Back in the summer of 2007 analysts working deep in the bowels of the leading London University Imperial College noticed something appeared amiss at a hospital many miles away.
The researchers, working for the private group Dr Foster, had spotted death rates at Mid Staffordshire NHS Trust were too high.
They raised the issue with the Healthcare Commission in July, and then the following month more anomalies were noted by the Imperial team.
The Healthcare Commission's own assessment system also started noticing potential problems, and within months a full investigation was launched.
It resulted in the watchdog publishing one of its most damning reports on an individual NHS trust.
The Healthcare Commission said standards of emergency care were "appalling" and would have led to unnecessary deaths.
Lessons to be learned
But what are the implications for the rest of the NHS?
Healthcare Commission chairman Sir Ian Kennedy said it was a story of one badly run hospital.
The watchdog looks into 12 alerts a month on average - the majority of which do not even result in a formal investigation.
None of these have thrown up the combination of concerns raised in the Mid Staffordshire report - namely low staffing levels, inadequate nursing, and lack of equipment, poor training, and bad management.
Things were so bad, the inspectors said, that receptionists were carrying out initial checks on patients arriving at A&E.
However, the watchdog still felt compelled to issue a number of warnings to the rest of the health service.
It said managers should not become obsessed with targets to such an extent that patient care is no longer the priority - as happened with Mid Staffordshire.
The report highlighted the use of a ward near to A&E which acted a "dumping ground" for patients so the hospital could meet the four-hour waiting time target.
It also said monitoring performance and comparing it to other NHS trusts was essential.
This is something the central command of the NHS at the Department of Health is expected to focus on in the coming weeks.
The above is part of the article on BBC NEWS Health
The real lessons to be learned are:
The Healthcare Commission is not fit for purpose; it has a policy of “a light touch to regulation.” “Gone are the days when inspectors would patrol the corridors of hospitals, and in their place is a system largely based on self-assessment and feedback.”
The problem with self assessment is just that, the hospital management tell the HC how wonderful they are performing, and the HC believes them, I have experience of both the HC and a Foundation trust, the Trust will lie and deny, the HC is completely biased towards the trusts and will believe what they are told.
The Healthcare Commission will cease to exist on April the 1st this year, what we need is to step back to “inspectors would patrol the corridors of hospitals,” and given the power to investigate “problems” and complaints.
Monitor, the institution that is supposed to ensure that the trusts are complying with the rules has failed; once again it believes what the trusts tell it.
That is the problem with self assessment, there are no checks, and the hundreds of deaths at Mid Staffs is the result layer upon layer of so called “regulators”.
“But Sir Ian rejected any suggestion that the watchdog was culpable.
He said the very fact the report had now been published was proof the watchdog's approach to inspection was working.
He said: "Everyone else was fobbed off. We alone stayed the course."
But whatever the truth, it seems the fall out from Mid Staffordshire has only just begun.”
Don’t forget that the deaths started back in 2002, and were ignored by the HC and Monitor for seven years.
If that is an example of “doing your job” then the unemployment figures should be increased by the number of pointy heads at the HC and Monitor.
“When will the state of the country be sound? When its people believe that the end result of cowardice is more disastrous than that of behaving with integrity.” Naquib Mahfouz
Angus
Angus Dei on all and sundry
NHS Behind the headlines
Angus Dei politico
The researchers, working for the private group Dr Foster, had spotted death rates at Mid Staffordshire NHS Trust were too high.
They raised the issue with the Healthcare Commission in July, and then the following month more anomalies were noted by the Imperial team.
The Healthcare Commission's own assessment system also started noticing potential problems, and within months a full investigation was launched.
It resulted in the watchdog publishing one of its most damning reports on an individual NHS trust.
The Healthcare Commission said standards of emergency care were "appalling" and would have led to unnecessary deaths.
Lessons to be learned
But what are the implications for the rest of the NHS?
Healthcare Commission chairman Sir Ian Kennedy said it was a story of one badly run hospital.
The watchdog looks into 12 alerts a month on average - the majority of which do not even result in a formal investigation.
None of these have thrown up the combination of concerns raised in the Mid Staffordshire report - namely low staffing levels, inadequate nursing, and lack of equipment, poor training, and bad management.
Things were so bad, the inspectors said, that receptionists were carrying out initial checks on patients arriving at A&E.
However, the watchdog still felt compelled to issue a number of warnings to the rest of the health service.
It said managers should not become obsessed with targets to such an extent that patient care is no longer the priority - as happened with Mid Staffordshire.
The report highlighted the use of a ward near to A&E which acted a "dumping ground" for patients so the hospital could meet the four-hour waiting time target.
It also said monitoring performance and comparing it to other NHS trusts was essential.
This is something the central command of the NHS at the Department of Health is expected to focus on in the coming weeks.
The above is part of the article on BBC NEWS Health
The real lessons to be learned are:
The Healthcare Commission is not fit for purpose; it has a policy of “a light touch to regulation.” “Gone are the days when inspectors would patrol the corridors of hospitals, and in their place is a system largely based on self-assessment and feedback.”
The problem with self assessment is just that, the hospital management tell the HC how wonderful they are performing, and the HC believes them, I have experience of both the HC and a Foundation trust, the Trust will lie and deny, the HC is completely biased towards the trusts and will believe what they are told.
The Healthcare Commission will cease to exist on April the 1st this year, what we need is to step back to “inspectors would patrol the corridors of hospitals,” and given the power to investigate “problems” and complaints.
Monitor, the institution that is supposed to ensure that the trusts are complying with the rules has failed; once again it believes what the trusts tell it.
That is the problem with self assessment, there are no checks, and the hundreds of deaths at Mid Staffs is the result layer upon layer of so called “regulators”.
“But Sir Ian rejected any suggestion that the watchdog was culpable.
He said the very fact the report had now been published was proof the watchdog's approach to inspection was working.
He said: "Everyone else was fobbed off. We alone stayed the course."
But whatever the truth, it seems the fall out from Mid Staffordshire has only just begun.”
Don’t forget that the deaths started back in 2002, and were ignored by the HC and Monitor for seven years.
If that is an example of “doing your job” then the unemployment figures should be increased by the number of pointy heads at the HC and Monitor.
“When will the state of the country be sound? When its people believe that the end result of cowardice is more disastrous than that of behaving with integrity.” Naquib Mahfouz
Angus
Angus Dei on all and sundry
NHS Behind the headlines
Angus Dei politico
1 comment:
happening all over the country - not a one off!
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