Quality | 2009.11.28
Eleven more NHS hospitals at centre of safety scandal
• Failures lead to thousands of deaths
• Government orders new investigation
The true scandal of NHS hospitals failing to comply with basic safety standards is revealed in today\'s Observer . Research that ranks every general hospital in England against a range of safety measures has named 12 NHS hospital trusts judged to be "significantly underperforming".
This is despite the fact that last month the Care Quality Commission, the health service regulator, judged overall care at eight of the trusts to be good or excellent. Today\'s study by Dr Foster, an NHS partner organisation that collates and analyses healthcare data, also highlights 27 trusts with unusually high death rates. Almost 5,000 more patients in their care died in the past year than was expected.
Revelations of such widespread safety failings will send shockwaves through the NHS, already reeling from scandals at two trusts last week. Poor nursing care, filthy wards and hundreds of unnecessary deaths were exposed at Basildon and Thurrock University NHS Hospitals Foundation Trust, and the chair of the NHS trust in Colchester was fired.
Now the new data proves that key safety failings are occurring in 11 more hospital trusts across England. They include Scarborough and North East Yorkshire Healthcare Trust, South London Healthcare Trust, Weston Area Health Trust, Hereford Hospitals Trust, Lewisham Hospital Trust and University Hospitals Coventry and Warwickshire Trust. Eighteen were found to have death rates the same or higher than at Colchester. Ministers want to know why seven in particular have had persistently high death rates over five years.
The Department of Health yesterday ordered the CQC to investigate if any other trusts needed urgent attention. The CQC said it was "monitoring closely a number of other trusts", but had no evidence there was another case in England where it would take action of the kind taken at Basildon.
John Black, president of the Royal College of Surgeons, last night told the Observer that patient safety had been neglected by hospitals too busy meeting NHS-imposed financial targets: "Too many hospitals are too concerned with meeting financial targets at the expense of clinical standards, and we are seeing patients suffering as a consequence."
Today\'s research exposes systemic failures in large parts of the NHS during the last financial year and finds:
■ 39% of trusts failing to investigate unexpected deaths or cases of serious harm on their wards.
■ At least 209 incidents in which "foreign objects", such as swabs and drill-bits, were left inside patients after surgery.
■ At least 82 cases in which medical staff operated on the wrong part of the patient\'s body.
It finds that 5,024 people died after being admitted for "low-risk" conditions such as asthma or appendicitis, of whom 848 were under 65. A proportion of those deaths will be linked to safety errors.
The Conservatives reacted by promising a complete overhaul of the regulation system, which rated Basildon "good" only weeks ago. Andrew Lansley, the shadow health secretary, said: "Labour\'s failed health inspection regime is more interested in targets than patients." He also questioned the timing of the Basildon announcement. Officials knew of the hospital\'s failings weeks ago but decided to publicise them last Thursday, just days before the Dr Foster research was due to be published in the Observer .
The study paints a picture of large variations in the hospital standardised mortality ratio, a measure used by Dr Foster. The measure, which was used last week by Monitor, the regulator for NHS foundation trusts, looks at the likelihood of individual patients dying, given their underlying condition, age and economic background, then compares that to the actual number of deaths.
Cynthia Bower, the CQC\'s chief executive, said improvements had been made, but added: "The NHS cannot stand still on safety. It must be able to look the public in the eye and say safety is top priority for the leadership of every NHS trust in the country – no ifs and no buts."
Some trusts in the bottom 12 question Dr Foster\'s methodology, the first time the researchers have created a patient safety indicator, which ranks hospitals across a range of factors. The board at University Hospital of South Manchester said it reacted with "shock and disbelief" at its inclusion in the bottom 12. A spokeswoman for St Helens and Knowsley NHS Trust said: "The trust has a consistently good patient safety and quality of care performance record, which is reflected in the second consecutive \'double excellent\' rating awarded by the Care Quality Commission... The Dr Foster figures do not include the patient safety data that was provided by the trust."
Roger Taylor, from Dr Foster, responded: "We have used the most credible available data to assess patient safety. CQC ratings are not designed to just assess patient safety and instead use broader indicators, including measures of effectiveness and patient experience. The hospital guide is focused on patient safety, and mortality ratios are used alongside other indicators."
For more information, please visit
http://www.guardian.co.uk/society/2009/nov/29/nhs-hospitals-safety-report
