A damning report into one of Britain's leading children's hospital revealed a catalogue of serious failings today.
Patients at Birmingham Children's Hospital (BCH) experienced delays in treatment, substandard care and youngsters being redirected to other services, according to the Healthcare Commission report.
The investigation also found some complex neurosurgery had been carried out without the relevant trained nurses.
The BCH NHS Foundation Trust was also criticised for its shortage of beds, equipment and access to operating theatres, and an "ineffective" partnership with the University Hospital Birmingham (UBH).
The Commission's report was ordered by Health Secretary Alan Johnson after concerns raised by consultants appeared in the Observer newspaper in November.
It is the second this week to criticise healthcare standards.
A review of Mid Staffordshire NHS Foundation Trust - where some patients drank water from vases because they were so thirsty - found deficiencies at "virtually every stage".
The failings included inadequately trained staff who were too few in number, junior doctors left alone in charge at night and dirty wards.
In its report, the Healthcare Commission said there was no apparent risk of actual harm to patients in the conditions described by families at Mid Staffordshire, but it added the Trust had been slow to respond to safety concerns and called for action to address its shortcomings.
Anna Walker, the Commission's chief executive, said: "While we have no evidence of serious incidents causing harm to patients, the standard of care has not been as good as it should have been in some cases. The response to safety concerns has been slower than ideal.
"While I would not say there were 'third world' conditions, there were serious potential risks in the way care was provided.
"Following the Trust's recent actions, we are reassured that there are no immediate safety concerns but there must be no delay in resolving the issues we have highlighted."
The BCH said it welcomed the report, but also paid tribute to staff, who it said had been "victims of our own success".
Sarah-Jane Marsh, BCH interim chief executive, said: "The quality of care for our young patients is our top priority.
"In some ways, we have been victims of our own success - as our services have grown ever more popular we have been faced with the challenge of meeting that demand and have been carrying out a great deal of work to make sure we do.
"We listened very carefully to those who gave us suggestions for improvements and now welcome the Healthcare Commission's report, which reinforces our improvement agenda, whilst also confirming that there is no evidence of serious incidents causing harm to patients."
Mr Johnson said: "I welcome this report and would like to thank the Healthcare Commission for producing it so quickly.
"(It) states very clearly there is no evidence of any serious incidents that caused harm to children.
"Nevertheless, it still highlights concerns about some specialist services that should never have happened.
"The Trust already had an action plan in place before I asked the Healthcare Commission to intervene, but I am now reassured that care is safe and that the Healthcare Commission, alongside the incoming Care Quality Commission and Monitor, will closely monitor the swift implementation of all of the report's recommendations."
Monitor, the independent NHS trust regulator, said it would work with the Healthcare Commission to ensure its recommendations were implemented and that it had instructed both trusts to work together.
Executive chairman Bill Moyes, said: "There are three priority areas requiring attention.
"The first is to ensure that Birmingham Children's Hospital address all the issues relating to the quality of care raised in the Healthcare Commission's report.
"The second is for University Hospitals Birmingham and Birmingham Children's Hospital to agree on, with their commissioners, and implement a plan that will deliver high quality services for children in the future. And the third, to demonstrate improved cooperation and communication.
"The Healthcare Commission's investigation confirmed that poor communication and ineffective joint working arrangements have been an important factor in the problems that gave rise to the investigation.
"We are taking each of the issues raised very seriously and have taken action to ensure that the two trusts resolve them as a matter of urgency."Reuse content