'Special Measures' Hospital Fails To Improve Care
A NHS Trust in Nottinghamshire has been rated inadequate by inspectors, more than two years after it was put on special measures due to concerns about high death rates and poor standards of care.
The inspection took place at Sherwood Forest Hospitals NHS Foundation Trust in June 2014. Death rates among patients diagnosed with septicaemia at the trust (32%) were almost double that of the national average across the NHS (17%). It was also found that basic lifesaving equipment was missing from resuscitation bays, prompting the Care Quality Commission to state in their inspection report that there are "extremely concerning" safety risks to patients at the Trust.
Sherwood Forest Hospitals NHS Foundation Trust was one of 11 trusts in England who were placed under the 'special measures' regime, which was created under the Coalition in July 2013 in an attempt to ensure that failings in hospitals were identified and services were subsequently improved. The Trust provides services for people across northern Nottinghamshire, in addition to parts of Derbyshire and Lincolnshire.
The Trust's 'special measures' action plan had contained 18 'high importance' action points to be completed by March 2015. At the time of inspection in June 2014 however, only one of these action points had been completed, with several of the other action points still in progress.
The Trust had previously been warned in 2010 to tackle the high mortality rates caused by blood poisoning. Their failure to address this issue was noted as a particular concern of the Care Quality Commission. Tragically, the report suggested that there had been 88 deaths as a result of septicaemia in the last 10 months alone at the Trust.
In addition to the worryingly high death rates at the Trust, inspectors also found that there were large shortages of nurses, with locum doctors often bridging the gap of nurses rather than permanent staff. This no doubt has contributed to the poor standards of care noted in the inspection findings.
The chief inspector of hospitals, Professor Sir Mike Richards, has said that he was so concerned about the Trust's performance and further decline despite the introduction of the "special measures" regime, that he has now written to the Health Secretary, Jeremy Hunt.
Professor Richards said that inspectors had "found a number of serious problems" since the inspection in 2014, and the findings of the report showed a "noticeable decline" in the services offered by the Trust since the 'special measures' regime had been introduced. He was also concerned with the report's findings that just 17% of patients treated by the Trust for sepsis "received care and treatment in accordance with national guidelines".
Frances Shattock, Regional Director at Monitor, the government department tasked with assessing the quality of care at NHS hospitals, said that the findings of the inspection were "deeply disappointing" and that "a number of interim appointments" had been made at the Trust in an attempt to bring urgent and necessary changes to the way in which the trust operates.
Jamie Green, Trainee Legal Executive at Fieldfisher, said: "This is very disturbing news and brings in to question the usefulness of the 'special measures' regime introduced in July 2013. It is imperative that the Trust is now provided with the best possible assistance the NHS can provide in order to bring about the drastic changes that have long been required at the Trust. It is unacceptable that there is a significant shortage in the number of nurses working at the Trust. The introduction of locum doctors to address this shortage is not beneficial to patients in regards to the continuity of the care provided to them. It also makes it more difficult for the Trust to ensure that they consistently provide the best possible care to their patients because of the high turnover of staff. I hope that the right steps are now taken to address the Trust's failings and provide patients with a safe and efficient service that they can feel proud of".
By Jamie Green, Trainee Legal Executive