NHS boss apologises for failings in care at hospital
PUBLISHED: 06:09 30 January 2020 | UPDATED: 11:26 30 January 2020
West Suffolk Hospital’s chief executive has apologised to the public, his staff and patients for failings in care after a critical inspection said newborn babies were put at “significant” risk and staff didn’t feel valued or respected.
The critical report from the Care Quality Commission (CQC), which rated the Bury St Edmunds site as "requires improvement", slammed the hospital for care of newborns, outpatient services and staff relations.
It also said that concerns about support for staff had been "exacerbated by the way the trust has managed recent issues of concern", with the Department of Health and Social Care also saying it wanted NHS England to carry out an urgent investigation into allegations it had conducted a "witch-hunt" into allegations of whistleblowing.
Chief executive Stephen Dunn said he would like to apologise for the short comings of the hospital and said: "I am very, very sorry that we did not meet all of our public, patient and staff expectations.
"I am absolutely committed to improving and we have taken immediate action."
Mr Dunn pointed out that the CQC had also highlighted and recognised the kindness and compassion of staff at the trust.
However the report, a major downgrade from the hospital's "outstanding" grading two years ago, makes a series of criticisms.
What concerns were raised?
- Inspectors found that there were 'significant concerns and risks' to mothers and newborn babies in the hospital, including a failure to properly observe patients to be able to identify health deterioration.
The CQC was so concerned by these risks that a warning notice was issued stating that improvements must be made by the end of the month.
- The welfare of staff at West Suffolk trust was called into question several times and Ted Baker, chief inspector of hospitals, identified a disconnect between the executive team and some specialist consultants.
He said: "Safety concerns were not consistently identified or addressed quickly enough, and incidents were not always reported in a timely manner.
"Wider lessons were not identified or shared effectively to improve patient safety.
"Not all staff felt respected, supported and valued or felt that they could raise concerns without fear of retribution.
"This has been exacerbated by the way the trust has managed recent issues of concern."
Whilst the inspection found that staff worked well together for the benefit of patients, the style of their leadership did not demonstrate an 'open and empowering culture'.
- Other failings were noticed in outpatient services where ways of keeping track of patients were found not to be good enough.
Inspectors also found that once concerns were noted, actions were not undertaken fast enough to address them and this resulted in risks to patients who were using the vascular service.
There were also concerns raised about not fully managing infection risks and the hospital's medicines management.
What will the hospital do about it?
The hospital must take definitive steps to improve the culture, openness and transparency of its staff.
- They must be actively encouraged to speak up about concerns as well as clinicians being encouraged to collaborate to improve the quality of care delivered.
Mr Dunn said that he had already spoken with freedom to speak up guardian Dr Henrietta Hughes to speak about staff relations, saying: "I know that some staff are not happy and I take it incredibly seriously.
"We would like all staff to feel valued, and respected and happy and we are reviewing our culture."
- There must also be an effective process of staff grievances and complaints - in line with the trust's policy - as well as processes put in place to deal with investigations and manage risks.
- Outpatients must be able to access care at the time they need it and the trust has brought in an audit programme to follow up on the service.
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- A nationally recognised standard of monitoring needs to be upheld for women and newborn babies.
The hospital have a new head of midwifery to oversee the department whilst they report improvements to the CQC and Mr Dunn reassured the public that their maternity and midwifery service is safe.
In particular, the trust is being told they must implement a nationally recognised monitoring observation tool for women attending triage in the labour suite as well as maternity day assessments.
Mr Dunn acknowledged that the recent investigations after the data breach could have been handled better and said that he had apologised for this previously.
What has the reaction been to the report?
Health Secretary Matt Hancock said it was "obviously disappointing" the West Suffolk Hospital, Bury St Edmmunds, had been criticised in a damning inspectors' report.
The West Suffolk NHS Foundation Trust, which is responsible for Mr Hancock's local hospital, has been criticised by the Care Quality Commission (CQC) for a failure of care in the report.
"I know everyone who relies on and works at the West Suffolk will be concerned to read the findings," he said.
MP for Bury St Edmunds, Jo Churchill, was shocked by the report saying she has "real concern with some of the findings".
In particular she was concerned by the comments around midwifery and culture, demanding they must be addressed as a matter of urgency.
She said parents should feel confident in the maternity care they receive and that procedures and safety precautions should always be implemented when delivering care.
"I am also concerned with the processes for incident reporting and investigation at the hospital," she added.
"As all staff should feel that they can speak up and have the confidence that anything they raise will be taken seriously and the improvements they suggest are acted on.
"However, I have been assured by the chief executive and leadership team that the comments have been taken on board and they are proactively working hard to implement the CQC recommendations in order to deliver the high quality standards patients expect and deserve."
The MP has previously offered to meet with managers at the hospital and says she will do so again if it was felt to be of use.
Dr Ed Garratt, chief executive of the NHS West Suffolk Clinical Commissioning Group, added that CCG will be working closely with the trust to help it bring about the necessary improvements required to deliver the very best patient care possible.
But independent watchdog Healthwatch Suffolk has called the implications of the report at best an "unsettling situation for people across our county".
A spokesman for the organisation said: "These are large NHS providers and so this will impact upon many thousands of people requiring care.
"When we examine feedback from patients it is clear that many continue to have a good impression of the hospital."
However, in its report to the CQC it highlighted areas patients felt could be improved which included concerns for the maternity service.
They said: "This includes that mothers have told us about their worries related to the availability of staff, the extent to which their pain levels are monitored and infection control measures.
"Whilst feedback concerning maternity staff is mixed in sentiment, there is a high level of praise for midwives and the kind support offered to mothers during and after the birth of their baby."
Guy Forster is a specialist medical negligence lawyer at Irwin Mitchell who represents a number of families who have raised concerns over the care they received under the trust.
He spoke about the worrying findings which have been echoed by his clients and their families.
"There appears to be a lack of transparency and perception of blame culture amongst some staff within the trust which is deeply concerning," he said.
"The report identifies concerns around patient safety, with the potential for lessons not being learned, which is unacceptable.
"We now call on the trust to ensure it improves not only patient care but also addresses its shortcomings in culture, particularly how incidents are investigated and how staff are treated."
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