Thursday 28 November 2013

Trafford General Hospital - a very sad day.


I’m a long way away from Manchester, so for me this story is just a sad footnote to history. For people in Manchester this is a very real problem and has been the subject of a fierce campaign to save a much loved hospital.

This is from the BBC News site, but much edited by me;

 

The A&E department of the hospital where the first NHS patient was treated has closed despite a campaign by residents to save it.

Trafford General Hospital, which had the second smallest A&E in England, is being downgraded as it was used by too few patients.

The Department of Health has given nearby Wythenshawe Hospital £12m to help it cope with extra demand.

Campaigners said patients will face longer journeys to other hospitals.

The hospital's A&E has been downgraded to an urgent care centre, which will now close between midnight and 08:00.

It will later be further downgraded again to a minor injuries unit.

Protesters, who set up the Save Trafford General group, said other local hospitals were already stretched to capacity.

Then named Park Hospital, it was the first NHS hospital opened by the Minister for Health, Nye Bevan in 1948.

Of course, it won’t end there. The A and E may have been tiny but losing it downgrades the whole hospital, which now becomes just a base for specialist units which can easily be moved away too. The loss of patients coming in through the A and E portal deprives it of patients and revenue which threatens the viability of other departments. The A and E is the heart and soul of a hospital.

In future other local hospitals will lose their A and E’s too and further closures and consolidations will result.

All adding up to larger and larger hospitals further away from their patients communities. Instead of efficiency, costs will rise.

If you don’t believe me check out my ‘Merger Mania’ series on ‘Pages’, which reviews an excellent academic review of the effects of previous ‘Merger Mania’s’.

Neil Harris

(a don’t stop till you drop production)
Home: helpmesortoutthenhs.blogspot.com

Friday 22 November 2013

Apologies.


I’m meant to be reviewing the government/NHS response to The Francis Report. I’ve downloaded it and I already did a quick blog – based on press reports only.

The detailed review is still to come, unfortunately, I can’t do it justice.

A month ago I had a Thrombosis, went to Accident and Emergency and was treated reasonably well. Then in the follow up it all went wrong. Doctors didn’t bother, no one listened.

In reading the detailed proposals to prevent failings – system failings as well as individual ones, it was just too personal for me to be able to be impartial or even sensible about it. As I read through all the things that are supposed to be changed, so many have just happened to me that I couldn't write about it.

I need some time to get over my recent problems (daily injections for the next 6 months make it a little difficult to forget) before I can do a reasonable job. I hope to come back to it.

So sorry about that. My own medical problems are turning me into a wuss.

The reports can be found at;

Why not take a look for yourself?
I'd welcome your views - post a comment or send me an e-mail at;
 
Neil Harris
(a don't stop till you drop production)
 

Wednesday 20 November 2013

First response to the health Minister's response.


The Government’s responses to the Francis report are now out; I’ve only scanned the headlines so far because it’s a mass of documents and a lot of data to download. I’ll do a proper analysis in a couple of days.

So far pressure is being put on the Royal College of Nursing to split its union function away from its regulatory one – which I have called for a long time. No mention of doing the same for the BMA – it’s just as important that Doctors are both regulated and represented properly and one organisation can’t both punish and protect at the same time.

Every patient will have a named nurse – which sounds fine as it makes one person responsible. However there are three shifts a day, sickness and holidays as well as courses to attend etc. it means if the named nurse isn’t there nothing will happen. Better to have a named Doctor to supervise overall treatment and be responsible but of course that is never going to happen.

The problem is that patients often rarely see a nurse – most work is done by unqualified care assistants. There should be a regulatory body for them with the ability to ‘strike off’ a care assistant. That’s not happening.

The new criminal offence I dealt with a few days ago if you scroll back – a pointless gimmick.

The ‘duty of candour’, will require that patients or families are told when there has been a medical error – at the moment they get hushed up. It’s alright as far as it goes but doesn’t go far enough.

It may be that I just reviewed the report without meaning to, hopefully there is some more in it besides.

I think my fear is that the Health Secretary, who still practises on a part time basis, is still too concerned about the sensitivities of the health professionals.

Neil Harris

(a don’t stop till you drop production)

Tuesday 19 November 2013

Breaking my own rules.


Rules are meant to be broken, time to break my own rules.

I’d been taken to St. Peter’s Hospital, Chertsey last year with a broken ankle but was diagnosed with a sprain and sent home with it all plastered up, to come back a week later.

In fact it was dislocated and broken – no hairline fracture either. I was horrified by this treatment and started a Blog campaign to be a focus for whistle blowers and a demand to change things. It’s nearly a year ago – I’ll do a review of what happened for the anniversary.

I started this Blog because
helpmesortoutstpeters.blogspot.com

which I’d intended to be a purely local health campaign was becoming dominated by me watching music, doing silly things and generally having fun. (Hey I’m really ill, why not live a little?)

The serious health articles I was also writing were getting squeezed out and so I decided they needed a home of their own, right here. No pictures, no silliness; just sensible reports and commentary on health issues.

Yet what I thought was an isolated event at one hospital now seems to be a general problem and so today I'm breaking my own rules.

At the end of October I had a Thrombosis – it’s a side effect of my medication and of my cancer. It wasn’t a surprise and I got myself off to my Accident and Emergency in good time, steering well clear of St. Peter’s.

I spent a long, hard day there, got a scan, an injection and a short briefing into the world of Anti coagulation. After a week of injections and doing well, I was moved onto warfarin tablets and to a routine nurse led clinic.

In fact, before I got there, the warfarin dose was far too high and it wasn’t monitored properly. The result was a sky high INR which didn’t come back down for a very long time. The long suffering nurses and phlebotomists were seeing me every couple of days, my arms looked like a junkies arms and I got really ill. It's also dangerous.

Near the end, waiting for a Doctor (first one for two and a half weeks), I lost it after a wait of five and a half hours in some pain. I told her what I thought of them all.

I refused a further blood test and left. Two days later more arguments. Now I’m being treated by my oncologist.

They made me really ill, made me worse than I needed to be and left me giving myself injections every day for 6 months – a reduced quality of life at the end of my life.

I’m too ill/tired/ground down to fight them over it.

What could I prove anyway? No one Doctor was dealing with me, it’s just that no one bothered. I’m sure the way I was dealt with fitted in with some plan or ‘pathway’, it’s just they got it wrong and then no one was interested enough to do anything about it until it was too late.

Meanwhile, a Sister was running everything at the clinic, slowly sinking under the weight of numbers, her life being made worse by me.

Unfortunately, I wasn’t alone. I started picking up stories of unhappy, neglected patients all around me; angry and disappointed by the treatment they’d had, yet too frightened or timid to do anything.

I’ve had a lifelong commitment to the NHS; been doing the marches and pickets, the petitions and the protests. It’s not the NHS as it was meant to be; it’s an organisation of high salaries for a minority, big profits for private companies (and some Doctors making money) and a general lack of care amongst all Doctors. The rest are struggling on low pay and being treated badly. Not a good way to run a caring environment.

No one could say that the NHS of the 1950’s was great – the staff were generally the pre-war generation of very conservative, old fashioned and money grabbing Doctors and surgeons.

The ideals grew over time and they were at their peak, ironically, in the conservative 1980’s when the new post war generation of young Doctors had risen to levels of influence.

It’s been downhill ever since and is now so low in terms of commitment, morale and idealism that I despair. I am now frightened of being in hospital, just when I need them.

I’m really glad I did these Blogs, that I fought back. I only wish I’d done it sooner and had had enough time and strength to have done a better job of it.

Sadly, I won’t see how things work out although my fears of the future are such that I don’t know that I really want to be around to see it. I do know that the future will bring more privatisation, poorer working conditions for staff who are going to be paid less and treated even worse while a few fat cats are going to cream off as much money as they can get away with.

And how do you deal with frightened patients, too ill or worried to make a fuss?

Neil Harris

(a don’t stop till you drop production)
home: helpmesortoutthenhs.blogspot.com

Sunday 17 November 2013

Criminalising caring people.


You can hardly fail to have noticed from my recent Blogs that I’ve been having problems with Doctors over the last few weeks. Perhaps you think I will be welcoming David Cameron’s proposal to create a criminal offence of ‘Wilful Neglect’ by Doctors, Nurses and NHS managers, building on criminal offences designed to protect children or the vulnerable?

Not a bit of it, it’s all nonsense. Whatever issues I may have with the Doctors, they are overworked and floundering. Criminalising what they do is wrong and pointless.

As I’ve said before there are already offences – manslaughter/murder where there is a death or assault and neglect. They could be strengthened but they are already there and are little used.

That’s because it’s almost impossible to prove – everyone works on 8 hour shifts so who did what?

Actually the problem is a culture where it’s OK for a whole host of people not to bother, not where one person is to blame. If this comes in, forms will be produced for everyone to ‘tick off’ actions ‘completed’ to protect themselves. It won’t mean those things have actually been done. Then it’s a question of who forgot to ‘tick’.

What we need are for there to be professional registers for everyone; carers, managers, nurses, Doctors, physiotherapists, midwives, the whole lot.

The registers need to be independent of the professionals they police and they need to be rigorous in striking off those who fail to do their jobs properly.

That and a system of ‘mystery shoppers’ (do I need to explain that again?) is what it needs.

Neil Harris

(a don’t stop till you drop production)
Home: helpmesortoutthenhs.blogspot.com

Saturday 16 November 2013

Speedwalking through the sleaze.


Sometimes it’s good to look into the future, sometimes it’s just as useful to look back into the past.

I’ve found the website www.spinwatch.org  really useful in researching articles. Its feisty reporters and excellent database provide an insight into the sleazy world of political lobbyists for hire.

I came across it when I was using a different site www.powerbase.info which does the same valuable job in exposing the sordid activities of the world of public relations (“match me, Sidney” – you’d have to be of a certain age or have an addiction to black and white films to get that one).

Anyway, back to Spinwatch. There is a really interesting video made by Tamasin Cave and posted on something called ‘Vimeo’ the link is;


Tamasin Cave goes for a speedwalk through the streets around Westminster, the home of Government and health provision. It was made in 2011, so the Health Minister, Andrew Lansley has bitten the dust but the subject matter hasn’t. It’s a tour of all the lobbying firms, the PR companies and the private healthcare providers who were queuing up in 2011 to get their hands on NHS money.

She also goes through the political contacts and her colleague delights in setting out the ministerial contacts (old and new) that make it possible for private investors to milk our NHS.

A couple of months ago, the biggest ever contract was put out for tender in a way that meant no NHS organisation could compete. £800 million of our money. After you’ve watched this excellent video you’ll understand why and will be able to follow what makes the money flow.

Neil Harris

(a don’t stop till you drop production)
Home: helpmesortoutthenhs.blogspot.com

Friday 15 November 2013

From here to Maternity.


I have posted numerous articles about the sexist attitude of NHS management to maternity services.

I have never understood why, after Accident and Emergency departments, that management, the NHS and government are so keen on closing maternity units.

The argument is always that bigger means more specialised and therefore more specialised staff available at all hours for emergencies. In fact there is no reason why there shouldn’t be specialist centres for dangerous births – but what pregnant people want is a maternity unit close to home, as a part of the community. And part of the community should be the midwife. Who knows, people might even want to have their baby at home, supported by a local midwife – when it’s safe.

This Guardian Society article shows how dangerous the cuts are getting, and doesn’t even deal with the closures.

By the way, this week it was revealed that the insurance premium the NHS pays for each birth is £700, such is the level of costly negligence.

Perhaps that’s why managers are so keen to close maternity units, rather than to improve them.

Oh and we should find a new job title – midwife is sexist and demeaning in this age. A new title would mean greater equality, respect and status – which would help with recruitment of both men and women for a start.

Half of NHS regions cut maternity funding despite baby boom

Five of 10 English regions see reductions of up to 15% in 2012-2013 compared with previous year

Denis Campbell, health correspondent

The Guardian, Wednesday 13 November 2013

 

The NHS has cut its funding for maternity care in half of England's health regions, despite births being at their highest in 40 years and childbirth services being understaffed.

The amount of money going to maternity units in five of the NHS's 10 English regions of the country fell by up to 15% in 2012-13 compared with the previous year. The East Midlands saw the biggest drop. NHS primary care trusts in the region spent £210m on maternity services in 2011-12 but that fell by 15% to £177m last year, according to official figures obtained by Andrew George, the Liberal Democrat MP for St Ives, in a parliamentary question.

London also saw a drop of 6% over the same period, from £526m to £494m, despite having one of the fastest rising birthrates in England. Spending also fell, though by smaller amounts, in the NHS's north-east, south-west and Yorkshire and the Humber regions.

The Department of Health disclosed to George, a member of the Commons health select committee, in a separate answer that only one NHS region has enough midwives to deliver the recommended staffing levels for mothers.

Health organisations recommend that each midwife should handle no more than 28 births a year in order to help ensure safe high-quality care for women. However, in 2012 only the north-east reached that level, with a rate of 28.1 births per full-time equivalent midwife.

Maternity units in the NHS South Central region are furthest away from meeting that target, with each midwife handling 40 births last year. But the south-east (36.2 births each) and east of England (35.8) were also nowhere near the figure.

In addition, although spending on maternity care across England rose from £2.53bn to £2.62bn between 2010-11 and 2011-12, it slipped last year to £2.58bn.

That represented 2.5% of total NHS spending, down on 2.6% in 2011-12.

Cathy Warwick, chief executive of the Royal College of Midwives, who published George's findings, said they were "worrying", given that the baby boom and increasing complexity of women giving birth was putting serious pressure on maternity units and midwives.

 

"There is not one midwife practising today who has seen this level of births and demands on maternity services. Midwives are far too often telling me of the unprecedented demands on their time and their struggle to deliver the safe, high-quality care they aspire to", Warwick added.

 

Health minister Dr Dan Poulter, who also still works part-time as an obstetrician at an NHS hospital in London, admitted that there was an "historical shortage on the ground in midwives" and that the best way to improve care was to "get more bodies on the ground".

The National Childbirth Trust, the baby and parenting charity, accused ministers of breaking pledges to improve maternity care. "It makes no sense that, while birth rates are rising, maternity services are being cut back", said Belinda Phipps, its chief executive.

"It is shocking to find that just one English region is meeting recommended staffing levels for maternity care and particularly disappointing after the pledges made by the government to increase midwife numbers", she added.

Andy Burnham, the shadow health secretary, said new mothers were paying the price of the coalition's £3bn controversial shakeup of the NHS earlier this year.

"Maternity units are already operating without enough staff and they fear what these budget cuts will mean. David Cameron promised thousands more midwives, but he's failing to deliver them."

 

Poulter said that hospitals had to ensure that they had enough staff to ensure mothers got good care. Midwife numbers had risen by 1,300 since the 2010 election, and those in training by 5,000, he said.

Neil Harris

(a don’t stop till you drop production)
Home: helpmesortoutthenhs.blogspot.com

Thursday 14 November 2013

First study on the non-emergency 111 scheme.


Hangin’ on…

V 111

I protested, then I grumbled – it didn’t do any good. The excellent NHS Direct was closed down at great expense by NHS England to save money and reduce the numbers attending Accident and Emergency.

Now Sir Bruce Keogh has recommended that the 111 non-emergency line be upgraded with adequate numbers of clinical staff – in effect going back to a poorer version of of NHS Direct.

Now we know why;

The next day out comes a properly researched report from, of all places The Department of Health who evaluated the 4 pilot areas results.

Of course, you and I would have carried out a pilot, evaluated it and then decided whether to roll it out nationwide.

The findings were that emergency ambulance call outs did not fall (why would they?) in fact they rose by 3 %.

The numbers attending A and E rose.

Nice one.

Neil Harris

(a don’t stop till you drop production)
Home: helpmesortoutthenhs.blogspot.com

Wednesday 13 November 2013

Sir Bruce Keogh - could do better.


Some of you will realise that compared to the truly dreadful Sir David Nicholson (Chief executive NHS England) so often described as ‘The Man with no Shame’ I hold Sir Bruce Keogh in some regard. He’s the NHS England Medical Director and has different priorities.

He’s just issued a report on Accident and Emergency treatment and it’s quite good. ‘Quite’ because I have some issues, good because it is at least intended to improve things.

1) Reduce the number of A and E’s dealing with Strokes, Heart Attacks and Trauma.

Great idea – in London the number of Stroke units were reduced from over 20 to 8 with the result that the death rate fell dramatically and outcomes improved.

For these three areas specialising works really well, getting early, good treatment is vital.

Before stroke victims waited all weekend for someone to turn up – by then it was too late. Heart Attacks are not the killers they were because of specialisation. Complex trauma needs highly skilled surgeons.

2) A revamped and improved 111 service – with more clinicians and Nurses available on the phone to reduce the number of A and E admissions. Great idea – that’s what we were arguing for when NHS England closed down NHS direct which did that.

Sir David Nicholson – well done again. You just finished off NHS Direct and still have time to watch the failing 111 service being turned back into a pale shadow of NHS Direct at enormous public expense to try and put right another mistake of yours.

3) Improved paramedics, dealing with more cases at home rather than taking them to A and E – who could object to that.

Problems;

1) Where I have a real problem was watching Sir Bruce on a ‘Newsnight’ interview last night. He repeated the nonsense that 40% attending A and E do not need to do so.

It’s nonsense because no one knows that until after the event. The 40% includes all who attend with suspected broken bones for an X-Ray, the abdominal pains, the suspected thrombosis etc. All require tests no Doctor does or paramedic can do. Failing to send those people in for the tests is just negligent; no Doctor would take the risk. So the 40 % includes those who needed a test but luckily they then didn’t need treatment.

2) Keogh expects to downgrade 70 out of 170 A and E’s.

The problem with that is that we have a pretend market not planning. It won’t be the best A and E’s that survive it will be the pushiest, grabbiest Foundation trusts. The others will lose the revenue from admitted patients and decline further.

Losing Cardiology, Stroke and Trauma will remove a massive proportion of any hospitals revenue and that means more closures.

No planning means no concern for local communities and no real search for expertise.

PFI contracts are so binding (an act of parliament could easily unbind them) that being lumbered with a catastrophic PFI is likely to safeguard a poor and inefficient hospital rather than ensure that quality survives.

So Sir Bruce, this paper doesn’t get full marks from me, which is a shame. You were doing quite well up till now. Don’t forget that while you may be thinking about best practise, the managers are only thinking about money.

Neil Harris

(a don’t stop till you drop production)
If you also look at helpmesortoutstpeters.blogspot.com I warn you that tomorrow this article will be repeated - I'm not so well at the moment and the Doctors seem to be out for revenge! Normal service will soon be resumed.
Home: helpmesortoutthenhs.blogspot.com

Tuesday 12 November 2013

NHS nursing shortages.


On Tuesday 12 November 2013, The Royal College of Nursing issued a valuable report on nursing vacancies. Using Freedom of Information legislation the union found that average vacancy rates at hospitals are around six per cent.

Extrapolating the figures from the 61 NHS trusts that replied, the College said this would amount to nearly 20,000 full-time equivalent nursing, midwifery or health visitor vacancies over the whole country.

Dr Peter Carter, chief executive and general secretary of the RCN, said: “Understaffing remains a real issue across the NHS, and we know that many trusts are down to the bone in terms of the number of frontline nursing staff they have due to cutting posts to save money.

“Unsafe staffing levels have been implicated in a number of high-profile investigations into patient safety. We call on employers in the NHS to put an end to boom-and-bust workforce planning and develop clear standards to ensure safe staffing levels are met, supported by robust inspection based on reliable data.”

 

All the reports into NHS scandals – The Francis Enquiry, the investigation onto the 14 failing trusts, have all highlighted that inadequate staffing levels result in poor care and worse outcomes. They also stress out staff.

The Francis report argued for minimum levels of staffing – something the government has refused to consider.

As the waiting times in Accident and Emergency grow, the reason is not a ‘shortage of beds’ as is often said – this is not true. There are plenty of empty beds and empty wards. Every so often they shut a hospital because there are so many closed wards. The shortage of beds is because there is a shortage of nurses – staff who leave aren’t replaced.

Worse than that, the RCN pointed out that “the Department of Health stopped collecting vacancy data in 2011, when vacancy rates for nurses stood at 2.5 per cent”.

Neil Harris

(a don’t stop till you drop production)

Friday 8 November 2013

Janice Harry gets away with it.


There you are, you are a nurse and you rise to become Director of Nursing and Quality Assurance, then you get made Director of Clinical Standards as well as becoming Chief Nurse and Infection Prevention and Control Director.

These aren’t everyday nothing jobs: in a hospital they matter. They are well rewarded with a salary and benefits that matches the responsibility.

In fact the nurse was Janice Harry and she did those jobs for Mid-Staffordshire NHS Foundation Trust and its predecessor between 1998 and 2006. She was a bully to her fellow staff and presided over a culture of neglect and cruelty towards her patients.

This week she was convicted by the Nursing and Midwifery Council of misconduct – she failed to ensure there were enough staff on wards, put patients lives at risk, failed to ensure patients were fed or given water.

People died – between 600 and 1200 of them according to statistical analysis and government reports and while she was not responsible for all of those deaths, she was certainly responsible for a number of them.

The penalty? - ‘A caution’ for five years.

That means she can continue to practice as a nurse, be an NHS manager or do similar work in the private sector or care industry.

It is unbelievable that she will enjoy comparable earnings, have a big fat NHS pension and be able to go on as if she had done nothing wrong.

My heart goes out to the bereaved relatives and Janice Harry’s unfortunate work colleagues as once again someone like her walks away unpunished.

Neil Harris

(a don’t stop till you drop production)
Home: helpmesortoutthenhs.blogspot.com

Wednesday 6 November 2013

Another guilty verdict from Mid Staffordshire Hospital Trust.


This is another case from Mid Staffordshire Hospital, taken from The Independent newspaper today based on a Press Asssociation report.

At least this is a ‘manager’ in the firing line – but no sentence yet.

Also where were the Doctors when this was happening?

 

 

Stafford Hospital former chief nurse Janice Harry found guilty of misconduct

 

Ella Pickover  

Wednesday 06 November 2013

 A former chief nurse at scandal-hit Stafford Hospital has been found guilty of misconduct.

Janice Harry's fitness to practise is "currently impaired", a Nursing and Midwifery Council (NMC) panel ruled.

 

Yesterday the disciplinary panel concluded that Mrs Harry had exposed patients to danger during her time at the hospital.

 

By not ensuring that there were adequate nursing staff on a number of wards, Mrs Harry put patients at risk, the panel ruled.

 

Between 1998 and 2006, Mrs Harry failed to ensure there were adequate numbers of nurses working in the accident and emergency department, the emergency admission unit (EAU) and another ward, they said.

 

Mrs Harry was criticised for not ensuring that her colleagues provided patient dignity and privacy in the EAU between 2004 and 2006.

 

The nurse also failed to ensure there was appropriate food and drink in the unit, the panel concluded.

 

She will also be reprimanded for using inappropriate language towards a colleague after telling her that she was a "waste of space".

 

Mrs Harry was employed by Mid Staffordshire NHS Foundation Trust and its predecessor Mid Staffordshire General Hospitals NHS Trust from 1998 to 2006. From 1998, she was director of nursing and quality assurance at Stafford Hospital and in 2002 was appointed director of clinical standards and chief nurse as well as director of infection prevention and control.

 

The panel will now decide what sanctions to impose on the nurse.

 

Stafford Hospital was at the centre of a major public inquiry after it was found that poor care could have led to the deaths of hundreds of patients as a result of maltreatment and neglect.

 

The inquiry highlighted the "appalling and unnecessary suffering of hundreds of people" at the trust and investigations into the scandal revealed that many patients were left lying in their own urine and excrement for days, forced to drink water from vases or given the wrong medication.

I don't think we should quickly forget Janice Harry’s contribution to human well being.

Neil Harris

(a don’t stop till you drop production)

Tuesday 5 November 2013

The Colchester General Scandal.


This article from BBC News is, as their medical correspondant says “Truly shocking”.

Colchester General Hospital escaped ‘Special measures’ in the Keogh review even though it had worrying death rates.

Union activists have been trying to get some things changed without success but a whistleblower exposed the Trust to the Care Quality Commission – they were altering cancer patients waiting times because there are national targets that patients are seen within time limits or the trust gets into trouble.

What does management do? It fixes the figures.

I’ve (up till now) opposed the police being called in – not this time.

We’ve had ‘coding’ scandals, we have the scandal of Accident and Emergency finding tricks to avoid triggering the 4 hour time limit by keeping patients out side as long as possible or dumping patients in ward corridors.

It’s all about fixing the figures not fixing the medical problems.

This cost lives;

Nick Triggle

BBC Health correspondent

Colchester General Hospital was tampering with records, inspectors say

News that a hospital has been tampering with patient records to improve its waiting times for cancer treatment, potentially putting patients at risk, is truly shocking.

The issue is so serious that the police have been asked to investigate Colchester General Hospital.

Such a situation is unprecedented in the NHS - and as a result the temptation is to dismiss it as a one-off that should be seen in isolation.

Unfortunately, it would be complacent to do so.

What this case demonstrates is the problem inspectors have in identifying some issues in organisations as complex as hospitals.

The Care Quality Commission did not find the dodgy records. It was told where to look.

During the spring Colchester was subject to an inspection as part of the Keogh Review into mortality rates.

The review - launched after the Stafford Hospital public inquiry - investigated the 14 trusts with the highest death rates.

Problems were identified, including with the ways complaints were handled, staffing rates and leadership weaknesses, but not this.

The concerns that were identified were not even considered important enough for Colchester to be placed in special measures.

When the results of the review were announced Colchester was one of only three trusts that escaped the sanction.

But towards the end of the Keogh process a whistleblower raised concerns about the tampering of records.

This was passed on to the CQC which carried out its own inspections in August and September.

These led to Tuesday's report that showed different information was being entered into the hospital's system than was on the patients' notes so their cancer performance data looked better than it was.

The trust has now been placed in special measures and the management of the trust is being reviewed.

But to make matters worse, the trust had also carried out its own probe in early 2012 after concerns were raised by admin staff in the cancer department.

It did not identify serious problems, but the trust now accepts the issue was "not properly investigated".

The fact that concerns had been aired but not properly looked into has chilling echoes of the Stafford Hospital scandal.

Christina McAnea, head of health at Unison, whose members raised the alarm, says: "They raised their concerns repeatedly and in emails to senior managers, right up to the chief executive, but they were ignored."

Last week a review of complaints by the Labour MP Ann Clywd said the culture of "delay and denial" had to end.

The Colchester case shows just how far the NHS has to go.

Neil Harris

(a don’t stop till you drop production)