Five hospital trusts with persistently high death rates are facing investigation tonight after a damning report into Mid-Staffordshire NHS Foundation Trust raised fears that basic clinical failings could be putting patients at risk across the NHS.
The inspections were announced by David Cameron in the wake of the excoriating report into the catastrophic failings at the trust which led the unnecessary deaths of up to 1,200 patients.
The Health Secretary, Jeremy Hunt, described the Mid Staffs scandal yesterday as “the most shocking betrayal of NHS founding values in its history”.
Ministers are concerned that the five trusts, all of which have higher-than-expected death rates, could have similar underlying problems.
The hospitals in Colchester, Tameside, Blackpool, Basildon and Lancashire will all face detailed inspections led by the Medical Director of the NHS, Sir Bruce Keogh, over the next three months. Department of Health sources suggested that other hospitals could also face inspections as part of a new “zero-tolerance” approach to poor care.
The announcement was made as Mr Cameron responded to the publication of the Francis report which chronicled the appalling neglect of patients at Stafford Hospital between 2005 and 2009.
In his report Robert Francis, QC, described how patients were left “unwashed, unfed and without water” while staff treated them and their relatives with “callous indifference”.
“There was a lack of care, compassion, humanity and leadership,” he said. “The most basic standards of care were not observed and fundamental rights to dignity were not respected.”
He detailed the systematic failings of the NHS to identify and deal with the problems “at every level” which he said had “betrayed” the trust of the public.
As a result Mr Cameron pledged new measures to combat poor care, including controversial plans to link the pay of nurses to performance and an overhaul of the professional bodies which hold doctors and nurses to account.
The Prime Minister said the report’s evidence of systemic failure means “we cannot say with confidence that failings of care are limited to one hospital”.
He also promised seriously to consider proposals in the Francis report for all medical staff to be made personally liable for care they provide to their patients, and face prosecution if they break a new statutory duty of “candour”.
But he disappointed groups representing the families of patients who died in Stafford Hospital by standing by the head of the NHS Sir David Nicholson – who was a senior health service manager for the area at the time. Last night they called on him to resign.
The inquiry was set up to assess the wider lessons to be learnt by the NHS from the Staffordshire scandal. The report makes a total of 290 sweeping recommendations for healthcare regulators, providers and the Government. These include:
* A new register for healthcare support workers which would be able to “strike off” poorly performing staff.
* The creation of a new set of “fundamental standards” for care in the NHS which can easily be understood by staff, patients and the public. Any hospital that does not consistently maintain these standards should be shut down by regulators. Non-compliance with the standards leading to the “death or serious harm of a patient” should be prosecuted as a criminal offence.
* There should be a criminal offence for any registered doctor, nurse or health professional to mislead regulators. They would also have an obligation of “candour” to patients or families and be trained in compassion.
The Government is due formally to respond to the Francis report next month but Mr Cameron made clear that he expected the Government would endorse most of its findings.
But patient groups were angry that there have so far been no prosecutions or high-level resignations as a result of the scandal.
James Duff, whose wife Doreen died after receiving sub-standard care at Stafford Hospital, called on Sir David Nicholson to resign.
“Not one person has lost their job over this – instead they have been promoted and some people have been moved sideways,” he said. Sir David confirmed that he would not be standing down but said he was apologising again “to the people of Stafford for what happened”.
Other NHS organisations also pledged to improve in the wake of the scandal. The chief executive of the Care Quality Commission, David Behan, said it would look to implement plans for a new Chief Inspector of Hospitals.
Lyn Hill-Tout, of Mid Staffordshire NHS Foundation Trust, which runs Stafford Hospital, said they “still get things wrong” but added that “the culture and quality of care had improved since 2008”.
Scandals in waiting: The five trusts
* Colchester Hospital University NHS Foundation Trust (Colchester General Hospital and Essex County Hospital): “We take the mortality indicator extremely seriously” – Sean MacDonnell, medical director.
* Tameside Hospital NHS Foundation Trust (Tameside Hospital, near Manchester): “We look at all the factors throughout our community which influence this data” – Tariq Mahmood, medical director.
* Blackpool Teaching Hospitals NHS Foundation Trust (Blackpool Victoria Hospital plus two community hospitals): “We are committed to improving the outcomes for patients” – Mark O’Donnell, medical director.
* Basildon and Thurrock University Hospitals NHS Foundation Trust (Basildon Hospital and Orsett Hospital, Essex): “The trust is working hard to improve our performance” – a spokesperson.
* East Lancashire Hospitals NHS Trust (Royal Blackburn Hospital, Burnley General Hospital): “Clinicians review every patient death to see if anything could have been done differently” – Rineke Schram, medical director.