Hospital Discharge - a silent scandal.

This is a BBC report dealing with a survey into the discharge of patients from NHS hospitals. It follows perhaps 15 years where hospitals have been pressured (a pressure they have largely been delighted with) to discharge patients as soon as possible.

 

The result is that decade on decade, hospital admission periods have been falling, with a corresponding saving of money and a theoretical increase in the number of beds available.

 

Except that over the same period, the number of beds has been falling which means that the savings have just been used to reduce costs and not to increase operations.

 

The problem? Readmissions following discharge have been growing too - it's making people ill sending them home too early.

 

The answer? A low dependency ward with reduced staffing for another days convalescence.

 

Because sending elderly people home too soon increases the number of Accident and Emergency admissions when it all goes wrong.

 

Here's today's BBC report (21/7/15); 

 

The way hospitals discharge patients is probably contributing to high levels of readmission, a year-long Healthwatch England inquiry has found.

 

It said many hospitals failed to notify relatives or check patients had any accommodation before discharging them.

The watchdog looked at data from Freedom of Information requests, patient surveys and more than 3,000 patient reports to its local teams.

Anna Bradley, who chairs Healthwatch England, called some of it "shocking".
"There is a huge human and financial cost of getting discharge wrong," she added.

One report said an 81-year-old stroke survivor had been sent home in a taxi while his wife was told he was being transferred to a rehabilitation centre.

Another involved a young man with severe mental health problems who had been discharged with no consultation with his psychiatrist and no treatment.

Of the 120 hospital trusts that responded to Freedom of Information requests:

• half were failing to record whether the patient's home environment was suitable
• a third were failing to record whether the patient's GP or carer had been notified of new medicines

In 2014, the National Audit Office reported the NHS saw a million readmissions within 30 days of discharge, costing an estimated £2.4bn a year.

A spokesman for NHS England said hospitals should be making sure patients are appropriately discharged.

"We need to ensure appropriate care is put in place before a patient leaves hospital which needs strong joint working across the health service."

Neil Harris
(a don't stop till you drop production)

Sorry about the gap since I last Blogged - I was checking hospital facilities at first hand - I broke my back.

If you want to know what is going on you can check out my other Blog on;

helpmesortoutstpeters.blogspot.com

Home:  helpmesortoutthenhs.blogspot.com
Contact me: neilwithpromisestokeep@gmail.com 

The best health provider in the world - the NHS.

I’ve been very critical of the NHS where it fails us, but on this Blog and on;

helpmesortoutstpeters.blogspot.com

I’ve always made it clear that the NHS is the best and fairest health provider in the world. It’s nice to have some independent confirmation in this Daily Telegraph article which is actually based on a Guardian Article;

Keith Perry 17 Jun 2014

The National Health Service has been praised as the world's best health-care system by an international panel of experts who said it was superior to those found in countries which spend far more on health.

 

 

The study, entitled “Mirror, Mirror on the Wall,” also described US healthcare provision as the worst globally. Despite investing the most money in health, the US refuses care to many patients without health insurance and is also the worst at saving the lives of people who fall ill, it found.

 

 

The Commonwealth Fund, a Washington-based foundation produced the report. The fund is respected around the world for its analysis of the performance of different countries' health systems. It examined 11 countries, including detailed data from patients, doctors and the World Health Organisation, the Guardian reported.

 

 

"The United Kingdom ranks first overall, scoring highest on quality, access and efficiency," the fund's researchers conclude in their 30-page report. Their findings amount to a huge endorsement of the health service, especially as it spends the second-lowest amount on healthcare among the 11 – just £2,008 per head, less than half the £5,017 in the US. Only New Zealand, with £1,876, spent less.

 

 

In the Commonwealth Fund study, the UK came first out of the 11 countries in eight of the 11 measures of care the authors looked at. It came top on measures including providing effective care, safe care, co-ordinated care and patient-centred care. The fund also rated the NHS as the best for giving access to care and for efficient use of resources.

 

The only serious criticism of the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th. The authors say that the healthcare system cannot be solely blamed for this issue, which is strongly influenced by social and economic factors. Although the NHS came third overall for the timeliness of care, its "short waiting times" were praised. "There is a frequent misperception that trade-offs between universal coverage and timely access to specialised services are inevitable. However, the Netherlands, UK and Germany provide universal coverage with low out-of-pocket costs while maintaining quick access to speciality services,", the report added.

 

The NHS also outperforms the other countries – which include France, Germany and Canada – in managing the care of people who are chronically ill, the report said.

 

Dr Mark Porter, leader of the doctors' union, the British Medical Association, told the Guardian the fund's findings were "clear evidence that our much-maligned NHS is one of the top-performing healthcare systems in the world.

 

"We should not be complacent as we are facing pressures that are threatening the high-quality care that the Commonwealth Fund has rightly praised. A combination of rising patient demand, staff shortages and falling funding is undermining the very foundations of the NHS, as is the constant short-term interference from politicians of all colours."

 

Dr Peter Carter, chief executive of the Royal College of Nursing, said: "I'm absolutely thrilled to see this because it reinforces that this is a very good NHS, despite the fact that it has such a low level of funding relative to other countries."

 

Jeremy Hunt, the Health Secretary, who has been criticised by some senior doctors for painting an unfairly negative picture of NHS staff and the quality of care provided, welcomed the report. "NHS staff work incredibly hard to care for patients and these encouraging results pay testament to that," he said.

 

Neil Harris

(a don’t stop till you drop production)

Home:  helpmesortoutthenhs.blogspot.com
Contact me:   neilwithpromisestokeep@gmail.com

What we really think about the NHS.

NSee?

It’s easy………when you know what you are doing!

You would think that everyone agreed with the Government and the managers of the NHS.

Static budgets at a time of high inflation means real cuts to the NHS.

At the same time the cost of care for the elderly and the cost of new drugs soars.

That means real cuts in services.

That’s what we all want, isn’t it?

Eh no, here’s a Guardian report on an IPSOS/MORI opinion poll in May 2014 which shows what we all feel about the NHS and it’s future;

 

 

Denis Campbell, health correspondent

 

   

The Guardian, Thursday 8 May 2014 20.43 BST     

 

 

Four out of five people in Britain believe the NHS should be protected from government spending cuts, according to a survey which reaffirmed the high level of affection in which the service is held.

 

Asked which two or three areas of public spending should be exempt from more austerity, respondents identified the NHS and healthcare (79%), schools (51%), care for the elderly (51%), the police (39%) and social services (21%).

 

Some 49% agreed that the NHS should be given more money "so that it can continue to provide services in the same way it does at the moment", while only 7% backed further rationing of care, in research undertaken by Ipsos MORI. Asked to name the biggest problem facing the NHS, 38% said lack of resources, 27% identified understaffing and 24% mentioned long waiting times.

 

Despite a series of care scandals such as Mid Staffs, Morecambe Bay and Winterbourne View, the NHS remains the thing that makes most people proud to be British. In all 52% identified the NHS as that institution, more than the armed forces (47%), royal family (33%), Team GB (26%) and the BBC (22%). That 52% is 7% up on 2012, when Ipsos MORI last asked that question.

 

But concern about the NHS's future is rising. One in four (24%) said it was one of the most important issues facing the country, a higher figure than in 2012.

 

Some 67% rated the quality of their healthcare as good, with another 17% describing it as very good. But 73% believe that the problems uncovered at Stafford Hospital, scene of the service's biggest scandal in years, exist in some, most or all other hospitals.

 

Britons are also among the most negative internationally about how sustainable their health services are, given the NHS is facing rising demand and further years of tight budgets. In the survey of public opinion in 20 countries only 9% said they expected the quality of healthcare on offer to improve, while in the UK 43% said "get worse".

So now we know how everybody feels about the NHS, we need to make our voice heard.

 

Neil Harris

(a don’t stop till you drop production) 

Home:  helpmesortoutthenhs.blogspot.com

Contact: neilwithpromisestokeep@gmail.com

The real truth about those 'timewasting' patients attending Accident and Emergency.

This is from the Guardian today, 22/5/14 and it’s based on a survey by The College of Emergency Medicine. As you probably know, I’m a big fan of their work.

I’m a big fan of this, because it confirms articles I’ve written before which have used evidence to show that people at Accident and Emergency departments are not ‘time wasters’, attending with minor ailments.

I’d go further; the small number of attendances that could have been dealt with at a G.P.’s surgery – how were the patients to know before they learnt what the problem was at A and E?

The arguments that patients were time wasters came from administrators and politicians who were trying to deflect blame away from themselves for underproviding A and E capacity.

And some lazy bad Doctors.

Have you tried attending an A and E recently?

College of Emergency medicine says only one in seven cases at emergency departments are non-urgent

 

 

  theguardian.com, Thursday 22 May 2014 06.57 BST    

 

One in seven people who attend A&E could be dealt with by a GP but the rest are justified in going to an NHS emergency department, new research suggests.

 

 

The College of Emergency Medicine found that 15% of people who attended A&E departments could be treated in the community rather than as an emergency case in hospital.

 

 

"[But] the fact that only 15% of attendees at emergency departments could be safely redirected to a primary care clinician without the need for emergency department assessment is a statistic that must be heeded by those who wish to reconfigure services," said Dr Clifford Mann, president of the college.

 

The figure equated to 2.1 million patients who come through the doors of emergency departments every year, the college spokesman said. Children with minor illnesses were among them.

 

The finding prompted the college to renew its calls for the establishment of GP centres within emergency departments.

 

The college argues that emergency health services are facing a shortage inspecialist doctors, rising numbers of people attending centres and a lack of accessible and effective alternatives to A&E.

 

"Providing a more appropriate resource for the 2.1 million patients represented by this figure would substantially decongest emergency departments," said Mann.

 

"Decongesting emergency departments is key to relieving the unprecedented levels of pressure placed upon them and improving patient care."

 

Seperately, Sky News said a freedom of information request had revealed that hundreds of thousands of patients were being sent home from hospital in the middle of the night, despite a promise to cut down on the practice.

 

 

More than 300,000 people had been discharged from hospitals between 11pm and 6am since 2012, an average of 400 a night. Many of them were elderly, giving rise to concerns that vulnerable people may be unsafe or struggle to get home at unsociable hours.

 

 

The figures, uncovered through Freedom of Information requests by Sky News, revealed that in almost half of cases the proportion of patients discharged overnight also increased.

 

 

The NHS has in the past been accused of persisting in the widespread practice to help free up beds for other patients.

 

 

In 2012 Sir Bruce Keogh, NHS England's medical director, called on hospitals to reduce the number of patients being discharged overnight. "It is simply not fair to be sending people home late at night. We will look at this."

 

Dr Mike Smith, chairman of the Patients Association, told Sky News: "They have got people in A&E chomping at the bit, lying in corridors, they have got to be admitted and they have no beds.

"It's for the convenience of staff and the person they are admitting but at the gross detriment to the person they are chucking out."

 

A spokesman for NHS England told Sky News: "Discharging patients at night without appropriate support is unacceptable, particularly if a patient is vulnerable."

Jamie Reed MP, Labour's shadow health minister, criticised the prevalence of the issue. "Hospitals are operating above safe levels. Ministers promised to put an end to this practice two years ago but it's getting worse. It's further proof you can't trust the Tories with the NHS."

What all this shows is that all those 'clever' managers who shut wards, closed hospitals, merged and shut Accident and Emergency Departments were just creating more and more problems.

Neil Harris

(a don’t stop till you drop production)

By the way, if you are a little bored or listless – why not take a look at my other Blog;

Help Me Sort Out St Peters!

X helpmesortoutstpeters.blogspot.com

 

 

Home: helpmesortoutthenhs.blogspot.com
Contact: neilwithpromisestokeep@gmail.com

Halving avoidable harm and saving 6000 lives

This is from a Department of Health press release dated 26/3/14 reporting a speech made by the Health Minister a couple of days before. I'm indebted to Carole Murphy for sending this to me - unfortunately in my own dispute with a hospital it has come 2 years too late.

 

 

Halving avoidable harm and saving 6000 lives 

 

A new ambition to reduce avoidable harm in the NHS by half over the next three years, cut costs and save up to 6,000 lives has been outlined by Jeremy Hunt. In a speech at Virginia Mason Hospital in Seattle, the Secretary of State has announced details of how NHS organisations can work together to improve patient safety and save money.

Each NHS organisation will be invited to ‘Sign up to Safety’ and set out publicly their ambitious plans for reducing avoidable harm, such as medication errors, blood clots and bed sores over the next three years. The NHS Litigation Authority, which indemnifies trusts against law suits, has agreed to review the plans and, when approved, reduce the premiums paid by all hospitals successfully implementing them. Every year the NHS spends as much as £1.3 billion on litigation claims.

The government will also introduce a Duty of Candour, making openness and honesty the norm across all health and social care organisations. It will mean providers must notify the patient about incidents where ‘significant harm’ has occurred and provide an apology.

Health Secretary Jeremy Hunt said:

It is my clear ambition that the NHS should become the safest healthcare system anywhere in the world. I want the tragic events of Mid Staffs to become a turning point in the creation of a more open, compassionate and transparent culture within the NHS.

We now have a once in a generation opportunity to save lives and prevent avoidable harm – which will empower staff and save money that can be re-invested in patient care. Hospitals are already “signing up to safety” as part of this new movement - and I hope all NHS organisations will soon join them.

Hospitals are now being approached to pledge their support to the movement and all trusts will receive an invitation to join over the next few months.

Other plans to improve patient safety as part of the package include:

• Consulting on the threshold for duty of candour to include significant harm, as part of the Care Quality Commission’s (CQC) registration requirements (as recommended by the Dalton-Williams review)
• Recruiting 5,000 safety champions as local change agents, identifying where there is unsafe care and developing solutions to fix it
• Creating a new Safety Action for England (SAFE) team that will consist of senior clinicians, managers and patients with a proven track record in tackling unsafe care. They will ensure that fast, flexible and intensive support is available where it is needed most
• Launching a dedicated section of the NHS Choices website in June called ‘How Safe is my Hospital’. The online tool will give everyone the ability to compare hospitals in England across a range of patient safety indicators
• Developing new reliable measures of avoidable hospital death rates and severe harm

A strong reporting culture, where safety incidents are reported and monitored is essential to improving safety. The measures announced today are likely to lead to an increase in the numbers of reported harm in the NHS even though care will be getting safer. NHS England will lead a project to accurately assess whether a hospital is reporting fewer, more or an expected number of incidents.

After an avoidable patient incident where a woman was accidently injected with cleaning fluid around ten years ago, Virginia Mason hospital in Seattle has turned itself around to become one of the safest hospitals in the world.

Virginia Mason Chairman and CEO Gary S. Kaplan, MD said:

Patient safety is our number one priority. We’re honored that the Health Secretary is advancing changes in England’s health system based in part on the value he sees in our commitment and dedication to always putting patients first.

Background information

1. In a consultation on the Duty of Candour, published today, it is proposed that the Care Quality Commission (CQC) will include the Duty of Candour as part of its registration requirements. This will mean every organisation registered with the CQC will have to be open about all cases of significant harm including death, severe harm and moderate harm, including prolonged psychological harm.
2. Virginia Mason hospital in Seattle employs more than 5,600 people and includes a 336-bed acute-care hospital; a primary and specialty care group practice of more than 460 physicians

 

 

 

 

 

 

 

Cutting jobs costs lives.

Thursday, February 27, 2014

 

 

Overworked nurses linked to higher death rates

           

 

Investigations in nine European countries have given statistical backing to claims that patients’ lives may be at risk when nurses are overworked, specialists said on Wednesday.

Published in The Lancet, the study touches on a sensitive topic in countries where health budgets are under strain.
Researchers looked at survival rates after surgery in 300 hospitals, and matched these against the workload and education of their nurses.
They looked at data from the surgeries of more than 420,000 patients aged over 50 who had common operations such as hip or knee replacement, appendix removal or gall bladder surgery.
The number of patients who died in hospital within 30 days of admission was low, on average. It ranged from 1.0 to 1.5 percent depending on the country.
Within a country, though, the death rate varied widely according to the hospital. In some hospitals it could be less than one percent, in others more than seven percent.
Two big factors correlated with higher mortality – a bigger workload for nurses and a lower level of nurses’ education.

Each patient added to a nurse’s workload increased the risk of a patient dying by seven percent. Every 10 percent increase in bachelor’s degree educated nurses was associated with a seven percent fall in this risk.
“Nurse staffing cuts to save money might adversely affect patient outcomes,” said the paper. “An increased emphasis on bachelor’s education for nurses could reduce preventable hospital deaths.”
It offered this statistical scenario: in hospitals where nurses cared for six patients each, and 60 percent of them had bachelor’s degrees, the risk of patient death was nearly a third lower than in places where nurses cared for eight patients and 30 percent had a degree. The investigation was carried out in Belgium, England, Finland, Ireland, the Netherlands, Norway, Spain, Sweden and Switzerland.
The findings in Europe closely mirror a previous probe in the US, said Linda Aiken, a professor at the University of Pennsylvania’s School of Nursing, who led the research.
“Our data suggest that a safe level of hospital nursing staff might help to reduce surgical mortality, and challenge the widely-held view that nurses’ experience is more important than their education,” she said in a press release.

Neil Harris
(a don't stop till you drop production) 

Six more NHS trusts on warning.

 

This is another NHS watchlist of failing hospitals – there are, of course, other indicators to watch out for as well. The last paragraph is a sign that things may be getting better.

Denis Campbell, health correspondent

theguardian.com, Wednesday 29 January 2014

 

Six hospital trusts are under fresh scrutiny after new NHS data revealed that more patients who had been treated there died during their stay or soon after.

 

Two of the six, Colchester Hospital University NHS foundation trust and East Lancashire Hospitals NHS trust, are already in special measures following NHS medical director Professor Sir Bruce Keogh's inquiry last year into 14 trusts with apparently high death rates.

 

Another of the six, Blackpool Teaching Hospitals NHS foundation trust, was also among the 14 but was not among the 11 put into special measures.

 

The NHS's Health and Social Care Information Centre (HSCIC) on Wednesday said that those three, plus Mid Cheshire Hospitals NHS foundation trust, Aintree University Hospital NHS foundation trust in Liverpool and Wye Valley NHS trust in Herefordshire, all had unusually high death rates in 2012-13, as judged by the summary hospital-level mortality indicator (SHMI).

 

The SHMI is one of the key ways of measuring if a hospital trust is seeing an average, higher or lower than average number of deaths among patients. It is one of four mortality indicators used by the healthcare information specialists Doctor Foster Intelligence to produce its influential annual hospital guide.

 

The SHMI captures and compares the number of patients who die while being treated as an inpatient or within 30 days of their discharge from hospital.The six were found to have "higher than expected" mortality rates under the SHMI.

 

The HSCIC explained that "the SHMI is the ratio between the actual number of patients who die following treatment at the trust and the number that would be expected to die on the basis of average England figures, given the characteristics of the patients treated there".

 

The centre was asked in 2010 by the Department of Health to develop the SHMI and publish data based on it after concerns were expressed that the hospital standardised mortality ratio (HMSR) was too crude and inadequate at capturing the complexity of hospital mortality rates.

 

The HSCIC stressed that its new SHMI data should not be taken "as a standalone verdict on a hospital trust's performance".

 

Overall hospital death rates as judged by the SHMI appear to be improving slightly, the new data show. Between July 2012 and July 2013 a total of nine trusts had a "higher than expected" SHMI value, two fewer than the year before, while 17 trusts had a "lower than expected" SMHI value, up from 16 a year earlier.

Neil Harris

(a don’t stop till you drop production)

The efficiency of free market competition.

 

 

This is a Guardian article about a Competion Commission ruling on the monopoly enjoyed by the 5 or 6 biggest providers of private hospital care in the UK.

It is, of course, missing the real point.

In an age where ‘State is bad, private is good’, the plan is that all NHS services should be put out to tender, so that these kind of companies with their restrictive practises, monopolies, and financial inducements to practitioners, should be the main suppliers of medical services to us;  

 Jennifer Rankin 

The Guardian 16 January 2014

Private healthcare groups have been ordered to sell off nine hospitals after an investigation by competition authorities found patients had been overpaying for medical treatment.

 

HCA, the largest healthcare group in the US, has been told to sell two hospitals in central London – London Bridge and the Princess Grace. Its rival BMI faces selling seven hospitals spread across London, the home counties and north-west England.

 

The recommendations from the Competition Commission follow an investigation last year, which concluded that prices were kept artificially high by the dominance of the largest private groups.

 

The commission said the market power of the three largest firms, HCA, BMI and Spire, made it difficult for rivals to open competing services and artificially inflated prices for patients and their insurers.

 

"'We've looked hard at how we can meet the challenging task of opening up this market to increased competition," said Roger Witcomb, chairman of the private healthcare inquiry group at the commission.

 

"We're now proposing those measures which we believe will offer practical and effective ways of improving competition and ensuring private patients get a better deal. Requiring operators to sell hospitals is a big step and we have focused on those areas where a sale will be effective in increasing competition – where a single operator owns a cluster of hospitals which face little rivalry."

 

The commission, which publishes its final recommendations in late March, estimates that the three largest hospital groups made excess profits of £173m-£193m a year between 2009 and 2011, equivalent to 10% of their revenues.

 

The private health insurer Bupa welcomed the proposals as "a decisive step forward for customers and patients". But the healthcare providers vowed to fight the plans.

 

Stephen Collier, of BMI, accused the commission of failing to grasp how the market for private healthcare worked. He said: "It is a fact that BMI Healthcare's shareholders have taken nothing out of the business they bought in 2006, instead reinvesting every pound earned back into our hospital operating business.

"It is therefore bizarre for the Competition Commission to claim that we are making excess profits and need to sell seven hospitals, a remedy that will have no benefit for patients because there is already sufficient competition and it won't lower costs."

 

Mike Neeb, the chief executive and president of HCA International, said the commission was "threatening unjustified and unfair remedies". He said: "The Competition Commission's provisional recommendations are plainly wrong. The CC's own report acknowledges there are nearly 50 competitors in Greater London. Our ownership of these hospitals encourages competition and drives a higher standard of care among hospitals in the UK."

 

Around 11% of the UK population are covered by private healthcare, mostly through employer schemes. This is the lowest level for more than 20 years, according to the health analysts LaingBuisson, although demand for policies has bounced back since the economic crash led many companies to rein in policies.

 

The Competition Commission also wants to restrict the widespread payment of cash bonuses to doctors for referrals – a practice that encourages clinicians to send patients to particular hospitals.

"Opening up this market to greater competition is not straightforward," said Witcomb. "Neither patients nor GPs have enough information, either on price or quality, to make informed decisions, and high costs and demand stagnation mean that new competing facilities are not going to spring up easily."

Neil Harris

(a don’t stop till you drop production)

New Year, New Bart's? January 2014 Update.

Here’s the latest update on The Bart’s Health Trust. There is good in the report at last – progress made.

There have been a number of themes in this Blog and its sister over the last year;

1) That there are many indicators of problems in a hospital, one of which is the ‘Never Happen Events’, of which Barts Health had a record number.

2) There is an appalling level of bullying in the NHS and the wider medical profession; of subordinates, women and ethnic minorities which is wrong and outdated.

3) From my experience in a different profession bullying is a useful cover for the dishonest and the incompetent – fearful or intimidated staff are less likely to expose failing colleagues. Bullies are also very unlikely to learn from others.

4) I don’t have proper evidence but in the light of 3) I believe there is a correlation between bullying and low morale and failing hospitals.

Staff at Barts trust living in fear of bullying

 

Ross Lydall, Health Editor

London Evening Standard

 

Published: 14 January 2014

 

Low staff morale and a fear of bullying were today highlighted at London’s biggest NHS trust after a visit by hospital inspectors.

The Care Quality Commission said it was approached by “too many members of staff” about bullying at Barts Health. An internal survey found one in three staff were bullied.

 

Patients using the trust’s six hospitals, which include the Royal London, St Bartholomew’s and Newham, were “at risk of harm” due to equipment not always being “readily available”.

 

However the CQC lifted three warning notices placed on Whipps Cross hospital last June after an earlier inspection had found major concerns in its maternity and older people’s wards.

 

It said the trust, which serves 2.5 million people in east London, provided generally “safe” services but highlighted concerns about staffing levels. It ordered improvements in 15 areas.

 

Professor Sir Mike Richards, CQC’s chief inspector of hospitals, said: “We found that Barts Health NHS Trust was, in the main, providing services that were safe.

My team identified a number of areas of good practice and the majority of patients we met were complimentary about the way they had been treated by staff.

 

“On a more negative note, we found that staff morale was low. Too many members of staff of all levels and across all sites came to us to express their concerns about being bullied, and many only agreed to speak to us in confidence.

 

“The trust needs to take action to make sure people feel confident to speak up.”

 

The trust, formed in April 2012 by merging three hospital groups, is axeing more than 200 nursing and managerial posts and downgrading 460 further nursing posts.

 

It had been targeted because of poor outcomes for cancer patients, delays in accident and emergency, financial troubles and a high number of “never events” — clinical blunders that should never happen, such as swabs being left inside patients.

 

Inspectors were informed that, because some staff spoke limited English, communication was difficult and could place patients at risk.

 

A healthcare assistant at the Royal London was asked to contact an anaesthetist in an emergency but did not do so because they did not understand the term.

 

Barts said the report was “tough but fair”. The trust said in a statement: “It recognises our challenges, where we have made progress, some of our areas of good practice, and confirms the care, commitment and compassion of our staff.

 

“We are reaffirming very strongly that bullying has no place at Barts Health, and staff are strongly encouraged to raise any concerns they have about their workplace or the care provided to our patients.”

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutthenhs.blogspot.com

Contact: neilwithpromisestokeep@gmail.com