'Trapped in mediocrity': The damning verdict on the NHS as report reveals 14 hospitals had higher than expected mortality rates

Poor care, inadequate staffing and bad management behind deaths of patients at worst hospitals, says NHS chief

Dozens of hospitals across England may have the “ingredients” of poor care, over-stretched staff and substandard management that led to the deaths of hundreds of patients in Mid Staffordshire, the Medical Director of the NHS warned today.

In a damming report into 14 hospitals with the highest mortality rates in the country Sir Bruce Keogh found they had become “trapped in mediocrity” ignoring concerns raised by patients and staff.

As a result of the inquiry 11 of the 14 hospitals are to be placed in special measures and will be subject to intense on-going inspections.

But Sir Bruce warned many other hospitals could have similar – but as yet unidentified – problems and called for new, more accurate, tests to identify failing hospitals.

A member of Sir Bruce’s review panel went further suggesting that the 14 hospitals investigated were not necessarily even the worst in the country.

In the House of Commons the Health Secretary Jeremy Hunt attempted to blame the previous Labour Government for the problems identified in Sir Bruce’s report.

He accused Andy Burnham, the Shadow Health Secretary of ignoring warnings of poor standards of care when he was in office and of “muzzling” regulators.

He also claimed that the mortality rates at the 14 hospitals concerned suggested that since 2005 “thousands more people may have died than would normally be expected”.

But Sir Bruce rejected this, warning that any attempt to use statistical measures to “quantify actual numbers of avoidable deaths” was “clinically meaningless and academically reckless”.

He added that during his long career in the NHS he had never felt under any pressure to suppress instances of poor care.

“In the discussions that I’ve had with ministers from both political parties I’ve never been asked to be engage in anything which I would have thought was a cover-up,” he said.

But Mr Burnham said Mr Hunt's “partisan” comments were “not worthy" of the report and claimed he did not have a “shred of evidence”.

He said Government briefings to newspapers over the weekend saying that the hospitals had been responsible for 13,000 additional deaths were part of a "cynical spin operation".

As he spoke, many Labour MPs shouted “smear” at Mr Hunt.

Sir Bruce’s report, which was ordered with the aim of quickly identifying other failing hospitals in the wake of the revelations about Mid Staffordshire earlier this year, found broader, systemic problems affecting the health service – but not of a similar scale to Mid Staffordshire.

At all 14 of the hospitals, effective care was hindered because of inadequate numbers of nursing and other staff, the report found. There was an over-reliance on temporary and unregistered staff and in some cases ward staff had to work 12 days in a row.

Complaints, when they were made took too long to be addressed or even acknowledged, the report said. Staff often felt unable to share concerns about the pressure they were under with senior managers.

Many of the 14 hospitals also suffered from being in “isolated” parts of the country, where it was hard to attract talented managers and senior medical staff, and care practice remained “behind the curve”.

“There is a sense that some of these trusts which are quite small or operating over several sites are operating in clinical isolation,” Sir Bruce said.

“Some of this is geographical isolation – and this leads to difficulties recruiting. They are not seen as centres of clinical excellence where aspiring doctors and nurses want to work.”

He added that too often the concerns of junior doctors were ignored.

“We have 50,000 junior doctors in the NHS who I don’t believe are sufficiently plugged into quality improvement programmes,” he said.

“I don’t think organisations listen to them as much as they should. We need to rectify that. What other industry would relegate people between the ages of 20 to their late 30s to simply being the worker bees?”

Mr Hunt said that “swift and tough” action would be taken to improve the hospitals. Eleven out of the 14 trusts have been placed under special measures and will be closely monitored by regulators. All 14 trusts will be subject to further inspections by the new Chief Inspector of Hospitals, Sir Mike Richards, who begins work on Wednesday.

But Professor Nick Black, a member of the review’s national advisory group, told the BBC that the 14 hospitals investigated were not necessarily the 14 worst in the country and that other trusts could have similar or worse problems.

“I think there are trusts out there that might be just as deserving of special measures and special review that might be just as deserving as those that were in the review,” he said.

The Royal College of Nursing (RCN) backed up the report’s findings.

“There is an undeniable link between nurse staffing levels and patient mortality and we can’t keep failing to address this issue,” said Dr Peter Carter, RCN chief executive. “…of course where there are examples of individuals delivering poor care these must be challenged and people must be held to account, but today’s review paints a picture of endemic poor leadership.”

Sir Bruce Keogh’s report sets out eight “ambitions” for the wider NHS in light of findings at 14 of the worst-performing trusts for mortality rates

  1. Reduce avoidable deaths with early warning systems for deteriorating patients and introduce more accurate statistical measurement of mortality rates.
  2. Expertise and data on how to deliver high quality care to be more effectively shared between NHS trusts.
  3. Patients, carers and the public should be more involved, and should be able to give real-time feedback.
  4. Patients should have more confidence in the regulator the Care Quality Commission, with wider participation of patients, nurses, and junior doctors on review teams.
  5. Hospitals in remote areas should not be left isolated, with staff from better-performing hospitals used to train and inspect others.
  6. Nurse staffing levels and mix of skills should be appropriate to the patients being cared for on any given ward.
  7. Medical directors should “tap into the latent energy of junior doctors” and include them in review panels.
  8. NHS employers should make efforts to ensure staff are “happy and engaged”.
Suggested Topics
News
Kenny Ireland, pictured in 2010.
peopleActor, from House of Cards and Benidorm, was 68
News
A scene from the video shows students mock rioting
newsEnd-of-year leaver's YouTube film features staging of a playground gun massacre
Travel
travel
Environment
View from the Llanberis Track to the mountain lake Llyn
Du’r Arddu
environmentA large chunk of Mount Snowdon, in north Wales, is up for sale
PROMOTED VIDEO
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
Voices
A family sit and enjoy a quiet train journey
voicesForcing us to overhear dull phone conversations is an offensive act, says Simon Kelner
News
i100This Instagram photo does not prove Russian army is in Ukraine
Arts and Entertainment
The cast of The Big Bang Theory in a still from the show
tvBig Bang Theory filming delayed by contract dispute over actors' pay
News
Morrissey pictured in 2013
people
Arts and Entertainment
Sydney and Melbourne are locked in a row over giant milk crates
art
Life and Style
The director of Wall-E Andrew Stanton with Angus MacLane's Lego model
gadgetsDesign made in Pixar animator’s spare time could get retail release
News
peopleGuitarist, who played with Aerosmith, Lou Reed and Alice Cooper among others, was 71
Environment
Tyred out: should fair weather cyclists have a separate slow lane?
environmentFormer Labour minister demands 'pootling lanes' for women cyclists
News
people
Sport
England celebrate a wicket for Moeen Ali
sportMoeen Ali stars with five wickets as Cook's men level India series
News
Field of broken dreams: Andy Bell visits Passchendaele
news5 News's Andy Bell visited the killing fields of the Great War, and his ancestor - known only from his compelling war diary - came to life
Travel
travel
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    VB.Net Developer - £40k - Surrey - WANTED ASAP

    £35000 - £40000 per annum + competitive: Progressive Recruitment: .Mid Level V...

    Digitakl Business Analyst, Slough

    £40000 - £45000 per annum + Competitive Benefits: Progressive Recruitment: Dig...

    Mechanical Estimator: Nuclear Energy - Sellafield

    £40000 - £50000 per annum + Car, Medical, Fuel + More!: Progressive Recruitmen...

    Dynamics NAV Techno-Functional Consultant

    £50000 - £60000 per annum + benefits: Progressive Recruitment: An absolutely o...

    Day In a Page

    Dress the Gaza situation up all you like, but the truth hurts

    Robert Fisk on Gaza conflict

    Dress the situation up all you like, but the truth hurts
    Save the tiger: Tiger, tiger burning less brightly as numbers plummet

    Tiger, tiger burning less brightly

    When William Blake wrote his famous poem there were probably more than 100,000 tigers in the wild. These days they probably number around 3,200
    5 News's Andy Bell retraces his grandfather's steps on the First World War battlefields

    In my grandfather's footsteps

    5 News's political editor Andy Bell only knows his grandfather from the compelling diary he kept during WWI. But when he returned to the killing fields where Edwin Vaughan suffered so much, his ancestor came to life
    Lifestyle guru Martha Stewart reveals she has flying robot ... to take photos of her farm

    Martha Stewart has flying robot

    The lifestyle guru used the drone to get a bird's eye view her 153-acre farm in Bedford, New York
    Former Labour minister Meg Hillier has demanded 'pootling lanes' for women cyclists

    Do women cyclists need 'pootling lanes'?

    Simon Usborne (who's more of a hurtler) explains why winning the space race is key to happy riding
    A tale of two presidents: George W Bush downs his paintbrush to pen father’s life story

    A tale of two presidents

    George W Bush downs his paintbrush to pen father’s life story
    Save the tiger: The day America’s love of backyard tigers led to a horrific bloodbath

    The day America’s love of backyard tigers led to a horrific bloodbath

    With only six per cent of the US population of these amazing big cats held in zoos, the Zanesville incident in 2011 was inevitable
    Samuel Beckett's biographer reveals secrets of the writer's time as a French Resistance spy

    How Samuel Beckett became a French Resistance spy

    As this year's Samuel Beckett festival opens in Enniskillen, James Knowlson, recalls how the Irish writer risked his life for liberty and narrowly escaped capture by the Gestapo
    We will remember them: relatives still honour those who fought in the Great War

    We will remember them

    Relatives still honour those who fought in the Great War
    Star Wars Episode VII is being shot on film - and now Kodak is launching a last-ditch bid to keep celluloid alive

    Kodak's last-ditch bid to keep celluloid alive

    Director J J Abrams and a few digital refuseniks shoot movies on film. Simon Usborne wonders what the fuss is about
    Once stilted and melodramatic, Hollywood is giving acting in video games a makeover

    Acting in video games gets a makeover

    David Crookes meets two of the genre's most popular voices
    Could our smartphones soon be diagnosing diseases via Health Kit and Google Fit?

    Could smartphones soon be diagnosing diseases?

    Health Kit and Google Fit have been described as "the beginning of a health revolution"
    Ryanair has turned on the 'charm offensive' but can we learn to love the cut-price carrier again?

    Can we learn to love Ryanair again?

    Four recent travellers give their verdicts on the carrier's improved customer service
    Billionaire founder of Spanx launches range of jeans that offers

    Spanx launches range of jeans

    The jeans come in two styles, multiple cuts and three washes and will go on sale in the UK in October
    10 best over-ear headphones

    Aural pleasure: 10 best over-ear headphones

    Listen to your favourite tracks with this selection, offering everything from lambskin earmuffs to stainless steel