly.

It comes after it emerged that senior Government figures are considering a plan for Sir David to “pre-announce” his retirement.

Sir David would then step down later this year or early in 2014, having managed the NHS through the first months of major Coalition reforms starting next month

Sir David is under intense political pressure over the Mid Staffs hospital scandal. A public inquiry into Mid Staffs led to calls for his resignation.

David Cameron has backed him to remain in his post, and this week sent him supportive text messages, sources have disclosed.

Mr Hunt attempted to divert some of the attention away from Sir David by insisting the he does not bear “personal” for Mid Staffs and that the deaths there would have happened with or without the NHS chief overseeing the trust.

Speaking at a debate in the Commons on NHS accountability, Mr Hunt said that Sir David has “apologised” and that he has “been held to account”.

“David Nicholson has been the focus of much attention and as a manager in the system that failed to spot and rectify the appalling cases of Mid Staffs he does bear some responsibility,” Mr Hunt said.

“He said himself, ‘We lost our focus’. He’s apologised and been held to account by this House and many others.

“But I don’t believe that he bears total responsibility or indeed personal responsibility for what happened.”

Attempting to shift the focus of blame onto Labour ministers, Mr Hunt insisted that Sir David had warned figures in the last government that the “target” culture in the NHS was dangerous.

“He was at the SHA [strategic health authority] for 10 months during the period in question, overseeing 50 hospitals at a time when his main responsibility was the merger of three SHAs into one.

“And he consistently warned both ministers and managers the dangers of hitting the targets and missing the point. It is just not true that if there had been no David Nicholson at the SHA there would have been no Mid Staffs.”

Sir David is said to be resisting pressure to make some sort of concession to his critics by announcing his resignation.

However, there is a growing feeling among ministers and officials that he will have to make some sort of statement about his future.

Several ministers are known to believe that Sir David must go, and even others who sympathise with him believe his departure is inevitable.

From:  http://www.telegraph.co.uk/Sir-David-Nicholson-is-partly-to-blame-for-Mid-Staffs-Jeremy-Hunt

Big variations in NHS surgery due to postcode lottery rationing

The number of patients undergoing common NHS surgical procedures varies widely across England because of postcode lottery funding restrictions.Big variations in NHS surgery due to postcode lottery rationingLocal NHS rationing of hernia repair, hip and knee replacements, cataracts and varicose vein surgeries has led to a “postcode lottery”, say researchers.

Writing in the Lancet, they warned such policies could be “storing up problems for the future”.

The Department of Health said access to services should not be decided on cost as suitability for surgery should be judged by clinical experts on the basis of individual need, a spokesman added.

There has been much anecdotal evidence about rationing of some surgical procedures on the NHS, but this has tended to focus on the number of policies in place rather than details on how this has affected patients being operated on.

And while there had been much debate about the “clinical value” of some elective surgical procedures, there was poor consensus on which treatments should be restricted to save costs, the Imperial College London team said.

A comparison of hospital data with primary care trust (PCT) policies on rationing of surgery showed a significant difference in the number of operations being done depending on local rules.

For cataract surgery, PCTs with rationing in place were admitting about 48% fewer patients than those with no such policy in the first year restrictions were introduced, the figures showed.

And for knee replacements there was at least a 20% difference in the number of patients having the operation, depending on whether there were restrictions in place, they found.

When rationing for hernia surgery was introduced in some areas in 2006-07, there were 59% fewer patients being operated on in some PCTs, compared with those with no policy.

The researchers said this gap had since narrowed but in 2010-11 there had still been a 15% deficit, which equated to 64 fewer operations per 100,000 people per year in areas with restricted access.

Significant variations had been seen in access for almost every year looked at since rationing policies had been in place, they said.

The type and number of procedures rationed by PCTs varied considerably and only 17 of 119 respondents had no policy for all five of the procedures looked at.

Elderly suffer from poor home care

A quarter of home care services provided to the elderly in England are failing to meet quality and safety standards, inspectors say.Elderly suffer from poor home careMore than 700,000 people above the age of 65 rely on home help for activities such as washing, dressing and eating.

But the Care Quality Commission found evidence of rushed appointments and botched assessments during its review of 250 services.

Campaigners said it was a sign of how much pressure the system was under.

Ministers have recently announced plans for a £75,000 cap on the amount the elderly will have to pay for social care in England – only the poorest get it free.

The proposal aims to stop the elderly having to sell their homes to pay for care.

But the move will do nothing to get extra money into the system, something the sector believes is vital if the quality of services is going to be improved.

Home help services are considered essential in keeping people out of more expensive care homes.

The numbers getting help is pretty evenly split between self-funders and those who get council-funded care.

This review looked at the support being provided to both – and found too many were struggling to maintain standards.

A total of 26% failed on at least one standard. One of the most common issues identified related to late, rushed or missed visits.

The regulator also highlighted assessments that had missed vital information, such as a diagnosis of diabetes, and care records that were incomplete, meaning problems such as pressure ulcers could be missed by carers.

Concerns were also raised about the way services were monitored and complaints handled.

The regulator said home care providers, many of which are private companies, needed to work closely with local authorities to remedy the problems.

It warned the problems identified could have a “significant impact” on the elderly, many of whom did not complain because of a fear of reprisals or loyalty to their carer.

CQC can’t guarantee it would spot another Mid Staffs disaster

The main health regulator quango  “cannot guarantee” it will spot another scandal on the scale of Mid Staffs- its new chairman has admitted.CQC can't guarantee it would spot another Mid Staffs disasterDavid Prior said the Care Quality Commission was “going to have to change” to provide the level of inspection demanded by the Francis report.

He also said it was a “no brainer” that the CQC should have dedicated hospital inspection teams, as recommended by Robert Francis QC, who chaired the inquiry.

Mr Prior, an experienced businessman and former Conservative MP, who recently chaired Norfolk and Norwich University Hospitals NHS Foundation Trust, told The Daily Telegraph that we and his colleagues were “under no illusions” about the job ahead.

“We are going to have to change,” he said.

He continued: “At this time, we can’t give a guarantee that we would spot another problem similar to Stafford.  “We can be much better as a regulator but at the moment we can’t give that guarantee.”

He said the CQC was already changing to be better at identifying problems.

“We are going to reshape the CQC, so that we inspect on a differentiated basis,” he said, explaining that they would have teams for hospitals and teams for care homes.

Mr Prior admitted this should have happened long ago: “It’s a no brainer, I think.”

He said the CQC would also move to more of a “risk-based” regime, meaning hospitals which had shown greater problems – such as high mortality rates – would have more visits and more in-depth inspections.

Another key recommendation in the Francis report is that the CQC should take on a large chunk of the current responsibilities of Monitor.

Its duty is to check that hospital trusts are good enough to gain semi-independent Foundation Trust status.

Mr Francis was scathing of Monitor’s contribution to the Mid Staffs scandal, saying it essentially ignored “issues of patient safety and poor care”.

He also criticised the fact that Monitor and the CQC’s predecessor, the Healthcare Commission, barely talked to each other.

These failings meant the “the public remained exposed to an unacceptable level of risk,” he wrote.

He consequently recommended that ministers should consider handing responsibility for authorising Foundation Trusts from Monitor to the CQC. Such a move would be highly likely to see the end of Monitor.

From: http://www.telegraph.co.uk/CQC-cant-guarantee-it-would-spot-another-Mid-Staffs

Stafford Hospital aftermath- five more hospital trusts to be investigated

Five other hospitals trusts are to be investigated in the wake of the public inquiry into failings at Stafford Hospital.Stafford Hospital aftermath- five more hospital trusts to be investigatedNeglect and abuse at the hospital led to hundreds of unnecessary deaths between 2005 and 2008.

In response to the inquiry, Prime Minister David Cameron announced that five other hospitals with persistently high death rates would be investigated.

All the trusts named have had high rates for two years.

They are Colchester Hospital University NHS Foundation Trust, Tameside Hospital NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Basildon and Thurrock University Hospitals NHS Foundation Trust and East Lancashire Hospitals NHS Trust.

Death rates are calculated by looking at the number of people that would be expected to die when taking into account the age and disease profile of the local population.

High death rates were one of the factors that triggered the original investigation into Stafford Hospital. While not necessarily proof there is a problem, they are a “smoke alarm” suggesting there could be.

The figures for the five hospitals were already known about within the NHS and were being monitored- however, the intervention has only now been ordered amid mounting concern about levels of care.

Speaking in the Commons, Mr Cameron said: “I have asked the NHS medical director, Prof Bruce Keogh, to conduct an immediate investigation into the hospitals with the highest mortality rates and to check that urgent remedial action is being taken.”

The government’s full response to the public inquiry will come next month, however, it has already been announced that a new post of chief inspector of hospitals will be created in the autumn.

Speaking in the House of Commons, David Cameron said he was “truly sorry” for what happened at Stafford Hospital, which was “not just wrong, it was truly dreadful” and the government needed to “purge” a culture of complacency.

There has been anger from some quarters after nobody has so far lost their jobs as a result of the public inquiry.

Sir David Nicholson has been the focus of anger from families affected by the scandal. He is currently chief executive of the NHS and was in charge of the Regional Health Authority while death rates were high at Stafford Hospital.

Responding to calls for him to go, he said: “I think it’s perfectly understandable, I understand the anger that they feel, the upset that they feel about the treatment of their loved ones in Mid-Staffordshire hospital.

“I absolutely understand all of that. At the time I apologised and in a sense I apologise again to the people of Stafford for what happened, but apologies are not enough.”

You are correct Sir David Nicholson- apologies are not enough, Health Direct asks you to resign now.