Wednesday 21 March 2018

Low nursing staff levels to blame for high hospital death rates, reveals report into NHS care

Charlie Coooper

Hospitals at the centre of a major review into the safety of NHS care all had “inadequate” nursing staff levels, according to early leaks from Sir Bruce Keogh’s report.

Sir Bruce, NHS England’s Medical Director, was tasked with reviewing care at 14 hospitals which had higher than expected mortality rates.

His report said: “Statistical analysis performed showed a high correlation between in-patient to staff ratio and a high hospital standardised mortality rates score.

“When the review teams visited the hospitals, they found frequent examples of inadequate numbers of nursing staff in some ward areas.”

The 14 organisations were all now carrying out “urgent reviews of safe staffing levels”, the report said.

Ahead of his statement on the report, the Health Secretary Jeremy Hunt faced questions over nursing staff cuts.

Sir Bruce also said newspapers claiming the 14 trusts were responsible for 13,000 “avoidable deaths” since 2005 were inaccurate.

His report said: “However tempting it may be, it is clinically meaningless and academically reckless to use such statistical measures to quantify actual numbers of avoidable deaths.”

The 14 trusts face: “[A] combination of problems that to a differing extent are experienced by all hospitals in the NHS: busy A&E departments and wards, the treatment of the elderly in and out of hospital, and the need to recruit and retain excellent staff. Such issues are complex and require a ‘whole system’ approach to deal with them,” the report said.

11 of the 14 Trusts investigated will now be placed into special measures, because of “fundamental breaches of care”, Mr Hunt said.

Shadow Health Secretary Andy Burnham argued that the Government had cut 4,000 nursing jobs, and that seven of the 14 Trusts had cut 1,117 frontline staff. He also accused the Government of attacking the integrity of NHS staff.

“This report exposes one of the more cynical spin operations of recent times. Nowhere does the claim of more than 13,000 avoidable deaths appear,” he said.

“They made unfounded claims that will have alarmed people in the areas concerned and they have questioned the integrity of staff working in the hospitals all for their own self-serving political ends.”

East Lancashire Hospitals NHS Trust announced the resignation of its chairman and deputy chief executive, minutes before the publication of Sir Bruce’s report.

The 14 trusts included in the review were: Basildon and Thurrock University Hospitals NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Buckinghamshire Healthcare NHS Trust, Burton Hospitals NHS Foundation Trust, Colchester Hospital University NHS Foundation Trust, The Dudley Group NHS Foundation Trust, East Lancashire Hospitals NHS Trust, George Eliot Hospital NHS Trust, Medway NHS Foundation Trust, North Cumbria University Hospitals NHS Trust, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Sherwood Forest Hospitals NHS Foundation Trust, Tameside Hospital NHS Foundation Trust, United Lincolnshire Hospitals NHS Trust.

All of the Trusts, except for Colchester, Dudley and Blackpool, are now in special measures.

Some of the care failings identified at the individual hospitals included:

• At Tameside Hospital NHS Foundation Trust, patients were left unmonitored on trolleys for hours.

• At United Lincolnshire Hospitals NHS Trust there were 12 'never events' – care failings that regulators agree should never be allowed to happen – in three years.

• At Sherwood Forest Hospitals NHS Foundation Trust, patients were unaware who was caring for them and buzzers went unanswered.

• At Basildon and Thurrock University Hospitals NHS Foundation Trust there were seven never events in three years

• At Medway NHS Foundation Trust there was poor communication with patients, delayed discharges, and long waiting times.

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