Patient safety is not a focus when the government calls the shots
Bookworm on Mar 17 2009 at 11:58 am | Filed under: Britain, Europe, Health, Medicine
For three years, a single British hospital that was obsessed with following government health care mandates to the letter, succeeded only in killing 1,200 patients unnecessarily:
Twelve NHS trusts are being investigated following a damning report which today slammed ‘appalling’ care at a single hospital.
Hundreds of patients may have died after bosses at Staffordshire General focused on Government targets rather than safety, the Healthcare Commission said.
A ’shocking’ catalogue of failures over a three-year period were disclosed after an investigation found hospital managers had sought to save millions by adopting foundation status.
[snip]
Among the findings of yesterday’s report were:
? receptionists carrying out initial checks on emergency patients
? too few consultants, with junior doctors left in charge overnight
? two clinical decision units used as ‘dumping grounds’ for A&E patients to avoid breaching four-hour waiting targets, one of which had no staff
? nurses so ill-trained they turned off heart monitors because they didn’t understand them
? delays in operations, with some patients having surgery cancelled four days in a row and left without food, drink or medication
? vital equipment missing or not working
? doubling of life-threatening C diff infection rates, which were kept from the hospital board and the public
? a target of £10 million savings which was met at the expense of 150 posts, including nurses
? more debate by the board about becoming a foundation trust than about patient safety
[snip]
Investigators were inundated with complaints from patients and relatives, the most it had ever received, including Julie Bailey, 47, who set up a campaign group following the death of her mother in November 2007 at the hospital in Stafford.
She was so concerned about her 86-year-old mother Bella that she and her relatives slept in a chair at her hospital bedside for eight weeks.
‘What we saw in those eight weeks will haunt us for the rest of our lives’ she said.
Thirsty patients drank out of flower vases, while others were screaming in pain and falling out of bed.
[snip]
Director of the Patients Association Katherine Murphy said ‘Government targets have directly impaired safe clinical practice and money and greed for Foundation Trust benefits has taken priority over patient’s lives.’
As you can see, the above story does not relate one of those increasingly frequent situations in which the British government decided to withhold treatment or tests from a single class of patients because the patients are more expense than they are worth. The government wasn’t directly involved here at all.
The problem, instead, was that a hospital, rather than seeing patients at its customers, saw the government as its patron, and redirected its energies accordingly. And because there was no connection between the patients and the hospital in terms of complaints (that is, the hospital didn’t care about the patients, who were not paying the bills themselves, nor did they have a direct relationship with an insurance company that wanted to keep their custom), the hospital managed to go for years without having to react to criticism or complaints. It was only when patients and their families were able to achieve a critical mass that made a noise loud enough to spur the government to action that the hospital’s conduct finally came under scrutiny.
It’s a reminder to us all that the market speaks loudly and quickly. The government may ultimately have the loudest voice of all, but getting it to speak is often an agonizing task for a consumer who is deprived of a true marketplace and, instead, is utterly dependent on the government to give him a voice.
bookwormroom.com
NHS 'Third World hospital' where patients drank out of flower vases: Report reveals appalling care
By Jenny Hope
Last updated at 7:49 AM on 18th March 2009
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Hundreds of patients may have died after bosses at Staffordshire General focused on Government targets rather than safety, the Healthcare Commission said
The full extent of the horrific conditions at an NHS hospital where hundreds may have died because of 'appalling' care was laid bare yesterday.
Dehydrated patients were forced to drink out of flower vases, while others were left in soiled linen on filthy wards.
Relatives of patients who died at Staffordshire General Hospital told how they were so worried by the standard of care they slept in chairs on the wards.
The 'shocking' catalogue of failures was released yesterday after an independent investigation by the Healthcare Commission.
It found Government waiting time targets and a bid to win foundation status were pursued at the expense of patient safety over a three-year period at Mid-Staffordshire NHS Trust.
The commission's report - revealed in yesterday's Daily Mail - said at least 400 deaths could not be explained, although it is feared up to 1,200 patients may have died needlessly.
Health Secretary Alan Johnson pledged high-level reviews of A&E services at the trust, and insisted the scandal was not being repeated at other NHS hospitals.
He said: 'It was a failure of management. Using targets as some kind of excuse is just poor management. There was a breakdown of communication.
'I can give a reassurance that what happened in Stafford is an aberration, it is not indicative of what is happening in other hospitals. As soon as the commission started to investigate they told the chief executive.
The commission launched its investigation in March last year after receiving 11 alerts about high mortality rates through an early warning system.
A tribute wall made by family members and loved ones at Stafford Hospital in memory of patients who have died
Sir Ian Kennedy, chairman of the Healthcare Commission, said the true scale of the hospital's failures was not known.
But he said patients had died because of deficiencies at 'virtually every stage' of treatment.
Among the findings of the report were:
Receptionists carrying out initial checks on patients;
Two clinical decision units - one unstaffed - used as 'dumping grounds' for A&E patients to avoid missing waiting targets;
Nurses who turned off heart monitors because they didn't understand how to use them;
Delayed operations, with some patients having surgery cancelled four days in a row and left without food, drink or medication;
Vital equipment such as heart defibrilators was not working;
A savings target of £10million met at the expense of 150 posts, including nurses.
Julie Bailey (left) was so concerned about the treatment of her mother Bella (right) that she and other relatives slept in a chair at her bedside for eight weeks
The trust won foundation status last February. Its chief executive Martin Yeates and chairman Toni Brisby resigned earlier this month.
Investigators had been inundated with complaints from patients and relatives, including Julie Bailey, 47, who set up a campaign following the death of her mother, Bella, in November 2007.
She had been so concerned the 86-year-old that she slept in a chair on the ward for eight weeks.
Deb Hazeldine pays tribute to her mother Ellen
'What we saw in those eight weeks will haunt us for the rest of our lives,' she said.
Thirsty patients drank out of flower vases, while others were screaming in pain and falling out of bed.
She said: 'We're demanding a public inquiry. We want a change to this system where there's an emphasis on finance.'
Tory health spokesman Andrew Lansley said: 'The public will be rightly shocked by the poor standards of care exposed at this hospital.
'It is unacceptable that the pursuit of targets - not the safety of patients - was repeatedly prioritised, alongside endless managerial change and a closed culture, which failed to admit and deal with things going wrong.'
'DREADFUL, ABYSMAL, INEXCUSABLE'
Arthur Peacham died as a result of 'dreadful, abysmal, inexusable' care at the hands of Stafford Hospital, according to his wife, Gillian
Arthur Peacham, 68, had been retired for just two weeks when he was admitted to Stafford Hospital with back pain following a hernia operation.
After a week he was about to go home when staff told his wife, Gillian, that he had caught the C.difficile superbug.
After that, Mrs Peacham said, a series of 'horrendous' blunders helped lead to her husband's death on March 19, 2006, including failing to give him food and leaving him on 'filthy' wards.
'What happened to him was horrific,' said Mrs Peacham, 69.
'When they told me he had caught C. difficile they admitted they had known 11 other people on the ward were already infected but they had nowhere else to put him.
'They told us it wasn't contagious but my son checked on the internet and saw that it was highly contagious and could result in death.
'My husband went downhill from there. He was having trouble keeping food down and they were supposed to give him a special drink but they didn't feed him most of the time.
'Either they would forget to get a prescription from the doctor or they were too short- staffed to care for him.
Mr Peacham, an agronomist who had two sons and four grandchildren, was eventually moved to New Cross Hospital in Wolverhampton in early March.
His widow said: 'There it was amazing. He was so clean and well looked after.
'Unfortunately by then it was too late. The C.diff had ravaged his body.'
She added: 'The care at Stafford Hospital was dreadful, abysmal, inexcusable.'
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