The latest “scandal” to hit the headlines is of course Basildon University Hospital,
“The way hospitals are regulated should be urgently reformed after a report found a catalogue of failings at two hospitals in Essex, a charity has said.”
The Patients Association said people had been "appallingly" let down.
The independent regulator highlighted an unusually high death rate and poor hygiene, including blood-spattered kit.
Basildon and Thurrock NHS trust said concerns were not indicative of wider problems, but a taskforce has been sent in to force through improvements.
The Patients Association said the failings were not isolated cases and patients had suffered a lack of monitoring, lack of help with feeding and a lack of dignity.
'Not complacent'
Director Katherine Murphy said: "How many times do the public need to keep hearing about this before the government is embarrassed enough to do something about it?
The Daily Fail reports it in a ‘slightly’ different way: “Dozens of patients died needlessly as a result of filthy conditions in an NHS hospital a shocking report said last night”
“Appalling nursing care in Basildon University Hospital contributed to a mortality rate that was more than a third higher than the national average. At least 70 people may have died who should have been saved.
It is the latest example of patients paying the ultimate price for labour’s failure to stamp out third world conditions in the NHS-despite trebling taxpayer funding over the last decade.”
Monitor the Foundation Trust regulator: We were established in January 2004 to authorise and regulate NHS foundation trusts. We are independent of central government and directly accountable to Parliament.
There are three main strands to our work:
“The way hospitals are regulated should be urgently reformed after a report found a catalogue of failings at two hospitals in Essex, a charity has said.”
The Patients Association said people had been "appallingly" let down.
The independent regulator highlighted an unusually high death rate and poor hygiene, including blood-spattered kit.
Basildon and Thurrock NHS trust said concerns were not indicative of wider problems, but a taskforce has been sent in to force through improvements.
The Patients Association said the failings were not isolated cases and patients had suffered a lack of monitoring, lack of help with feeding and a lack of dignity.
'Not complacent'
Director Katherine Murphy said: "How many times do the public need to keep hearing about this before the government is embarrassed enough to do something about it?
The Daily Fail reports it in a ‘slightly’ different way: “Dozens of patients died needlessly as a result of filthy conditions in an NHS hospital a shocking report said last night”
“Appalling nursing care in Basildon University Hospital contributed to a mortality rate that was more than a third higher than the national average. At least 70 people may have died who should have been saved.
It is the latest example of patients paying the ultimate price for labour’s failure to stamp out third world conditions in the NHS-despite trebling taxpayer funding over the last decade.”
Monitor the Foundation Trust regulator: We were established in January 2004 to authorise and regulate NHS foundation trusts. We are independent of central government and directly accountable to Parliament.
There are three main strands to our work:
And
Supporting NHS foundation trust development.
Assessing NHS trusts for NHS foundation trust status
We receive and consider applications from NHS trusts seeking foundation status and look at three areas:
Is the trust well governed with the leadership in place to drive future strategy and improve patient care?
Is the trust financially viable with a sound business plan?
Is the trust legally constituted, with a membership that is representative of its local community?
If we are satisfied that certain criteria are met, we authorise the trust to operate as an NHS foundation trust.
Regulating NHS foundation trusts
Once authorised, we regulate foundation trusts to ensure they comply with their terms of authorisation. These are a set of detailed requirements covering how foundation trusts must operate – in summary they include:
The general requirement to operate effectively, efficiently and economically;
Requirements to meet healthcare targets and national standards; and
The requirement to cooperate with other NHS organisations.
The board is the first line of regulation in NHS foundation trusts - we ask them to submit an annual plan and regular reports to us. We then monitor how well they are doing against these plans and identify where problems might arise.
Where problems start to develop we make sure the trust has an action plan in place and monitor progress against the plan. Where possible we work closely with a trust to resolve a problem quickly.
We have powers to intervene in a foundation trust in the event of failings in its healthcare standards, or other aspects of its leadership, which result in a significant breach of its terms of authorisation.
Take which view you like, this is not about funding, or the Government, although the “target driven policy” has not helped, the real problem is ‘Foundation Status’ which allows hospitals to become almost independent of the NHS.
NHS Foundation Trusts are a new type of NHS organisation, established as independent, not for profit public benefit corporations with accountability to their local communities rather than Central Government control.
The Secretary of State for Health has no powers of direction over them.
NHS Foundation Trusts remain firmly part of the NHS and exist to provide and develop healthcare services for NHS patients in a way that is consistent with NHS standards and principles - free care, based on need not ability to pay.
NHS Foundation Trusts have greater freedoms and flexibilities than NHS Trusts in the way they manage their affairs, this extends to:
Freedom from Whitehall control and performance management by Strategic Health Authorities
Freedom to access capital on the basis of affordability instead of the current system of centrally controlled allocations
Freedom to invest surpluses in developing new services for local people
Freedom of local flexibility to tailor new governance arrangements to the individual circumstances of their community
In line with the programme of reforms set out in The NHS Plan, NHS Foundation Trusts give more power and a greater voice to their local communities and front line staff over the delivery and development of local healthcare. NHS Foundation Trusts have members drawn from patients, the public and staff and are governed by a Board of Governors comprising people elected from and by the membership base.
This is the “star rating” for my local foundation trust in 2005, the year in which “M” spent 27 days in ICU because of the failure to diagnose sepsis by a “senior surgical consultant” from a cut bowel and a leaking anastomosis, and the later failure by the same senior surgical consultant to diagnose recurrent bowel cancer for seven months, by which time it had become inoperable.
The CEO, Medical Director and the Chairman have consistently refused to tell me why “M”s cancer was inoperable and what effect the sepsis had on her cancer.
The CEO, Medical Director and the Chairman have consistently refused to tell me why “M”s cancer was inoperable and what effect the sepsis had on her cancer.
This is part of that three star rating:
Clinical focus-High
Patient focus-High
Staff focus-High
And yes I know you can say that one case does not make a failure, but the real failure is responsibility: responsibility of the people who work in foundation trusts devoid of any need to account to anyone.
The Healthcare Commission was about as much use as a paper scalpel and was totally biased toward the trusts, Monitor was only concerned with approving the maximum number of foundation trusts that it could in order to show patients how wonderful the NHS is and believed everything that the hospital management told them, and once approved the trusts were more or less left to get on with it.
The CQC is about the same as the Healthcare Commission in that it talks tough and does nothing until stories such as Mid Staffs and Basildon are splashed all over the media.
But the failures of those hospitals are due to poor care, by Consultants, Doctors, Nurses and the lack of leadership by management.
And I know that nurses will cry “not us” there are not enough Nurses on the wards and we work 14 hours a day and don’t even have time for a pee let alone looking after patients, and most do.
But in the two hospitals mentioned they didn’t; the Nurses failed, the Doctors failed and the Consultants failed, but hospital Doctors and particularly Consultants do not ‘rock the boat’, I am not going to get into “whistle blowing” because it is a moot point, but the deaths at Basildon happened because of the attitude of the staff, the lack of initiative, the lack of pride and worse of all the arrogance of the management.
The real problem as I see it is “Foundation Trust” hospitals; they should not be cut adrift from regulation, and along with the CQC and Monitor they do not work, they are not fit for purpose, all hospitals should be the same, regulated by one department with ad hoc powers to inspect without prior notice and with the power to close wards or even hospitals if need be, and to be able to sack senior managers all the way up to the CEO and Chairman if it is warranted.
Patient safety must be the number one priority in the NHS, it really is about time that hospitals were brought into line and provide the service that they are paid for and we deserve, and responsibility must be placed on those who fail to perform.
Angus
Angus Dei on all and sundry
AnglishLit
Angus Dei politico
Clinical focus-High
Patient focus-High
Staff focus-High
And yes I know you can say that one case does not make a failure, but the real failure is responsibility: responsibility of the people who work in foundation trusts devoid of any need to account to anyone.
The Healthcare Commission was about as much use as a paper scalpel and was totally biased toward the trusts, Monitor was only concerned with approving the maximum number of foundation trusts that it could in order to show patients how wonderful the NHS is and believed everything that the hospital management told them, and once approved the trusts were more or less left to get on with it.
The CQC is about the same as the Healthcare Commission in that it talks tough and does nothing until stories such as Mid Staffs and Basildon are splashed all over the media.
But the failures of those hospitals are due to poor care, by Consultants, Doctors, Nurses and the lack of leadership by management.
And I know that nurses will cry “not us” there are not enough Nurses on the wards and we work 14 hours a day and don’t even have time for a pee let alone looking after patients, and most do.
But in the two hospitals mentioned they didn’t; the Nurses failed, the Doctors failed and the Consultants failed, but hospital Doctors and particularly Consultants do not ‘rock the boat’, I am not going to get into “whistle blowing” because it is a moot point, but the deaths at Basildon happened because of the attitude of the staff, the lack of initiative, the lack of pride and worse of all the arrogance of the management.
The real problem as I see it is “Foundation Trust” hospitals; they should not be cut adrift from regulation, and along with the CQC and Monitor they do not work, they are not fit for purpose, all hospitals should be the same, regulated by one department with ad hoc powers to inspect without prior notice and with the power to close wards or even hospitals if need be, and to be able to sack senior managers all the way up to the CEO and Chairman if it is warranted.
Patient safety must be the number one priority in the NHS, it really is about time that hospitals were brought into line and provide the service that they are paid for and we deserve, and responsibility must be placed on those who fail to perform.
Angus
Angus Dei on all and sundry
AnglishLit
Angus Dei politico
1 comment:
Heartily concurr with your views Angus. Trouble is I can take you to hospitals both worse and newer than this. They do not have an excuse but the real blame lies with Government both Labour and Tory.
The Tories started with 'competition' and the Labour 'me too' Government perpetuated it and then decided to go one better (look City we can do better as Capitalists than the Tories).
Never once was the standard of care of the constituent ever considered, just how much could our new friends blag off the system that was pretty piss poor anyway, but, at least had the excuse that it was starved of resources.
Foundation Trusts are an appalling idea fostered from the ISTC concept without the Profit that are expected to be independent businesses but within the NHS; an impossible dream only a politician conjur up. The concept of monitoring these is based on their own criteria pretty much as the bollocks of 'quality assurance'. Which is a standard decided by the body that adopts it, with its own protocols written as a manual, then checked and monitored by an outside body (Monitor ?) to ensure little or no deviation from the set standard. IT IS TOSH.
I've done this for a living! It's US drivel. You can write a standard, perfectly acceptable as regards ISO 900-whatever, that is for the manufacture of buckets with holes in the bottom ! And it would get a certificate of compliance!
Smoke and Mirrors, Smoke and Mirrors.
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