Health secretary’s warning to James Paget Hospital

The comments by Andrew Lansley, ahead of his visit to the Gorleston hospital next week, were made as its top two bosses maintained a wall of silence on concerns raised by the Care Quality Commission (CQC), MPs, GPs, and patient groups.

MPs used a parliamentary debate this week to call for a change in leadership, saying two failed inspections into privacy, dignity and nutrition, and fears that a third was looming, had cast doubt over the management's ability.

Today Mr Lansley, who has been sent a letter from local GPs pleading for intervention, told the EDP: 'Sub-standard care in the NHS will not be tolerated. I expect the management team at James Paget University Hospital to take the necessary steps to urgently improve their services for their patients in light of the serious concerns raised by Monitor and the CQC.

'I am visiting the James Paget Hospital next week to meet the chair and chief executive to discuss what they are doing to address these critical issues.'

The Ministerial visit on Thursday will top off a difficult week for the hospital, which closed one of its wards to new admissions for 10 days so that staff training could take place.

Chairman John Hemmings visited Monitor yesterday, as part of the independent regulator of NHS foundation trusts' ongoing formal process into whether the hospital has breached its terms of authorisation. Monitor placed the hospital on the highest level of governance risk - red - the day after the James Paget received its second failed inspection report from the CQC.

On Thursday, Norfolk and Suffolk MPs spoke in a parliamentary debate on NHS care of the elderly, with Suffolk Coastal MP Therese Coffey called for Mr Hemmings to resign, which was echoed afterwards by Great Yarmouth MP Brandon Lewis.

Mr Lewis said yesterday that the management of the hospital had let down both patients and hard-pressed front line staff.

A spokesman for the hospital said: 'We recognise a heightened degree of public concern and wish to reassure our patients around the changes and improvements already made at the James Paget University Hospitals in respect of dignity, privacy and nutrition.

'Recent feedback from our patients, governors and visitors indicates that improvements are being experienced. The changes we have made have been supported by external partners and health care professionals.

'To compare this trust to the tragic events at Mid Staffordshire NHS Foundation Trust is ill considered.

'Government figures published yesterday rank the James Paget Hospital within the best performing 14 Trusts in the country in terms of mortality rates (Summary Hospital-Level Mortality Indicators (SHMI).

'The Care Quality Commission inspections did raise concerns around nutrition, privacy and dignity which have already been highlighted in the local media. We have taken action in respect of those issues and continue to do so to ensure the best possible care for all of our patients.'

While there were no comments forthcoming from both chief executive Wendy Slaney and Mr Hemmings, it was left to deputy chairman of the governors Hugh Sturzaker to fend off the criticism and to attack MPs and the media for damaging staff morale.

He said: 'As the leading governor for the JPUH and responsible for representing the public, I have been distressed to see the reports in the press, television and in parliament which have led to a staggering effect on staff morale and which must be very upsetting for patients, their carers and the local population.

'In spite of what has been said, surveys showing patient and staff satisfaction rates at the James Paget University Hospital are in the top 20pc nationally.

'I am concerned that an anonymous letter from some GPs suggests that we might be heading towards the problems experienced by Mid Staffordshire Hospital. Such an allegation is unfounded.

'The governors have had concerns over some issues which have been discussed openly with the chairman and trust board and changes have been made. To reassure our members, we have been carrying out audits on wards to ensure the effectiveness of the processes introduced by the leadership. While not being complacent I would like to reassure patients that they come first in this hospital.'

However, the statements failed to impress Mr Lewis, who said it was 'head in the sand stuff' and that hard-working front line staff, as well as patients, were being let down by the failures of management.

He said: 'This is exactly what they said after the first inspection.

'I'm concerned they are just repeating what they been saying for the last nine months or so.

'Again it has the potential to look like they are hiding behind the front line staff by saying it is damaging staff morale.

'I don't doubt it is, because they are being let down by the people above them and for their sake, the patients' sake and the reputation of the hospital we need to see a clear statement of intent about how things will move forward.'

He added: 'There comes a time when you have to take responsibility. The management need to do that now with clear outlines of action and we need to see the third, most recent inspection showing that all is now well. Otherwise many more people will be calling for change at the top, to give the great staff and their patients a fresh chance. The latest CQC report must be a good one, or bigger questions will rightly be asked.'

This week it emerged the hospital closed one of its wards to new admissions in a bid to address serious concerns over the standard of care.

The ward stopped receiving any new patients for 10 days so that staff training could take place. The closure was a decision taken by the hospital on its own initiative, rather than being imposed by the CQC, to address the concerns raised around dignity and nutrition.

A hospital spokesman said: 'As part of our ongoing improvement work at the hospital, the trust took the decision to close one ward to new admissions for a period of time. This was to allow for intensive training, staff development and enhanced clinical leadership. This work has now been completed.'

Dr Coffey said: 'I recognise improvements have been made and, absolutely, that's been made by big efforts with the staff.

'Failings were made and it is useful to acknowledge them while not detracting from the excellent health care which people generally enjoy.

'It would be fantastic for the chairman to prove me wrong and for a third report to come back a glowing success, because that would absolutely be evidence of great care for everybody who enters the JPUH and that's what everybody wants to see.'

Patrick Thompson, chairman of Norfolk's patient watchdog Norfolk LINk, said the concerns had gone on for far too long for his organisation, MPs, doctors, and the primary care trust to sustain confidence in the management.

He said: 'As a statutory body on behalf of the patients I'm aware of the action plans being put in place and on behalf of the patients I would like to see positive results from that action, but I'm somewhat unhappy we have got to the stage of the third inspection which hasn't cleared the trust completely of the problems that were found.

'Although the trust has been highlighted as an exemplar trust in other areas, there are still concerns from patients and their GPs that certain areas are still failing and it would be advisable for all levels of staffing, not just front line staff but senior levels, to maintain and to have sustainability on what should be provided for best patient care.'

Mr Thompson said if that was not achieved, then it would be up to those responsible to 'take action'.