Saturday, November 28, 2009

More Hospitals as Dangerous as Basildon

In my Eastern Daily Press column today I wrote...
How is it possible for Basildon University Hospital to be rated “Good” on the very same day that it was established that dozens of people had needlessly died due to the filthy conditions on its wards. Blood was found spattered on curtains and chairs in the A&E ward, patients were not being fed properly and patients were being treated on trollies. Mortality rates were a third higher than comparable hospitals. It is clear that the entire management of the hospital needs to be replaced quickly. But what it also shows is that hospital ratings are worth nothing. If Basildon is rated ‘Good’ be very worried about hospitals which are only rated ‘Satisfactory’.
Today we had news that the Chairman of the Colchester PCT has been sacked after serious deficiencies were found in the area's general hospital. Tonight The Observer has revealed findings of a Doctor Foster's hospital report, which shows that 18 hospitals have equivalent or higher death rates than Basildon and 39% fail to investiagte causes of death properly. Assuming one can trust the results of this survey, this is all deeply worrying for everyone.

But one thing is clear. All this is the result of the tick box mentality which Labour has instilled into NHS managers. As long as boxes are ticked, a hospital can be classified as 'good', even if standards of cleanliness and patient care leave a lot to be desired.


Anonymous said...

I may be off beat here, but surely we need to know how all the hospitals stack up

Then we can ensure that the "leak" isn't just sleight of hand

When Alan Johnson was in charge he said he wouldn't resign for Staffordshire, so will a minister now resign for being in charge of all these failures?

True Belle said...

I wonder whether highly paid consultants ,junior doctors physios, xray technicians, nursing sisters, bloodletters, visitors, ambulance crew and anyone else who daily walks through A+E and intensive care and else where had SUNGLASSES ON or ROSY TINTS or a GUIDE DOG even.

Did they all just walk by and ignore the filth and squalor? HOW could they?

WE should all sniff around our hospitals as 'friends' of, and forget about the so called Angels of mercy. I think they are all hung over uncaring slatterns nowadays.

We will be hearing more stories like these of that I am certain.

Martin S said...

They box tick:

Does the trust have a Diversity Education Policy? (Check)

Does the trust have a verifiable Energy Action Plan? (Check)

Does the trust have a Racial Harassment Attitude Awareness Plan? (Check)

And so forth.

Therefore the hospital trust looks good on paper. However, the following questions might not be asked:

"Is the CEO a bullying little ****?"

Is the hospital a filthy ****hole?

Does anyone have responsibility for ensuring seriously ill patients who can't feed themselves don't starve to death?

Anonymous said...

Bad management and lack of interest by staff mya be a problems with Basildon.

However - there is something else to consider. What is the level of funding?

We hear lots of stories about loadsamoney being thrown at the NHS - but I know as a matter of fact that my own local trust has had tens of millions cut from its budget, year on year such that it seems to me no manager could stop it going well in to the red and still treat patients. Its likely to face further cuts from Labour this year.

Could it be that the 2 new seats created out of Basildon are considered not to be marginal? We do know where the real motives lie with Labours health spending.

Magical_Mist said...

Privatise the NHS...

True Belle said...

I reckon that Agency nursing staff and lousy management are the main cause of all the NhS woes.

Of course nursing bods will stick to using agencies, they get more pay, and the hospital has to pay through the nose.

Hospital need proper contracts for their staff,agencies are a holding hospitals to ransom.

Staff moving from one hospital to another create cross infection probs. We can't have that, can we?

Staff moving backwards and forwards from Medical to surgical will also spread bugs.

Hospital managers have created their own safe little niches. They need shaking up .

Poor old NHS , running on empty always, it is an attitude that has festered for years. A bottomless pit for account pilferers!

Charles said...


My understanding was that the "Good" rating was from a planned visit while the recent report followed a surprise visit post complaints.

Doesn't make it right - just that if you set people criteria they will cheat to meet them

Bill Quango MP said...

Labour's strategy on everything from crime to education to health to defence.

A-tick is the best form of defence

JuliaM said...

"When Alan Johnson was in charge he said he wouldn't resign for Staffordshire, so will a minister now resign for being in charge of all these failures?"

Hmmm, that's a tricky one.

I'm going with 'No'...

Anonymous said...

"strongholdbarricades will a minister now resign for being in charge of all these failures?"

You have got to be joking !!!

Philipa said...

Excellent post, Iain.

In answer to 'True Belle' who wonders why the staff don't do anything it's because it's not their responsibility and no-one takes any notice of their opinion outside their scope of responsibility.

John Woolman said...

Where are the Coroners?

howard thomas said...

The problem ,no doubt, is the 'system' which allows the existance of highly paid layers of management that actually don't have a clue about what is happening at the sharp end. These are the people who tick the boxes, but have no idea how to manage and how to achieve improvements.
A good start would be to cull large areas of highly paid upper and middle management and replace them with much smaller numbers of people who know what the jobs of nurse/cleaners etc really entail. these people would need to be on the 'shopfloor' and not hidden away in an isolated office. Such people need not be paid silly amounts of money (to get the right people) but must have the right sort of attitude that actually deals with the problem rather than ignoring it as is the case right now.
Inspections of hospitals should occur randomly and without warning which would ensure the need to keep the place clean and efficient at all times.

AndrewSouthLondon said...

Level of funding is for the population on a supposedly equitable (needs adjusted capitation formula) basis across England and Wales. The formula is skewed to "overfund" areas with high density population, equating to labour strongholds, and underfund southern healthy middle class areas, but pass on that.So there is "enough" money in the pot in Essex as anywhere.

Hospitals don't have "tens of millions cut from their budget". They overspend their budget by tens of millions, and they called to order to stay within their budget. Been reading to much NHS propaganda.

The bigger question is where were the Primary Care Trusts who fund (ie pay for) the care provided for the population of Essex by these hospitals? They are responsible yet the poor sods trying to run the hospital get sacked every time, while the PCT's swank about doing sod all claiming to know nothing. Why is the PCT Director of Acute Care Commissioning still in a job?.

The public level is misinformation about how things work and who does what and who is responsible for what is continuingly extraordinary. The purchasers/ commissioners of acute hospital care have been here a decade and no-one seems to know they exist.Very convenient for politicians to whip up anger about "hospital bosses"

If you dig deep into what the Essex PCT's have done with the money it is probable they have pissed away a lot of it to please their friends the GP's and cheated the hospitals by not paying for all the care delivered.

The financial recovery plans to get the hospitals to balance their books usually involve a lot of vacancy freezes and measures to tighten spending on drugs. They bend over backwards not to affect clinical services, which is why very often the plans acheive very little, and the hospitals sink futher into the red.

Then they fire the Chief Executive. Again.

Good game this NHS isn't it?

Houdini said...

13 people...fathers, mothers, sons, daughters, brothers sisters or whatever, are dead. These are real people with real stories and are in reality being sorely missed and grieved over.

Where is their story and who will be held to account in the modern NHS?

That is the real scandal and why it will never change until that is addressed.

Blair started it with his call not to concentrate on the bad but the masses of good.

Complacency kills and this needs to be addressed, and people held to account. In the private sector this would be classed as mass murder, but in the NHS it is ignored and at worst people are shoved aside or sacked with massive pay-offs.

Sceptical Steve said...

On the subject of NHS funding, I remember the headlines here in Wakefield that the local hospital was going to be replaced at a cost of over £400 million. The local newspaper headlines approved of this, but no-one seemed to question why a hospital should cost this much to build. It's a bit like military equipment spending - the numbers are huge yet no-one seems confident enough to challenge the orthodoxy.

The hospital, like all others, will be staffed by highly qualified health professionals. However, in the various failed hospitals,none of these professionals seems to have seen the blood on the floor, dirty equipment etc. We hear about a culture of bullying within the individual hospitals, but, ultimately, staff should be able to whistle-blow through their professional bodies. The fact that this has not happened would seem to suggest that the RCS/BMC/RCN etc. have gone native, and are now more interested in maintaining the status quo.

In answer to John Woolman's query as to the absence the any action from the coroners, surely if the medics sign a death off as "Natural Causes", the coroner doesn't get a look-in?

Nurse Anne said...

My hospital is one of the failing ones I think.

We haven't been allowed to use agency nurses for years.

What they do use are unlicensed assistive personal...they hire them instead of hiring nurses. These people are sometimes agency but they are not at all a nurse.

Even with unlicensed assistive personnel (UAP) the staffing of a 25 bed general ward will have only maybe 2 RN's and 2 UAP's on duty for 12 hours. That is the entire ward staff. Not only are most of the patients requiring one to one care but they are so much more acute these days that the 2 RN's are 100% tied up with drugs/IV's, assessments, chasing equipment to give that potassium infusion, trying to find a doctor to review critical blood results that need immediate intervention etc etc.

The money never ever seems to hit the shop floor. The trained nurse to patient ratios are ridiculous. I've worked all over the world and I have never seen anything like the lack of trained nurses on NHS wards.

But they come up with one expensive worthless scheme after another rather than using common sense.

Victor, NW Kent said...

Shortage of funds is a lame excuse for filth. Florence Nightingale preached about cleanliness in hospitals 150 years ago - one might assume that the truth might have sunk in in that time.

Much stems from the practice of privatisation of hospital cleaning. Once profit is the sole motive then penny-saving becomes paramount.

The reduction in the number of hospital beds under Labour is also a contributor. Staff have to deal with hot-bedding where a new patient is bedded within 30 minutes of the discharge of the previous occupant.

Having been a frequent visitor to hospitals whilst my wife was in them I saw, on all occasions, a central desk crammed full of staff peering at computers, reading files or chatting. Nurses, sisters, call them what you will are no longer stationed at a desk in a ward. They visit.

Unknown said...

It is a sad statistical fact that half of all hospitals are worse than average, and 10 of them are the worst 10. Just don't try and rate them all as good! OFSTED anyone?

Nurse Anne said...

Few of those staff members would have been nurses Victor, but even so, the few nurses are going to have to spend a hell of a lot of time at the pc.

Your HB shoes that you are anemic and need a blood transfusion? I have to make multiple calls to get the blood ordered by a doc and then make multiple orders via the PC to actually get the blood. Haematology also has many flaming hoops for me to jump through via paperwork and pc before they will even let me have the blood. If your transfusion gets delayed because I am cleaning rather than doing the 70 things I need to do in order to get your blood I am in big trouble. Especially if you crash.

You are in a hypertensive crisis and need an anti-hypertensive stat? Got to phone the doc, send orders to pharmacy via phone and computer etc etc to get you that med. If I decide not to do it and answer all the call lights instead you may very well stroke out before you get your drug. Remember that I will be the only RN on duty.

You potassium is tanking and that means your heart is going to stop if you don't get some prescribed and infused. Back to the nurses station again to notify the doctor that he has a patient with critical lab values, then he gives 3 pages of orders that have to be documented 3 different places. Have to use the PC to actually get the potassium as well as order the IV pump to infuse the stuff. Pharmacy and equipment supply won't play ball until I have filled in a ton of paperwork, faxed it and computer documented the three pages of orders. There is someone crying for a commode but if I go and get it for her that only delays you getting your potassium and if you die I am in deep shit.

Oopsie I wasn't watching your telemetry constantly and titrating your cardiac meds because I was helping the care assistants bedbath and I sure don't want them to think I am too posh to wash. Oopsie now you're dead. It's not like there will be another RN around to watch it and we don't have ward doctors anymore.

Now remember that there is one RN for 15+ patients getting slammed with this stuff constantly with no let up at all..during mealtimes, during visitings etc.

Unsworth said...

@ True Belle

"Did they all just walk by and ignore the filth and squalor? HOW could they?"

Well that's what you get when you micromanage from a Whitehall office. You issue instructions which are ill-considered and impossible to oversee, and everyone says 'it's not in my job description'.

It's simple enough, take away all these cretinous 'rules' and 'guidance' and reinstate personal responsibility and authority to act. In other words - delegate properly

Unsworth said...

@ Nurse Anne

Damn right! Well said.

Twig said...

Years ago you could smell the disinfectant a mile away before you even got to the hospital, the nurses wore nurses uniforms instead of cleaners overalls and they looked immaculate and the doctors spoke fluent English.

Happy days.

WV: heala