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Experienced teams of doctors, nurses and patient representatives are set to make their first visits to hospitals as part of the Keogh Review.
Led by Regional Medical and Nursing Directors of NHS England, review teams will visit the 14 Trusts whose mortality ratios have shown higher-than-expected rates for the past two years. Site visits for the first four hospital Trusts will commence between 7 and 9 May.
A further six hospitals will receive visits over the following four weeks, while the final four will be visited in mid-June. During the visits, each expected to last 2-3 days, teams will carry out “rapid responsive reviews”, observing the hospital in action, as well as taking part in meetings with patients, members of the public, and staff. These visits will be followed up with unannounced visits.
The review, led by former heart surgeon and now Medical Director of NHS England, Professor Sir Bruce Keogh, seeks to find out whether there are any sustained failings in the quality of care and treatment being provided to patients at these Trusts. It will identify:
- Whether existing action by these Trusts to improve quality is adequate and whether any additional steps should be taken
- Any additional external support that should be made available to these Trusts to help them improve
- Any areas that may require regulatory action in order to protect patients.
Prof Keogh said: “I am determined that these reviews should be about identifying solutions to any problems that may exist. I am interested in not just providing a diagnosis, but helping to write the prescription and provide support to these hospitals to help them improve.
“A higher than expected mortality rate does not in itself tell us that a hospital is unsafe. For example, units delivering highly complex and specialist care could legitimately have higher mortality rates. It is, however, a warning light that suggests further investigation is necessary.
“It is important that the mortality data warning light – which went unheeded at Mid-Staffordshire Hospitals – is checked in future. That is what this review is all about, and the lessons of Mid-Staffordshire will inform all of the NHS’s new ways of monitoring hospitals.”
Since the review was announced, a vast array of hard data and soft intelligence held by different organisations across the NHS has been collated to build up a picture of quality across the 14 Trusts. This information, on clinical effectiveness, patient experience and patient safety as well as clinical governance arrangements, is being analysed in order to develop key lines of inquiry to support the rapid responsive review teams in targeting their investigations . Information packs including data for each Trust will be made publicly-available online.
Following the visits, the statutory organisations responsible for commissioning, regulating and performance managing the 14 hospitals will hold Risk Summits for each of the 14 hospitals. These Risk Summits, informed by the reports from the Rapid Responsive Review teams, will consider and agree what additional action may be needed to support further improvement or, if necessary, to protect patients. A report following each Risk Summit will also be made publicly available.
Any review team that identifies any serious concerns about the quality of care and treatment, that it believes requires rapid action or intervention, will immediately notify the chief executive of the hospital trust and the relevant regulator(s).
Prof Keogh, who was asked by the Prime Minister to lead the review, following the publication of the Francis Report into catastrophic failures at Mid-Staffordshire Hospitals, said the review visits would add an extra layer of assurance for patients and staff at the 14 Trusts, over and above existing regulatory frameworks and safety alert procedures.
He said: “Right across England, a new network of Quality Surveillance Groups is now operational, providing additional scrutiny of NHS-funded services and helping to detect problems at an early stage. The lessons learned from this review will also help to inform the soon to be established role of Chief Inspector of Hospitals.”
Prof Keogh is personally leading, and accountable for, the review, with administrative and organisational support from NHS England.
Information packs for each hospital Trust’s review will be published in due course, highlighting specific areas that the review teams will investigate.