Who guards the guards?

This is from today’s Daily Telegraph on their excellent health pages. It’s worth posting in full – it comes from a non-executive member of the Care Quality Commission board. She is plainly not ‘one of us’ and I’m guessing her career in health oversite has come to a very premature end. The headings are all mine and I have edited this article.

“Telegraph.co.uk  Monday 10 June 2013

Our Hospitals Reform delays put lives at risk, NHS watchdog is warned

By Laura Donnelly, Health Correspondent

09 Jun 2013

Kay Sheldon, a director of the Care Quality Commission, also accused its senior managers of “deceit and evasion” in refusing to be straightforward about its failings.

The CQC was set up to expose problems in hospitals and care homes. It has far-reaching powers of inspection which allow it to order reforms or even close health services which put patients at risk. It has already been at the centre of external criticism – including in the damning report into the Mid Staffordshire Foundation Trust, where up to 1,500 patients died needlessly – but Mrs Sheldon’s intervention is significant as it comes from such a senior insider.

She sits on the CQC’s board as a non-executive director, and her role is to hold it to account. She has now spoken out, having refused to sign a wide-ranging gagging order in the wake of attempts to have her removed by the former chairman after she gave evidence about its failings to the Mid Staffs inquiry.

She warned that key reforms being planned by the CQC to improve patient safety would come as “too little too late” and renewed questions over its willingness to acknowledge its errors that she raised at the Mid Staffs inquiry.

Mrs Sheldon was appointed to the board when the CQC was set up in 2009, having worked for one of its predecessors, the Mental Health Act Commission, as a commissioner for five years. But she became increasingly concerned about the CQC’s performance, believing that it put more effort into defending its reputation than monitoring NHS failings. Last year, in correspondence seen by this newspaper, she accused those then running the watchdog of “deceit and evasion” in their efforts to defend its failures to expose problems in hospitals and care homes. The regulator has come under fire repeatedly for failing to act on warnings that patients were being harmed, carrying out too few inspections and placing gagging orders on staff who tried to express concerns.

MPs said last year that it was not fit for purpose, and Cynthia Bower, its chief executive, left after a critical government review of the organisation. In April, David Behan, the new chief executive, announced plans for a change of approach. Key to this is the reintroduction of national teams of experts, which were disbanded more than three years ago, despite warnings from Mrs Sheldon and senior members at the regulator.

Mrs Sheldon told The Telegraph that she feared the changes, which will not begin to take effect until October, after staff are recruited, would come too late. She warned that patients were not protected because it had taken so long for the regulator to heed warnings more than three years ago. Although she welcomed the return of the “elite” inspection teams, she said it would take some time before the right staff were recruited, leaving the public unprotected.

“I am worried that right now the system could be unsafe. The bottom line is that getting this wrong costs lives and this is what those leading CQC need to focus on, not about whether their actions embarrass the minister or damage the reputation of an organisation.”

She added: “I am worried that the regulator has been giving false assurances that hospitals are safe, when they are not, and that could mean patients are at risk, it could mean that they are harmed and it could mean that some die, when their deaths could have been prevented.”

In 2011, Mrs Sheldon, a former trustee of Mind, the mental health charity, gave evidence to a public inquiry into the scandal of appalling care at Mid Staffordshire Foundation Trust, expressing “grave concerns” about the operation of the CQC and its ability to detect risk to patients.

 

Gagging order

She has now disclosed that on the same day, the watchdog’s chairman wrote to Andrew Lansley, then health secretary, demanding that she be suspended and replaced. Mr Lansley agreed, only reversing the decision last year after she threatened legal action because witnesses in public inquiries are protected in law.

Letters seen by The Telegraph disclose that lawyers for the Department of Health then attempted to put a gagging order on the deal to pay her legal costs, to which she successfully objected.

She issued her warning as the CQC prepared to publish a report on its failure to prevent a series of deaths of mothers and babies in a maternity unit, despite being told of repeated concerns.

 

Morecombe Bay

 

She accused regulators of trying to hide their failure to alert the public to risks to mothers and babies at University Hospitals of Morecambe Bay Foundation Trust, which had been given a clean bill of health in April 2010 even though the CQC’s regional director, Alan Jefferson, had warned of “systematic failures” which could mean further deaths.

 There is to be an independent inquiry into the hospital’s failings, after a police investigation into up to 16 deaths – as well as the inquiry into the CQC. The inquiries only came about after a campaign by James Titcombe, of Dalton-in-Furness, whose son, Joshua, died in 2008 after midwives failed to treat him for an infection.

The team investigating the CQC failings has been told that in April 2010, 18 months after Joshua’s death, it unconditionally registered the hospital, giving it a clean bill of health. It was not until September 2011, after a CQC inspection, that the trust was finally warned that failings were so serious that it would be closed down if it did not make major changes.

By then, its hospitals had the highest mortality rates in the country: data suggested more than 600 “excess deaths” between 2008 and 2012.

In an email to the board last July, Mrs Sheldon wrote: “The CQC line is that we responded 'robustly’ and 'uncovered the issues’. This is blatantly untrue. It is this deceit and evasion that I find so concerning, as is the board’s failure to take the issues seriously and to take appropriate action.”

 

Barking, Havering and Redbridge scandal.

She also detailed concerns about how regulators failed to expose another scandal after a series of babies’ deaths and “a culture of abuse” among midwives at Barking, Havering and Redbridge University Hospitals. She is due to stay on the board until November, but said she believed the term would not be extended.”

 

Barking scored a sad 7 in the ‘never happen events’ league of shame – you can check out your own hospital Trust on this Blog at ‘never happen events’, thanks to work done by the BBC.

Neil Harris

(a don’t stop till you drop production)

helpmesortoutthenhs.blogspot.com