Professor Sir Bruce Keogh to investigate hospital outliers
As announced in today’s Prime Ministerial statement on the Francis Report, Professor Sir Bruce Keogh is to lead an investigation into hospitals that are persistent outliers in hospital performance and provide practical support.
Full terms of reference for the investigation, including which measures will identify the hospitals to be covered, will be published at the end of next week (update 15 February 2013 – the terms of reference have now been published). However, we can announce today that the first five hospital Trusts confirmed are:
- Colchester Hospital University NHS Foundation Trust
- Tameside Hospital NHS Foundation Trust
- Blackpool Teaching Hospitals NHS Foundation Trust
- Basildon and Thurrock University Hospitals NHS Foundation Trust
- East Lancashire Hospitals NHS Trust
Each of these has had outlying poor results for a key mortality measure (Summary Hospital-level Mortality Indicator) for a period of two years.
Professor Sir Bruce will undertake this investigation in his joint role as NHS Medical Director at the Department of Health and Medical Director of the NHS Commissioning Board. The Care Quality Commission, Monitor, NHS Trust Development Authority and Clinical Commissioning Groups will all be invited to be involved in the process.
Professor Sir Bruce Keogh said: “Each of the hospitals we identify today is already under scrutiny by regulators. This clinically-led and practical investigation will allow me to assure myself, Parliament and patients that these hospitals have everything they need to improve.”
If you want to submit any information or raise any concerns you may have about any of the 14 hospital trusts covered by this review you can do so on the NHS Choices website.
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22 comments
It is very easy to blame doctors n nurses. What about politicians who are cutting the budget. That is why there is staff shortage. 4 years ago govt refused visa for doctors from nonEU. Over 5000 Indians and others were forced to leave uk. UK thought that docs from east Europe could replace them. Never happened. The east Europeans lack English skills and were not prepared to do non training posts. Who is to blame?
The hospitals now hire very expensive locums, junior doctors demanding 60 to 70 pounds an hour. Locum agencies run by British are making lot of money. James cann from dragons den owns such an agency. The result money for drugs scans and patient use being diverted away. Whose fault? Is it the fault of doctors or nurses or politicians? I am a doctor in the nhs and see incompetent managers who do not listen to clinicians but use the whip against them. The British public is hoodwinked by politicians. The staaford enquiry costed £13 million pounds. Could have used that on patient care. Investigating these 5 hospitals will cost over £50 million. Who is gaining? The investigators have secured good salary for themselves. Why not do it for gratis? The people do not want to look after their own elderly, that is a problem too. How many of u have cooked and taken fresh meals for your elderly. Why can’t u help too. Is it too much to come and help nurses who are busy demoralised. Before you point fingers, reflect how many of you cancelled your holidays when an elderly relative landed in hospital? The hospitals belong not to the CEO, doctors, managers or politicians but to the community. Before you blame anyone, how many of you have helped in your own hospital, but you complain about food, parking, delays and everything.
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As Sir Proffessor Bruce was NHS Medical Director for 2 years during the Mid Staffs scandal. Is it not time for the gallant Knight to ‘fall on his sword’ ???
Colchester Hospital’s CEO is blaming the high mortality at this hospital on the elderly and terminally ill. Well, my grandson came under neither of these categories when he died, his skull was crushed when they attempted to deliver him with forceps. The devastion this hospital has caused to my family is every parent’s nightmare. Please investigate with all your powers as the management at Colchester Hospital’s idea of transparency is called fabrication. Contact those that have experienced the wholly inadequate care and enumerating deficiencies at this hospital.
I HAVE WAITED 4 YEARS TO TELL WHAT HAPPENED TO MY PARTNER AT COLCHESTER HOSPITAL. HE TOOK A STROKE AND WAS TAKEN TO THIS HOSPITAL, HE WAS ALERT AND INDICATING TO HIS DAUGHTER TO CONTACT ME AND TELL ME WHAT HAD HAPPENED. BUT BY THE TIME I GOT TO HIS SIDE HE DID NOT KNOW WHO I WAS…THEY HAD NO BEDS IN THE ‘SO CALLED’ STROKE WARD, SO HE WAS LEFT IN A&E FOR THREE DAYS. NO EFFORT HAD BEEN MADE TO GIVE HIM THE URGENT TREATMENT NEEDED TOAFFORD STROKE VICTIMS THE BEST CHANCE. BY THE TIME A BED WAS FOUND FOR HIM IN THE STROKE WARD, WE WERE INFORMED HE HAD PNEUMONIA…THERE NEVER SEEMED TO BE ANYONE ATTENDING TO HIS NEEDS, WE HAD TO INSIST HE WAS GIVEN ANTIBIOTICS WHEN HIS TEMPERATURE SUDDENLY BECAME SO HIGH, HIS BODY WAS RED HOT. WE HAD TO CONSTANTLY FIND SOMEONE TO EMPTY HIS URINE BAG, WHICH WAS FULL TO OVERFLOWING. HE WAS SUPPOSED TO HAVE A VAPOUR MASK TO AID HIS BREATHING BUT THE INEXPERIENCED PERSON WHO FINALLY FITTED IT, AFTER MANY DAYS HAD ALREADY PASSED, HAD NOT WARMED THE LIQUID, SO COLD VAPOUR WAS PASSED OVER HIS ALREADY STRESSED LUNGS…HE WAS ONLY 62 AND A VERY STRONG PERSON BUT FROM THE MINUTE HE ENTERED THIS WRETCHED HOSPITAL, NO EFFORT WAS MADE TO SAVE HIS LIFE…WE CAME IN TO FIND THEY HAD LAID HIM DOWN, WHICH YOU NEVER DO WHEN A PATIENT HAS PNEUMONIA AND I WILL NEVER FORGET THE SOUND OF HIS CHEST STRUGGLING TO CATCH A BREATH…RIGHT FROM WHEN HE WAS TAKEN TO THIS DREADFUL HOSPITAL WE HAD TO FRANTICALLY RUN AROUND TO TRY TO FIND STAFF TO LOOK AFTER OUR LOVED ONE. I AM CONVINCED A DECISION WAS MADE THE MINUTE HE WAS TAKEN TO THIS ‘HOSPITAL’ THAT IT WOULD TAKE UP TO MUCH OF THEIR TIME TO NURSE HIM BACK TO HEALTH AND THEY GAVE HIM A DEATH SENTENCE THERE AND THEN. EVEN WITH HIS STROKE HE WAS TOTALLY COHERENT BUT WITH NO SPECIALIST STROKE BED AVAILABLE, HE DID NOT RECEIVE THE IMMEDIATE URGENT TREATMENT WHICH IS NECESSARY TO GIVE A STROKE VICTIM THE BEST CHANCE OF SURVIVAL. I KNEW I COULD NOT SAY ALL THIS 4 YEARS AGO BECAUSE I WAS JUST ONE LONE VOICE BUT THANK GOODNESS, THIS PLACE AND THEIR ACTIONS ARE NOW RIGHTLY BEING INVESTIGATED. IT WON’T BRING MY AND MANY OTHER PEOPLE’S LOVED ONES BACK BUT IF IT SAVES JUST ONE MORE FAMILY FROM THIS UNBARABLE PAIN, IT WILL BE WORTH IT.
I feel your pain Justice Needed and relate to a lot of what you exerienced. I’ve been carrying a similar burden since my mum died in Hospital. The treatment or neglect and abuse she suffered eats away at me. If I tried to explain here it would run to several pages. I could write a book about it.
A similar thing happened to my father.
He was discharged by Tameside two weeks before he died. He was admitted to Stepping Hill almost immediately (1-2 days) after being discharged from Tameside. He died two weeks later. As a result of this, his death will not be recorded as having occured at Tameside but at Stepping Hill, when in reality his treatment – if I can call it that – was entirely at Tameside. I wonder how often doctors at Tameside did this.
Will the investigation look at complaints and involve those that have reached the end of the complaints process without resolution?
Will the investigation look at complaints outstanding with the PHSO?
My story …
For the last eighteen months I have been fighting a battle with Colchester Hospital to get a diagnosis for my 78 year old father’s heath problems.
After two complaint letters and two complaint meeting, including one with the Chief Executive plus three of his cardiologists’ team, I have reached the end of the line with achieving any suitable complaint outcome from Colchester; our case is now being prepared to submit to the Parliamentary and Health Service Ombudsman.
I am very grateful to be able to say that, whilst there has been a significant and continued deterioration in Dad’s health he is still alive! Thank goodness he hasn’t yet become one of the dreadful statistics being alluded to in the report from Robert Francis QC and other recently published statistics.
My heart goes out to the family and friends of those that have unnecessarily lost their lives due to lack of care and compassion by those in the very profession that should have these as their ultimate objectives.
I am overjoyed to hear that Colchester was specifically named as one of the five hospitals to be investigated following the publication of the Francis Report – about time.
Having attended Colchester Hospital with my father many times over the last 18 months I can honestly say that, in my experience, this institution falls well short of an acceptable level of health care service. The condescending behaviour, accompanied by a lack of care and compassion shown by the Chief Executive, at our meeting in October was extraordinary for someone receiving a very high salary to oversee the running of such an organisation. I wonder if I am alone with these opinions.
In my opinion, this hospital would benefit hugely from an IMMEDIATE appointment of a trouble shooter – someone who cared and who can make things happen; just walking around the hospital would throw up a list of very quick wins that would start Colchester hospital back on the road to becoming a health care institution to be proud of.
Long term and fundamental change will take longer and that needs to start at the top – the culture of the place is flawed! Only new leadership and direction can change this with a person that is visible to all staff, setting standards, directions and actually keeping the promises of the hospital.
I do hope that this ordered investigation will start Colchester Hospital back on the road to recovery; it has been very ill for a long time.
And after seeing a press release from Colchester Hospital published 6 February, disagreeing with that they have a problem, I have to say that this hospital need urgent attention as it clearly in a state of denial!
What records are kept about patients that die shortly after being discharged. My father was discharged twice from Sandwell Hospital in 2012, they stand by their decision sayingthat it was clinically appropriate to discharge him. He was so week and frail and died soon after. I have written a letter of complaint on a number of issues where I feel he was let down. I would like to see improvements in the quality of care and importantly communication, especially with patients families where the patient is vulnerable and cannot communicate his/her needs clearly. It would help immensely to be able to differentiate between different grades of staff and doctors – not knowing whether the person you are talking to has the authority to provide information doesn’t help.
Should you wish to read my letter and the response from Sandwell Hospital please contact me by email
My reply to MF I would like to see your letter and the response from sandwell hospital and I am sorry t to learn of your distress
Any information/comments I would like to add I would not want published, I am sure I am not alone .Can you indicate how best members of the public can contact you with their concerns fears or evidence relating to standards of care.
Hi Antoinette
Thank you for your comment. Patients and members of the public will play a central role in the overall review and the individual investigations, working in partnership with clinicians. The views of patients in each of the 14 hospitals, either directly or through representatives, will be sought by the teams and reflected in their reports.
Further details will be set out shortly on this website as to how patients and members of the public will be able to feed information and concerns into the investigation (by email, letter or phone).
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
Thank you all for your comments. Please find below some more information on Sir Bruce Keogh’s investigation:
This review is about investigating hospitals where there may be inadequate quality of care being provided to patients. Identifying which hospitals to investigate as part of this review is not an exact science. However, learning from Mid Staffs, we are going to look at hospitals that have been highlighted as outliers using two, nationally published mortality indicators – the Summary Hospital Mortality Indicator (SHMI) and the Hospital Standardised Mortality Ratio (HSMR) over 2 years. The five Trusts highlighted by SHMI were announced on Wednesday 6 February, and the six highlighted by HSMR have been announced this afternoon (link)
The Hospital Standardised Mortality Ratios (HSMR) and Summary Hospital-level Mortality Indicators (SHMI) are two commonly used ways of measuring whether the death rate at a hospital is higher or lower than you would expect, after taking account of a variety of factors around condition, severity and age of patients treated. These are not absolute measures of quality, they are statistical calculations that identify what you would expect the death rate to be, and are not an analysis of individual cases. These indicators can help identify potential problems in the quality of care being provided to patients which, if higher than expected warrant further and more detailed investigation.
We will publish the full terms of the investigation by the end of the week, but we will be using a two stage process using tried and trusted methods endorsed by the National Quality Board – a rapid response review followed by a risk summit.
· The rapid response involves a team of experienced clinicians, patients and regulators going into the hospital and observing the hospital in action. This involves walking the wards and interviewing patients, trainees, staff and the senior executive team. The team then meet to discuss and share opinion before providing a report to the Risk summit.
· A risk summit will be held for each hospital. This will bring together a separate group of experts from across health organisations that will consider the rapid response report to make specific recommendations and offers of support to these hospitals.
Kind regards
Simon
Digital Communications Officer
NHS Commissioning Board
I hope the rapid response team will also observe the hospital at night/weekend/bank holidays. The ward culture is completely different at these times especially elderly designated wards. Staff shortages, lack of qualified staff on duty, lack of ward checks all impact on patient care.
Background/psychological checks on staff and individuals that have patient contact (Jimmy Savile a case in point) would provide some assurance to patients and their families as to who is caring for them.
Looking at the profiles of the Board members at Sandwell Hospital it can be seen that the Chair and Vice Chair are Chartered Accountants. Directors and Non-Executive Directors go to pains to explain their responsibilities” seeking assurances that financial information is accurate, …and deciding executives’ pay”, little or no mention is made about striving to achieve excellence in patient care.
Isn’t this just indicative of a system that has lost its way; where financial performance overrides patient care? Can you tell me whether quality of care performance indicators are used just as rigorously as financial performance indicators?
Yes, we need a way of reporting serious care and patient safety issues that occured over the last 5 to 7 years. There have been recent improvements but over the the longer period, the care at Essex Rivers (Colchester) was rock bottom and people were seriously harmed. I will present a written submission outlining my concerns once we know who to write to.
Good. My father was in Basildon & Thurrock Hospital in 2006. He was 85 & died there after a week. He was always frightened of dying alone but I got there just too late. The care that week was poor from nursing staff who did not understand English well. He tried to communicate his concerns but could not speak well with a very dry mouth. On one occassion the flourescent ceiling light was too strong in his eyes & he was told nothing could be done about it. He & we knew he was dying but the night staff rang my brother who lived near Bristol when the nurse thought he had already died instead of ringing me earlier at my father’s address in the area. Complete lack of understanding & a waste of our time explaining the situation to them. I really wish I had not left him that evening.
I was initially very pleased to read that Tameside hospital would be investigated in order to uncover problems similar to those which bedevilled Stafford.
My father died there in 2009 after a disastrous misdiagnosis and treatment. The hospital displayed many of the same problems revealed at Staffordshire. The hospital in 2008 and 2009 was unfit for purpose on many levels.
The more I read of this investigation however, the more disappointed I am.
I am shocked the investigation is not going to be independent. I have little faith the NHS is willing to acknowledge its failings see no reasons why an internal investigation of these five hospitals with a narrowly drawn frame of reference and short time window will do anything other than conceal the problems.
Once I heard that 5 more hospitals were to be investigated after South Staffs I was pretty sure that Colchester would be among them. Once the terms of reference for the Professor’s investigation are published I would like to see an on-line form on this website asking for relevant information from concerned citizens. I believe that it will be necessary to consider information arising from the past 5 to 7 years to get a proper view of the situation, not just over 2 years.
I read an article on this subject with posts from family members of patients and one in particular struck me. Someone that complained said that it was common for the complaints procedure to muddy the waters with such things as….no witness and lost records both of which were relevant to my experience. If this is common place it needs to be highlighted.
I am pleased to see that Walsall NHS Trust are to be investigated. My Mum was on several wards in 2011-2012 and there were notable inconsistencies in the care she received depending on which ward she was on. Whilst the care on the better wards was excellent the cause for concern on the poorer wards were in the areas of lack of compassion, leaving meal trays out of reach at the bottom of the bed and insufficient staff to help feed the patients. Also the staff seemed to be attached to the nurses stations for too long and there was a culture of bullying.
My Dad died in Colchester hospital in July 2010. He was only 68. Some of his care was very good but at other times it was shocking. I am concerned about some of the care he received and I have often wondered would it have been better if he hadn’t been admitted at a weekend – could he still be here?
Good its about time Basildon & Thurrock were investigated and held to account for all the misery they have caused patients and their families.
I was in and out of Basildon Hospital between 2010 – 2011. I made a complaint about several areas of serious concern. The weekend issue as raised by AW was highlighted within my complaint along with areas of gross professional misconduct. I was too ill to take the matter further at the time yet I felt I was up against a machine set up to conceal the full truth. I was subject to shocking levels of care and I am not surprised that people have died due to the low standards. Eventually I took control of my environment, medication and treatment as I had lost trust in those that we’re supposed to do this.