D.N.R. orders yet again.

This is a continuing problem in The NHS; the use of "Do Not resuscitate" orders on peoples files when this has not been discussed with either patients or their families/carers.

This is just the worst situation....a doctor making a judgement based on a persons disability.

It could be you!

Kent hospital apologises for putting do not resuscitate order on Downs Syndrome man before he died

December 8, 2015 | by SWNS Reporter               

 

A man with Down’s Syndrome was given a ‘do not resuscitate’ order by hospital staff, who listed his learning difficulties among the reasons for doing so.

Andrew Waters (SWNS Group)

 

East Kent Hospitals NHS Trust have admitted breaching the human rights of Andrew Waters, 53, by placing the ‘DNR‘ notice on him.

Mr Waters’ family were not consulted or informed and only found out after he was discharged from hospital and they found the crumpled note in his bag.

The order was placed on him when he stayed at the Queen Elizabeth, the Queen Mother Hospital in Margate, Kent, in 2011 because of problems related to his dementia.
Hospital staff decided he should not be resuscitated if he developed heart or breathing problems.
Mr Waters died in May but the order did not have a bearing.

His brother, Michael Waters, said: “For someone to make that decision, without consulting a family members or any one of his carers, was just totally unacceptable.
“No-one has the right to make such a decision in such a disgraceful way, to put those reasons down.
“We were there at hospital and involved in his care at every point.
“The form was a folded up piece of paper found in his bag after discharge, by his carers.
“There was nothing wrong with Andrew’s health at the time which would have an effect on his resuscitation.”

A statement from the Trusts apologised unreservedly for the distress caused to Mr Waters’ family.
It read: “The trust accepts that it breached its duty owed to the patient.“Actions have been taken to ensure this does not happen again and the trust has now reached a resolution with the family.”
Michael Waters welcomed the apology and the trust’s admission that they breached Andrew’s human rights.
Michael said: “It’s taken a long time for the hospital to admit this, which we’ve found hard.
“All we ever wanted from this case was a simple apology.
“People with Down’s Syndrome deserve the right to live like you and me.”


Rosie Neale, 55, who runs a support group called Little Buddies for families and carers of Down’s Syndrome sufferers in Kent yesterday condemned the DNR decision.
She said: “It is just dreadful. I just think it is wrong. They have got a right to live like everybody else.”
Rosie, whose 12 year-old daughter Emily suffers from Down’s Syndrome, added: “I have been quite lucky with my daughter.
“She has not been ill very much. But my experience of being told that my daughter had Down’s Syndrome was not very good. It was just come in, have a look at what’s wrong.”

The lawyer who brought the case says trust breaks down between doctors and families if the reasons behind resuscitation orders are not communicated effectively.
Leigh Day solicitor Merry Varney, also fought the case of Janet Tracey, which established last year that doctors had a legal duty to consult and inform patients about DNR orders.
She said: “Sometimes they can be really aimed at trying to give a patient a dignified death.
“This is not about giving up on someone or writing them off.
“But that’s generally what I hear people say they feel, if they find out about these after the decision has been made.
“I still receive around three calls a fortnight from families or patients who are concerned about what a DNR means and whether it means not to treat more generally.
“Unfortunately, the portrayal of cardio-pulmonary resuscitation in TV dramas sometimes suggests it’s a quick fix and works for everyone.
“That’s simply not the case – and there’s a real onus on healthcare professionals to communicate that.”

Yesterday that two orders not resuscitate were placed on Andrew Water’s medical records without the knowledge of his family.
The Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders were placed on his medical records giving his disability, Down’s Syndrome, as one of the reasons.

Mr Waters, who died from an unrelated cause in May, took legal action against the Queen Elizabeth the Queen Mother Hospital through a litigation friend, his brother Michael.

In August 2011 Mr Waters, who suffered from dementia, was admitted to the hospital where it was decided he required a feeding tube.
Without consultation with his family or with carers from his residential home, a DNACPR order was placed on his file.
Despite holding a ‘best interests meeting’ to discuss Mr Waters’ feeding tube, resuscitation was not discussed and his family were not informed of the order, even on his discharge.
In September 2011 he was again admitted to Queen Elizabeth the Queen Mother Hospital in Margate, Kent.
Throughout his time at the hospital his family visited virtually every day, yet on admission a DNACPR order was again imposed without any discussion or consultation.
The rationale for the DNACPR order was stated to be:”Downs Syndrome, unable to swallow (PEG fed), bed bound, learning difficulties.”
It inaccurately recorded the family as “unavailable” and was marked as indefinite in duration.
Following his final discharge back to the residential home where he lived, staff at the home found the DNACPR in Andrew’s possession.
The manager of his residential care home contacted Andrew’s Community Learning Disabilities Nurse who telephoned the hospital and challenged the doctor about the order.
She then informed Andrew’s family as she felt they needed to know, not least as Andrew had by that time been admitted back into hospital.

His family were shocked to learn about the imposition of the DNACPR, not only in light of the comments on the form itself but also the fact a decision to withhold potentially life sustaining treatment had been made with no consultation with the family, let alone their agreement.
Initially, apologies were offered from the Trust but without any actual acknowledgment of any wrongdoing.

Andrew’s brother, Michael Waters : “I still feel very angry about this, especially the fact that my brother’s Down’s Syndrome was put as the reason for the DNACPR.
“As a family we are also upset that the doctor concerned has still not offered any personal apology despite this admission from the Trust.”

Jan Tregelles, CEO of Mencap, said: “Many families who have lost their loved ones to poor care within the NHS have told us about the inappropriate use of Do Not Attempt Resuscitate (DNAR).
“There have been circumstances where DNAR notices have been applied without the knowledge or agreement of families.
“DNAR orders have also been applied hastily, in inappropriate situations, solely on the basis of a person’s learning disability.
“This is unacceptable and highlights the failures of care that are a daily reality for many people with a learning disability trying to get access to good quality healthcare.
“1,200 people with a learning disability are dying avoidably in the NHS every year.
“The Government must take action to ensure that people with a learning disability get the right healthcare within the NHS and put an end to this scandal of avoidable deaths.”

Merry Varney from the Human Rights team at Leigh Day said:
“The acknowledgment that it was unlawful and in violation of human rights to impose a DNACPR order on Andrew without first discussing it with his relatives is welcomed.
The decision to impose a DNACPR order is a critical and sensitive one, and it is important that family and carers of patients who lack the mental capacity to make their own wishes known, are involved in the decision making process.
“The Trust had initially argued that there was no unlawfulness as the DNACPR was not acted upon and because “there is no indication that [Andrew] was even aware that the decision had been made or understood its significance.”
“Although it is disappointing not to have reached this agreement whilst Andrew was alive, the family welcome the Trust’s acceptance that their actions amounted to a violation of the human rights of a vulnerable adult and hope that no other family will have to endure the nasty surprise of discovering a DNACPRR decision has made unilaterally.”
Down’s Syndrome sufferer Jack Adcock, six, died after a hospital doctor at Leicester Royal Infirmary called off life-saving treatment after mistakenly thinking he was under a Do Not Resuscitate order.

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

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

The 999 scandal spreads nationwide.

The South east Coast Ambulance trust scandal (where the trust fiddled their NHS targets by "reassessing" response times whenever a call came via the 111 number) was exposed by a whistleblowing Paramedic.

He or she has told us more;

To put it simply the trust was also doing some other "reassessments".

Whenever they missed the requirement that an ambulance should arrive within 8 minutes of a call 75% of the time......they changed the rules.

They created an app which told them whether a defibrillator was nearby and if it was.....that counted as if the ambulance had arrived in time, even if it hadn't.

What's worse is that this appears to just be an extension of the NHS rules.

If it's true, all the Ambulance trusts are probably missing their targets and thousands of people are potentially dying unnecessarily.

Here's the full article;  

Telegraph.co.uk
Sunday 08 November 2015

NHS accused of 'scandalous' 999 response time policy
Exclusive: Whistleblower from troubled ambulance trust says thousands of calls that appeared to miss eight-minute target are being counted as hit.
 
By  Laura Donnelly, Health Editor
08 Nov 2015

The NHS has been accused of operating a "scandalous" policy that means 999 calls are being recorded as receiving a swift response - even if no help was given.

Thousands of “life threatening” calls which apparently miss the response time target have been retrospectively assessed and counted as a hit regardless of whether the patient was seen by professionals, a whistleblower has told the Daily Telegraph.

It is alleged that the South East Coast Ambulance trust was able to manipulate the figures by proving that equipment used to restart someones heart - put in place in thousands of shopping centres, doctors’ surgeries and village halls – was within 250 metres of the patient, even if their symptoms were completely unrelated.

The 111 number was brought in for people to call if they felt their medical condition was not life threatening.

Ambulance services are supposed to ensure that three quarters of
"life-threatening" calls receive a response in eight minutes.

South East Coast Ambulance Trust is already under investigation for deliberately delaying thousands of “life-threatening” calls which came to them via 111.

Regulators are trying to establish the extent of the harm to up to 20,000 patients who were forced to wait up to twice as long under a secret scheme.

But a whistleblower from the trust has spoken out about his concerns about the separate policy affecting thousands more life-threatening calls.

National NHS guidance about "Red 2" cases - the second most serious level of urgency - says the eight-minute target can be achieved if a response comes from an ambulance, rapid response vehicle or from a "public access defibrillator” with a person trained to use it.
 
The equipment can be used to try to restart the hearts of those suffering a cardiac arrest.

But the Telegraph has learned that trusts have been allowed to count the targets as being hit as long as the equipment is on hand.
The rule is applied even if the medical emergency could not have been helped by a defibrillator, and no attempt was made to use it.
South East Coast Ambulance Service NHS trust has been accused of retrospectively changing more than 5,600 calls in a year, because a public defibrillator was within 250 metres.

A paramedic whistleblower said a web programme had been deployed to reasess "life-threatening" cases which appeared to have missed the eight-minute target.

If the mapping tool located a nearby defibrillator, the case would be recorded as meeting the eight minute target, he said – whether or not the heart-starting device was used.

These included cases in which the patient had suffered conditions such as strokes or breathing problems, in which a defibrillator would be no help.

The trust said the rule would only apply if the 999 caller had been asked if someone was available to collect the device.

A data report leaked by the paramedic discloses that in the 12 months from April 2014 to March 2015, the “webdefib” tool was applied 5,631 times by the trust.

The classification of such calls as achieved within eight minutes helped the organisation towards the NHS target to achieve this in 75 per cent of “life threatening” cases.
 
Official figures show that the trust narrowly achieved this last year, with 75.3 per cent of such calls getting a response in eight minutes. Without the reclassification, the target would have been missed.

The paramedic told The Telegraph: “This is a complete scandal, the public would be deeply concerned about this if they knew.”

“Every day in the control centre administrators look at every missed 'red' call to see if a defibrillator was within 250 metres.

They use a mapping tool to see.

"It doesn’t matter if it was used, or even if it could have been used – some of these are people suffering strokes, or breathing problems. This is occurring when a defibrillator has not left the wall where it was mounted and no one has been sent to collect it.”

“We simply should not be doing this,” he added. “We are manipulating data to hide the true picture.”

The use of the protocols meant that calls appeared to be met far earlier than they were, he said.

"In areas - especially rural settings where we frequently miss our 8 minute responses - a defibrillator will be placed, meaning we will always reach our 8 minute response time, even if an ambulance takes 30 minutes to get to scene," he
said.

The revelations follow a string of disclosures about the trust, which is at the centre of a growing scandal.

Last week, an official investigation found up to 20,000 “life threatening” calls were deliberately delayed under a secret policy.

The NHS England report said a failure to monitor the scheme meant it was impossible to say how many patients had come to harm, under the protocols affecting 111 calls.

Regulators have launched a new investigation to try to establish the extent of the harm.

A spokeswoman for the trust denied any manipulation of response times. She said: "Our response time performance is recorded completely in line with the national guidance."

She said the trust understood that under NHS rules, such calls would be treated as met within eight minutes if as an automatic external defibrillator was publicly accessible, and the 999 caller had someone available to fetch it. Such public devices were specifically devised for use by those with no training, she
said.

However, NHS England said the clock should only be stopped if a "fully trained" person and a defibrillator were right by the patient's side.

A spokesman said that if these criteria were met within eight minutes, the response target was achieved - regardless of what turned out to be wrong with the patient or whether the device was used.

Neil Harris

(a don't stop till you drop production)

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

The NHS Report into the South East Coast Ambulance Trust scandal.

Investigation into 111 scandal branded a 'whitewash' after it fails to establish who was responsible

Patients groups and safety campaigners have criticised an NHS investigation which found up to 20,000 patients were subjected to deliberate delays under a secret policy - but failed to work out who was responsible for the scandal 

By Laura Donnelly, Health Editor

 05 November 2015
    

An investigation into deliberate ambulance delays has been branded a "whitewash" after it failed to establish who is to blame for a major NHS scandal.

An eight-day-old baby and a patient suffering an obvious stroke were among up to 20,000 patients whose ambulances were delayed as part of a secret policy by South East Coast Ambulance Service NHS Foundation Trust.

For two months, “life threatening” cases referred to them from the 111 phone line were routinely forced to wait twice as long for an ambulance.
 

The secrecy meant that 111 call handlers assured patients in 'life-threatening' situations that an ambulance was on its way, with no idea that it was not.
 

NHS England on Thursday published the findings of its investigation into the matter, the findings of which were revealed by the Telegraph earlier this week.

The report was unable to establish which senior managers were responsible for the secret project, and how it came to be hidden from the trust’s medical director, non-executives, and the public.

 

Under NHS rules, calls designated as “life-threatening” are supposed to receive an ambulance response within eight minutes regardless of whether the caller dials 999 or the non-emergency 111 line. The target is to achieve this in 75 per cent of cases.

 

But the ambulance trust “unilaterally” invented its own system resulting in the routine downgrading of thousands of 111 calls, which were held in a special queue to be reassessed, with ambulances either cancelled or delayed for up to 10 minutes more.

“They were warned again and again about the risks this was posing to patients.”

Call handlers were not even told about the secret project – reassuring callers that an ambulance was on its way, when this was simply not true, the report found.

 

The scheme was introduced by a group which was established by Paul Sutton, the trust’s chief executive, and overseen by at least four executives, but health officials could not work out who was responsible for the scheme.

 

"Because of the lack of documentation and the lack of information provided at interview, we have not been able to understand who made certain decisions or if they were issues that had been considered," the report concluded.

 

It was only when a whistleblower contacted NHS organisations responsible for monitoring safety that the scheme was aborted.

 

Katherine Murphy, chief executive of the Patients Association, said: "The findings of this report are very damning and paint a worrying picture.

 

"It is unacceptable for NHS England to say they cannot identify who gave the instructions to downgrade calls to 111 services in the South East. These decisions placed the public at risk and their actions were completely inexcusable.

"This is a whitewash and a major scandal.”

 

Surveillance of the scheme was so poor that it was impossible to work out whether patients were harmed by the delays, the report found.

 

Regulators have ordered a further independent investigation to establish how many patients were affected by it.

 

Cases placed in the queue included an eight day old baby, whose “clinical outcome” was not recorded, and a 60 year old man, who was suffering clear signs of a cardiac arrest but was pronounced dead soon after a 40 minute wait for an ambulance.

Peter Walsh, chief executive of patient safety charity Action against Medical Accidents said: "It's unacceptable that after an investigation of several months into a major scandal we are now none the wiser about who was responsible."

"I don't find it credible that neither the ambulance trust nor NHS England seem able to establish who took the critical decisions here."

 

A spokesman for NHS England South said: "The report makes clear that this project was initiated entirely within South East Coast Ambulance Service and resulted in changes to the handling of calls within the 999 service, not the 111 service.

"The regulator, Monitor, will oversee the next steps with the trust."

 

Paul Sutton, trust chief executive said: "Patient safety is fundamental to what we do.

 

"As paramedics, we come to work to save lives and we would never do anything to deliberately put patients at risk.

 

"We understand the concerns that the public have and wish to reassure people that we work constantly to provide the safest service possible.

 

"We recognise that the proper processes were not fully followed in setting up the project and we do apologise for this.”

 

The policy affecting thousands of calls was launched without the knowledge of 111 staff, board non-executives, the medical director or local commissioners of services, the report found.

 

• Patients with life-threatening conditions can wait twice as long for ambulance because they called 111

 

The secrecy meant that 111 call handlers assured patients in “life-threatening” situations that an ambulance was on its way, with no idea that it was not.

 

Instead, paramedics with just one day’s training in call-handling, were ordered to phone thousands of cases back to see if ambulances were really needed.

 

As a result, life-saving cases forced to wait up 18 minutes, were still counted as hitting the eight-minute target, while non-life threatening cases were given an extra 20 minutes.

 

Because the 111 staff referring the calls were never told about the system, many remained on the phone to monitor patients – blocking the line for the assessment call.

 

Those who should have been in charge of surveillance were not notified, with incidents only reviewed retrospectively by an administrator with no clinical background, it says.

 

The NHS England report examined seven “serious incidents” including five deaths.

However it says such cases are an unreliable way to assess safety, as they are usually under-reported.

"Not enough work has been done to identify whether patients were harmed as a result of the project"

A Monitor spokesman

Highlighting the main concerns found by the investigation, the report says:

 

• "There was no transparency with the public, as they were not told their call was going into a queue. They thought an ambulance was on its way when this was not true.

 

• This organisation potentially put the public at risk by changing nationally agreed operating standards with a project that had no evaluation built into its design.

 

• The governance structures that the Trust had in place were not followed. Whether or not this was intentional we have not been able to answer.

 

• The risks of the project were either not recognised or were ignored.

 

• Key staff were not consulted during the design and implementation of this project.

 

• The project was overseen by at least 4 Executives, who had a responsibility to have worked to the governance policies of the organisation.

 

• Serious Incidents were not identified, as the clinical risk system had no clinical input and key people within the department were unaware of the R3/G5 call partition."

 

The trust's efforts to check whether harm was done to patients were neither "appopriate" nor safe, it concludes.

This report speaks for itself; the NHS prepared a secret report which we only got hold of because it was leaked.

The report fails to tell us who was responsible for the scandal because the executives at the trust wouldn't tell them and because they didn't keep any records.

To me this seems like fraud - a job for the Police.

After all there's every reason to believe that people died as a result.

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

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

 

The South East Coast Ambulance Scandal worsens.

There has been a further leak about The South East Coast Ambulance Service and the methods its management used to make it seem as though they were meeting their response time targets when they weren't.

This is a BBC report, The NHS has given in and the report will be released to us on Thursday.

The background to this scandal is on the last posting on this site;

                                  --------//----------

Up to 20,000 patients had their ambulances delayed while an NHS trust took extra time to assess their conditions, it has emerged.

 

A leaked document says call handlers told patients ambulances had been dispatched, with no idea they were not.

It said it is impossible to conclude that patients were not harmed and has examined seven "serious incidents".

The South East Coast Ambulance trust said it has "not found the process impacted negatively on patients".

The ambulance service's council of governors met the trust's chairman, chief executive and non-executive directors on Tuesday to discuss the issue.

It was given further information on the grounds for concerns and the process that will follow.

Brian Rockell, South East Coast Ambulance's (Secamb) lead governor, said: "I am confident that the process outlined will allow the council to fulfil its statutory duties and be assured that a quality service is provided to our patients."

NHS England has confirmed plans to publish the leaked report on Thursday.

A Secamb spokesperson reiterated its previous statement that "the purpose of the process was to protect patient safety by ensuring that our most seriously-ill patients received the care they needed as quickly as possible".

It added: "There has been some suggestion that this resulted in less serious patients being harmed. We would like to make it clear that our investigations to date have found no evidence to support this suggestion.

'Truly shocking'

The draft report examines a pilot project at Seacamb which was launched in secret by a clique of senior managers.

It was set up without the knowledge of 111 staff, board non-executives, the medical director or local commissioners of services. Secamb covers Kent, Surrey, Sussex, Brighton and North East Hampshire.

In the project, the trust decided to transfer certain 111 calls to the 999 system, thus gaining up to 10 additional minutes to assess patients' conditions.

In one case - known to be the death of a 60-year-old Horsham man who had suffered a cardiac arrest - there was a "missed opportunity" to improve his outcome, the report said.

It found: "We cannot conclude that patients were not harmed by the R3/G5 project, as all the facts are not known for the calls that went unanswered or for the callers who had significant delay by the re-triage process."

The report said the trust's efforts to check whether harm was done to patients were neither "appropriate" nor safe.

Patients Association Chief Executive Katherine Murphy said: "The reports today are truly shocking. There has been a complete disregard for patient safety through a policy that has put thousands of patients at risk."

Health regulator Monitor said the trust had not fully considered patient safety.

It has added a condition to Secamb's licence so that if insufficient progress is made, the leadership team could be changed.

Seacamb Chief Executive Paul Sutton has defended the project but also admitted: "These are serious findings."

                                 ---------//----------

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

Home: helpmesortoutthenhs.blogspot.com
Contact me: neilwith promisestokeep@gmail.com

The South east Coast Ambulance Trust Scandal.

For the best part of 18 months I've been highlighting problems with the 111 non-urgent phone line which replaced the much loved NHS Direct advise line.

Little did I ever imagine that Ambulance chiefs would decide to secretly change the rules on response times to get themselves out of a hole; they were missing Government targets.

The answer?
Fiddle the books.

This is an excellent piece of investigative reporting by the Daily Telegraph and all the more important because whenever anyone in NHS management does something wrong the first response is to cover it all up.


DailyTelegraph

How trust made secret 111 plan to hit all-important NHS targets
The deaths of up to 25 patients have come under investigation, after
whistleblower reveals extent of policy that delayed help for seriously ill patients

By  Laura Donnelly, Health Editor
31 Oct 2015

In December last year, South East Coast Ambulance trust was facing major problems.

Key NHS targets - to send an ambulance out within eight minutes for all cases designated as “life-threatening” were slipping far out of reach, with too few crews to send out to meet growing pressures as winter drew in.

The creation of the controversial 111 phone line was supposed to ease demand for ambulances, making sure those with more minor needs could get help without an ambulance being dispatched.

“The executives knew, there were people warning directors and senior managers in January and February that this was happening and it was extremely dangerous."

Instead, the phoneline was adding to pressures on services, with fears that “risk averse” call handling were too often sending out ambulances.
 
And so a plan was hatched.

Behind closed doors, senior managers at the ambulance trust devised their own protocols.
 
Any “life-threatening” calls which were sent their way would no longer get an automatic ambulance response.

• NHS 111 scandal: 25 deaths blamed on ambulance delays

Those which had been categorised as “Red 2”– life-threatening, but not the most immediately time-sensitive – would be allowed an extra ten minute delay, while the 999 service “re-triaged” them to decide on the best response.

Such cases would still be counted as hitting the all-important NHS targets, implying that a response had still been received within eight minutes.
 
In some ways, the policy appeared successful.

A meeting of the trust’s clinical committees was told that “pro-active” management of the cases meant up to one quarter of the ambulances called were being stood down.
 
Meanwhile, staff working in the trust’s own 111 call line had no idea that when they had ordered an ambulance to be dispatched, the case could be put aside for up to 10 extra minutes, despite its urgency.

At the start of this year, a series of clues began to fall into place.
111 call handlers from Ashford working occasional shifts in the 999 centre in Maidstone stumbled upon the policy – which had never been discussed at the trust’s board meetings, let alone announced publically.

Then a string of serious incidents occurred.

One, on January 28th, involved the death of a man, aged 60.
His wife called 111 when her husband was short of breath, clammy, vomiting and suffering pain high in his chest, towards his shoulder.

During the call, the man began to suffer signs of cardiac arrest, and his wife began attempts to resuscitate him.

Incredibly, under the system, the call passed on to the 999 centre was categorised as “Red 3” – meaning it remained unassigned to an ambulance crew for 10 more minutes.

Crews finally reached the man 39 minutes after the call was made, but could not save him.

The details are contained in a safety report, sent from senior NHS managers to the trust’s chief executive and other senior managers, on 4 February which concerns were raised.

Another email, sent by a senior NHS 111 manager two days earlier, warns of the potential of “severe” reputational damage if the truth came out.

In the correspondence, the health official says he has “personally amended” official reports to remove references to the controversial policy, but warns that “it is inevitable that this process will filter through to a wider audience at some stage”.

Yet the policy – described as a “rogue operation” by those outside the trust – remained in place.

Two weeks later, one of the trust’s senior managers became so fearful that he decided to contact health officials outside the trust, to warn them what was going on.

The man, who spoke to the Telegraph on condition of anonymity said: “The executives knew, there were people warning directors and senior managers in January and February that this was happening and it was extremely dangerous. “

“They simply did not listen. “

In emails seen by the Telegraph, he contacted two senior managers at local NHS commissioning groups – who are responsible for monitoring safety of the services – warning them of a string of deaths which had not been included in official serious incident reports.

The disclosure caused immediate panic: within two days, orders came from the clinical commissioning groups to close down the scheme. An NHS investigation was then opened, and handed information suggesting that up to 25 patients might have died after being subject to the deliberate delays.

But in public, there was nothing. No board papers have been published about the concerns, nor any public statement issue.

Meanwhile there were furious disputes within the trust about how many patients covered by the policy had come to any harm, and whether any such harm was explained by the delay waiting for an ambulance, or would have happened anyway.

But it was not until this week that NHS watchdogs suddenly announced that the protocols were under investigation, with a major review by regulators about how many patients had come to harm under the rules.

Health officials at NHS England said the trust had acted “unilaterally and inappropriately” while Monitor – the regulator for foundation trusts – said it would now hold its own investigation to establish levels of harm to patients.
 
The trust has refused to say who introduced the policy and whether any managers have been disciplined.

On Friday a trust spokesman said: “We will now work closely with Monitor as they undertake the reviews outlined in their recent media announcement and therefore do not feel that it is appropriate to comment further on specific points at
present.

The spokesman queried any suggestion that 25 people had died as a result of the policy. He added: "Our investigation and our own internal processes to date have not found that the process impacted negatively on patients."

                                 ----------//----------

Yeah right, if you believe that you'll believe anything.

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

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

In court with the Mid Staffordshire NHS Trust.

The Mid Staffordshire Hospital scandal continues; The health and safety executive are now prosecuting the Health Authority for some of the most blatantly negligent of the 600 odd deaths caused by poor staff and management at this nightmare group of hospitals.

Except it is being wound up and effectively a 'legal body' is being taken to court when it should have been the management and those directly responsible.

This would be just a farce except one of the deaths occurred last year - long after the scandal was exposed, the official report was published and  a 'new' trust created to take over.

You can read about Mid Staffs and The Francis Report on the archive pages of this Blog.

This is from The Daily Telegraph;

Sponsored

 

Mid Staffordshire NHS Foundation Trust charged over four deaths

The trust at the centre of the worst ever NHS scandal is facing criminal charges over the deaths of four patients

 

     

By Laura Donnelly, Health Editor

15 Oct 2015

The trust which ran Stafford Hospital is to face criminal charges related to the deaths of four patients - one as recent as last year.
 

The Health and Safety Executive (HSE) has brought charges against Mid Staffordshire NHS Foundation Trust over the deaths of four elderly patients between 2005 and May 2014.

Mid Staffordshire NHS Foundation Trust was at the centre of one of the biggest scandals to hit the health service over the deaths of hundreds of patients, amid appalling failings in care.

The HSE said the charges related to the deaths of Patrick Daly, aged 89, who died in May 2014, Edith Bourne, aged 83, who died in July 2013, Ivy Bunn, aged 90, who died in November 2008, and Lillian Tucker, aged 77 who died in October 2005.

Mrs Tucker died after a junior doctor gave her a penicillin-based drug despite being told she was allergic to the antibiotic, an inquest heard. She had suffered fall, which led to a small fracture while on a family holiday in the area.

His son later said he "would not touch the hospital with a barge pole" after detailing the family's repeated warnings about his mother's allergy.

The HSE said it had charged Mid Staffordshire NHS Foundation Trust following a "thorough and comprehensive investigation into the circumstances of four deaths of patients under its care".

The trust is due to appear before Stafford Magistrates on November 4. A new trust began to run the hospital last November.

Last week police and health officials said they are investigating claims of an NHS “cover-up” over the death of a three-year old boy, Jonnie Meek, at Stafford Hospital, last year.
 
The parents of Jonnie Meek, who died at Stafford hospital, say failings were covered up .

This probe will check claims that statements from health workers who witnessed his death were falsified.
It is very rare for the HSE to act in cases involving clinical failings, and the body has previously been criticised for its reluctance to prosecute.
 
The Mid Staffs inquiry accused the body of “looking for reasons for not taking action rather than starting from a consideration of what is in the public interest. “
 
“The more serious and widespread a failure is, the less likely it is that the HSE will decide to intervene, even where it is apparent that no other regulator is likely to do so,” Robert Francis, the chairman of the inquiry said.

Last year the same trust was fined £200,000 over the death of Gillian Astbury, 66, who died in 2007 because nurses at Stafford hospital failed to give her the routine insulin she required to stay alive.
Wayne Owen, HSE principal inspector in the West Midlands, said: "We have concluded our investigation into the death of four patients at Stafford Hospital and have decided there is sufficient evidence and it is in the public interest to bring criminal proceedings in this case."

The trust remains in place as a legal entity but no longer provides patient services.
University Hospitals of North Midlands NHS Trust took over the running of Stafford Hospital and Royal Stoke University Hospital.

The Mid Staffs special administrator Tim Rideout said the remaining "shell organisation" would oversee any "potential criminal liabilities".
He added: "I am committed to bringing matters to a conclusion as efficiently and effectively as possible in the best interests of the families concerned.

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

Home: helpmesortoutthenhs.blogspot.com

Contact me: neilwithpromisestokeep@gmail.com

 

Safety staffing levels to be ignored.

NHS 'backtracking' on ward nurse numbers introduced after Mid Staffs

Critics fear safety will be sacrificed to cut costs after NHS bosses tell hospitals that 1:8 nurse-to-patient ratio is a guide, not a requirement

 

Denis Campbell

Health policy editor

Tuesday 13 October 2015 

 

  

The NHS has been accused of backtracking on improvements in patient safety made after the Mid Staffs scandal by reducing the number of nurses on wards because of its growing financial crisis.

NHS bosses have told hospitals they no longer have to ensure that one nurse is caring for no more than eight patients at a time, in order to help tackle a £2bn black hole that has left 80% of hospitals facing deficits of up to £100m each.
The letter states: “We would stress that a 1:8 ratio is a guide not a requirement. It should not be unthinkingly adhered to. Achieving the right number and balance of clinical and support staff to deliver quality care based on patient needs in an efficient way that makes the best possible use of available resources is the key issue for provider [hospital] boards.
 
 
The move, set out in a letter to all hospital chiefs, has sparked fears that patient safety will be sacrificed to help hospitals cut costs. It makes clear that financial considerations are deemed to be as important as the safety and quality of care patients receive when deciding how many nurses should be on duty.

Cash-strapped hospitals may be tempted to cut their nurse staffing levels as a result of the new advice, the Royal College of Nursing (RCN) warned. Staffing takes up 70% of the NHS’s budget and its bill for employing temporary staff to plug gaps in rotas, especially expensive agency nurses, has hit £3.3bn in the last two years.

The letter has been signed by NHS England, the Care Quality Commission, the National Institute for Health and Care Excellence (Nice), and the regulator NHS Improvement. It recommends that hospitals can ask health professionals, such as physiotherapists, to help look after patients, and use technology to monitor their condition, to reduce the need for nurses on duty.

It urges hospitals “to take a rounded view of staffing” that shows they are “making the best use of resources” as well as providing safe care. It lists a set of variables, including how ill patients are, and then adds: “In some cases these factors will mean a higher number of nurses per patient, and in other cases it will mean a lower number or different configuration of staff can be justified.”

It adds: “It is therefore important to look at staffing in a flexible way which is focused on the quality of care, patient safety and efficiency rather than just numbers and ratios of staff.”

NHS facing £2bn deficit and 'worst financial crisis in a generation'

Hospitals have overspent by nearly £1bn in three months due in part to soaring bill for agency and other temporary staff, according to regulators. 

           

The NHS is under heavy pressure from ministers to make £22bn of “efficiency savings" by 2020 to help plug the £30bn gap expected to have developed in its finances.
The new advice is a substantial downgrading of guidelines produced only last year by Nice, which insisted that no nurse should look after more than eight patients to ensure good, safe care. That ratio was widely hailed as a way of avoiding a repeat of the Mid Staffs scandal, in which a lack of nurses was found to be a key cause of the appalling care.

Howard Catton, the RCN’s head of policy, said: “There’s a risk that people in the NHS may interpret this letter as a green light to row back on safe staffing when the NHS’s finances are in the perilous state that they are.”

However, he added that other suggestions in the letter, such as allowing hospital managers to use their professional judgment about how many nurses were needed and not rigidly applying fixed ratios, were “common sense”.

Labour said the NHS circular showed that patient care could be put at risk as a result of the fast-ballooning deficit.
“The idea that hospitals can ignore safe-staffing guidance will alarm patients. Safe staffing levels are essential for patient safety and were a key recommendation of the Francis report,” said Heidi Alexander, the shadow health secretary.
“If ministers attempt to balance the books in the NHS by cutting staff and putting patients at risk, then Labour will oppose them all the way. It is yet further evidence that the financial crisis in the NHS is now a real threat to patient care.”

Analysis Is NHS being overcharged by agencies – or are staff shortages the real issue?

Health secretary Jeremy Hunt is bringing in curbs on the use of employment agencies in the health service, but is he missing the point?            

            

Ian Wilson, chair of the British Medical Association’s representative body, said: “Adequate staffing levels are vital to deliver safe, high-quality patient care. Flatline funding at a time of rising demand has left services and the frontline staff who deliver them under enormous pressure. The solution is not to stretch existing staff even further, but to ensure the NHS has the resources needed to deliver safe care.”

But hospital bosses welcomed the move away from the 1:8 ratio. “NHS England boss Simon Stevens deserves credit for persuading Jeremy Hunt to soften his previous hard line on safety at any cost. We need to be pragmatic in the face of spiralling deficits,” one told the Guardian .
“It will give more discretion to senior nursing colleagues, giving them a vote of confidence. A ‘one size fits all’ is not the solution to staffing levels; it is about empowering frontline leaders.”
Canadace Imison, director of healthcare systems at the Nuffield Trust thinktank, said: “This letter shows a welcome attempt by NHS regulators to deliver a consistent message about safe staffing levels. It also rightly recognises that the 1:8 nurse to patient ratio is a crude metric and not to be seen as a benchmark.”

But it also leaves NHS trusts no wiser about whether they should under-staff or overspend in order to provide high-quality care, Imison added.

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This article in today's 'Guardian' is very worrying; we spent two years analysing the appalling mistreatment of patients at Mid Staffordshire Hospitals and the long awaited official report made clear (among many other recommendations) that a minimum of one nurse to 8 patients was an absolute requirement.

This was endorsed by N.I.C.E. and the other regulatory bodies.

Now that money is short?

Forget it.

All the studies show that patient safety and outcomes are worse when there are too few nurses to patients. We came to this conclusion years after other advanced countries.

For some reason, we have historically trained too few nurses and doctors and there is always a shortage.

Secondly, there is a historic reluctance to accept that too few staff is dangerous.

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

Home: helpmesortoutthenhs.blogspot.com

Contact me: neilwithpromisestokeep@gmail.com