11:00am Wednesday 17th July 2013
By Lawrence Dunhill
THE trust which runs East Lancashire’s hospitals has admitted it has ‘a number of areas’ it must address after being placed into ‘special measures’ following a damning report.
An investigation led by NHS medical director Professor Sir Bruce Keogh into high death rates at Blackburn Royal and Burnley General hospitals found several issues which were below accepted national levels.
Among them were:
The report also referred to ‘a number of areas of good practice and dedicated staff’, with the inspectors understood to be particularly impressed by the hip fracture ward and surgical triage unit.
Russ McLean, chairman of the Patient Voices Group, said: “Unfortunately, the report has just re-iterated what our group has been telling the trust for the last two-and-a-half years.
“There are pockets of very good practice but there are general staff shortages and a lack of compassion.
“It is so sad for the staff because they are the ones who will bear the brunt of this, but it’s the management that should be held accountable.”
The five-month investigation into 14 hospital trusts, which were identified as having ‘higher than expected’ death rates, was ordered after the publication of a shocking report into failings at Stafford Hospital, where hundreds of patients may have died unecessarily over a four-year period.
The death rate for East Lancashire Hospitals NHS Trust has been higher than expected on one measure, the Summary Hospital-level Mortality Indicator [SHMI], which suggested there were 319 ‘more deaths than expected’ between October 2011 and September 2012.
However, the trust has always argued that high deprivation levels in East Lancashire have impacted on the data, pointing out that mortality is ‘within the expected range’ on a separate measure, called the Hospital Standardised Mortality Ratio [HSMR].
Jack Straw, Labour MP for Blackburn, said: "This is a vitally important report, which has led to some painful, but in my view, necessary decisions about the East Lancashire Hospitals NHS Trust.
“Today's report shows clearly that the emergency department of Royal Blackburn Hospital, over the last year, was one of the busiest in the country, and amongst those under greatest pressure. I shall be visiting the department next Tuesday afternoon to talk personally to staff and patients.”
Andrew Stephenson, Conservative MP for Pendle, said: “It is clear that the last Government encouraged hospital bosses to avoid negative publicity whenever possible and this consideration was put ahead of patient’s dignity and respect.
“Given what the Keogh report says about capacity issues at Blackburn Hospital and that the hospital is ‘struggling to deal with the number of patients’, serious questions again have to be asked about the decision to downgrade Burnley Hospital’s A&E department in 2007.”
Hospital bosses have accepted the report’s findings, and said ‘robust plans’ were in place to address all the issues.
The Lancashire Telegraph asked chief executive Mark Brearley if he had considered offering his resignation after seeing the report.
He said: “I came to East Lancashire two years ago to be chief exec and lead the organisation and give both consistency of leadership and direction which hadn’t been evidenced in the trust previously.
“I think we’ve made improvements in the last two years and I’m committed to delivering this action plan, I’ve still got a job to do.”
He said staffing issues within the medical and nursing divisions had already been identified, and a recruitment process had taken place while the review was taking place.
However, he admitted the trust’s complaints process needed to improve, and extra work would be carried out with staff to ensure a more ‘compassionate’ system. He said chief nurse Lynn Wissett was the director responsible for complaints, but her resignation was not connected to the criticisms in the report.
Mr Brearley said: “This report strengthens our resolve to deliver zero tolerance of poor care, the report has identified areas of good practice and we intend to ensure that this is replicated across the organisation so that we can deliver the best care to all our patients.
“The review team considered the caring and dedicated staff at the trust to be a huge asset. However, they noted that staff were working at full capacity and we will be addressing these staffing pressures immediately.”
The governance problems highlighted in the report included two issues that were ‘escalated immediately’ due to concerns for patient safety.
There were eight still-born babies at the maternity ward in Burnley in March, compared to a monthly average of five, but the review found this had not been brought before the board or investigated.
Dr Ian Stanley, deputy medical director, said the issues were in fact probed, and no clincial concerns identified, but the process by which they were brought to the board was ‘too complicated’.
He said that there were too many stages before the concerns of ward staff reached board members, so the trust will ensure that medics, in future, can flag up issues directly.
A separate issue about the safety of two ‘close observation’ beds in the maternity ward is currently being reviewed by an external team, to see if there is a problem.
Mr Stanley said weekend staffing levels had also been addressed, and the trust now had more senior consultants on duty over the weekend than most others.
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