BASILDON and Thurrock University Hospitals Foundation Trust has been told to take “urgent action” on clinical staffing levels following Sir Bruce Keogh’s mortality rates review reports the Nursing Times.
The NHS England medical director’s review, published today, highlighted a number of areas which required urgent actionwhich also included patient complaints and bed management.
The review team’s individual report on the trust said: “The systems for bed management and patient flows need to be urgently reviewed and improved.
“The board needs to urgently review and understand what their patients’ views are and address key complaints themes.”
The trust would be re-inspected in October and it was likely this would be a targeted one day site visit to the trust reviewing key areas, it added.
Keogh Report said: Inspectors found patients were forced to stay up to two weeks in temporary areas without even shower facilities. Others were left in ambulances “stacked” outside A&E as the hospital failed to cope with demand. Patients were repeatedly moved during an in-patient stay.
The report said temporary areas being used for patients were not fit for purpose. Inspectors said: “For example there were no showers for in-patients in AMU [Acute Medical Unit] where patients were staying for periods of up to 14 days.”
Staffing levels were not sufficient, with one nurse left caring for 10 patients at a time during a night shift, and patients waiting for 14 hours in casualty.
The report said the trust had been too focused on financial targets and now needed to focus on safety, and improving its bed management, patient flows, infection control and to review staffing levels for nursing and medical staff.
The patients: Terry Day died 20 days before his planned marriage to Samantha Blythe following what an inquest described as “very serious failings” in care at Basildon Hospital.
The 35-year-old insurance worker had been diagnosed with a low-grade brain tumour in July 2010. But when he was admitted to A&E in August the following year staff failed to take the condition into account and treat him appropriately. No neurological assessments were carried out and his airways were not checked. When his tumour haemorrhaged, Mr Day went into cardiac arrest, suffering brain damage.
The manager: Basildon hospital’s former chief executive, Alan Whittle, 57, received a £72,000 pay-off as “compensation for loss of office” when he left the trust in September 2012 after initially resisting repeated calls to quit. The figure came on top of his £150,000 salary, which he received between April and September 2012, and an additional £30,000 “cash”, which is tax free. Mr Whittle also left with a pension pot worth £1.7 million.
Clare Panniker, Chief Executive, said: “We welcome the feedback from the Keogh report. While it recognises a significant transformation programme is already underway here, we take very seriously the areas identified as needing urgent and further action and are addressing them as a priority. We welcome the support we will receive from an external team and the partnership with another NHS organisation.”
Actions advised by the review include:
The need to develop and communicate a single, prioritised action plan which outlines all the Trust’s improvement work. This has been developed and has been shared with staff and stakeholders.
The need to improve the management of beds and patient flows across the hospital. An additional £4.5million is being invested to open 67 new beds across the Trust by November 2013 and a new patient administration system is being rolled out.
A review of current staffing levels to improve quality and safety of care. The Trust is investing £1.8 million to employ approximately 200 additional nursing staff in 2013/14 with a recruitment drive underway.
Better listening and understanding of patients’ views and complaint themes. The Trust has appointed a new patient experience lead and each month a complainant will speak at a Trust board meeting.
The need to improve infection control practice.
Ian Luder, Chairman of the Trust, said: “We are absolutely committed to ensuring that we learn from the Keogh process, and to delivering long term solutions to issues and not short term quick fixes.
“We will concentrate on engaging with our staff and making sure that every patient has a positive experience. The Board is committed to ensuring our hospitals provide high quality and safe care.”