More ‘Mid-Staffs scandals’ will happen unless changes are made, warns charity

Ministers are warned not to back away from full implementation of Francis Inquiry findings

The NHS is at risk of further scandals similar to that at Mid-Staffordshire unless the Government fully implements the recommendations of the Francis Inquiry which is due to report next week, a national patient safety charity said today.

There are already signs of ministers backing away from changes that the report is expected to recommend, including minimum staffing levels for hospital wards and a legal duty of candour on medical staff, said Peter Walsh, chief executive of the Action against Medical Accidents.

Hundreds of patients died as a result of neglect and poor care at Stafford hospital while managers focused on meeting financial targets in what proved to be a historic example of professional and regulatory failure for the NHS.

In an open letter to Health Secretary Jeremy Hunt, Mr Walsh wrote: “Patient safety should be the primary concern in any reform of the NHS. Unfortunately we now see ‘perfect storm’ conditions for further ‘Staffords’ to happen with not only pressure on resources but increased demand, fragmentation, low morale and chaos brought about by the reorganisation.”

Mr Walsh said shortage of staff, especially nurses, had been a key issue in the inquiry blamed for poor care. In his summing-up, Tom Kark, QC for the inquiry, said: “We submit that because poor care has been shown to be so closely related to low numbers of qualified staff, this is something the CQC [the NHS regulator] should specifically address and guidance may help that exercise.”

Mr Walsh said: “That is a pretty clear sign of where the inquiry is going, But there have been many statements [from ministers] suggesting the Government do not agree with setting minimum standards for staffing.”

Giving patients a stronger voice, improving the complaints system and tightening regulation were essential even if it meant a U-turn on some policies, Mr Walsh said.

In a separate move, the British Medical Journal published an investigation into how the Mid-Staffordshire Trust missed a clear signal of the unfolding scandal in rapidly rising death rates.

It has been alleged that NHS managers deliberately engineered what the inquiry chairman, Robert Francis, called the “academic rubbishing” of the death rate figures by experts known to be sceptical of their value.

But the investigation by Nigel Hawkes found the explanation was as likely to be cock-up as conspiracy. “The old NHS had ingenious ways of burnishing its outcomes and concealing its failings.

Even death, the most unambiguous outcome of all, lost its sting when changes in coding practice resulted in many deaths being excluded from the calculation of hospital mortality ratios,” he said.

A Department of Health spokesperson said: “Whilst failings in care at Mid Staffordshire NHS Foundation Trust have shocked many, we cannot say with confidence that some of those failings do not exist in pockets elsewhere in the NHS and social care system.

“Putting in place proper structures and safeguards that support the right culture and leadership to sort this out is a major priority for the Health Secretary. The Inquiry took evidence from a large number of witnesses and considered over a million pages of evidence. We will carefully consider all of its recommendations but we will not pre-empt its findings.”

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