- Hospitals failing care standards inspections in last year reach one-in-five
- Hospitals operating below safe staffing levels in same period hit more than one-in-six
- Health Secretary told to take urgent action on staffing levels
Reports disclosed to Labour by the official care standards regulator in England suggests a sharp decline in standards in England’s hospitals over the last 12 months.
In the last year, inspectors observed examples of unacceptably poor care at one in five hospitals. By March this year, the care regulator listed 45 hospitals not providing safe care following 215 inspections – close to three times the 16 hospitals failing on this measure in the same month in 2013.
In the same period, Care Quality Commission inspectors found 32 hospitals without adequate numbers of staff – more than one in six - after inspecting 175, up from 14 only a year earlier.
The inspectors’ official reports catalogue the failings witnessed, including:
- a trebling of bed sores put down to under-staffing;
- patients on the wrong wards not visited by doctors over the weekend;
- patients transferred from other hospitals without any medical notes;
- diabetic patient left without insulin;
- unstaffed ambulance triage area, leaving patients and paramedics waiting;
- unanswered call-bells;
- patient needing fall assessment every 48 hours not seen for 3 weeks;
- inexperienced A&E receptionist told patients with chest pains to take a seat, against hospital olicy on suspected heart attacks;
- patients at risk of malnutrition or dehydration not given assistance to eat and drink;
- backlog of X-rays and CT scans reports caused by lack of staff;
- an overreliance on locum and agency staff.
Andy Burnham MP, Labour’s Shadow Health Secretary, said:
“This provides indisputable proof that the NHS is heading seriously downhill on this Government’s watch.
“Hospitals across England are operating way beyond safe bed occupancy levels and without enough staff.
"It is simply not good enough for the Government to blame the NHS, as they always trying to do. Hospitals are having to pick up the pieces from their botched policies. Severe strains on general practice, mental health and social care are piling pressure on hospitals. There is a limit to what hospitals can safely do and these reports show that many have now reached and even gone beyond it.
"What we are now seeing are the consequences of David Cameron’s disastrous decision to destabilise the NHS with an unwanted and unnecessary re-organisation. Hospitals are struggling, NHS waiting lists are at a six-year high and it has got harder for millions to get a GP appointment.
"But, as the NHS in England goes downhill, Ministers have spent the last year pointing the finger at the NHS in Wales. Self-serving spin like that is of no use to patients. People will rightly ask: why wasn’t their attention focused where it should have been - on services in England?
“This explains why people have reached the conclusion the NHS is simply not safe in David Cameron’s hands. He must cut the spin and bring forward a credible plan to ensure hospitals are safe and properly staffed.”
Ends
Editor’s notes
1. Inspections by the Care Quality Commission judge hospitals against essential standards, including:
- Outcome 4: Care and welfare of people who use services – “People should get safe and appropriate care that meets their needs and supports their rights.”
- Outcome 13: Staffing – “There should be enough members of staff to keep people safe and meet their health and welfare needs.”
By March 2014, the 45 hospitals not compliant with Outcome 4 include:
The Royal London Hospital, Liverpool Women’s Hospital,The Princess Alexandra Hospital, The London Chest Hospital, King George Hospital, Birmingham Heartlands Hospital, Whipps Cross University Hospital, Queen’s Hospital, Good Hope Hospital, Newham General Hospital, Stamford & Rutland Hospital, The Royal Orthopaedic Hospital NHS Foundation Trust, Bradford Royal Infirmary, Peterborough City Hospital, Chase Farm Hospital, Kingston Hospital, University Hospital Lewisham, Southport & Formby District General Hospital, Dorset County Hospital, Croydon University Hospital, North Manchester General Hospital, Alder Hey Children’s NHS Foundation Trust, Kings Mill Hospital, Hull Royal Infirmary, The Queen Elizabeth Hospital, Derriford Hospital, Lincoln County Hospital, Wexham Park Hospital, The Royal Wolverhampton NHS Trust, Pilgrim Hospital, Heatherwood Hospital, Hereford Hospital, Watford General Hospital, Basildon University Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Dewsbury and District Hospital, Colchester General Hospital, Tameside General Hospital, Royal Sussex County Hospital, Royal Bournemouth Hospital, Cumberland Infirmary, Royal Preston Hospital, University Hospital Aintree, West Cumberland Hospital, The Princess Royal Hospital.
By March 2014, the 32 hospitals not compliant with Outcome 13 include:
The Royal London Hospital, Queen’s Hospital, The Princess Alexandra Hospital, St Bartholomew’s Hospital, Stamford & Rutland Hospital, Birmingham Heartlands Hospital, Bradford Royal Infirmary, St George’s Healthcare NHS Trust - Tooting site, Royal Lancaster Infirmary, Dorset County Hospital, Kings Mill Hospital, Southport & Formby District General Hospital, Alder Hey Children’s NHS Foundation Trust, Derriford Hospital, Lincoln County Hospital, Luton and Dunstable Hospital, Great Western Hospital, Pilgrim Hospital, The Queen Elizabeth Hospital, Royal Hampshire County Hospital, Watford General Hospital, Wexham Park Hospital, Cumberland Infirmary, Pinderfields Hospital, Milton Keynes Hospital, West Cumberland Hospital, Dewsbury and District Hospital, Liverpool Women’s Hospital, Kettering General Hospital NHS Foundation Trust, Royal Preston Hospital, King George Hospital, Northampton General Hospital
2. The Care Quality Commission revised its inspection model in 2014 for a number of inspections, yet two-thirds of the above failings were found with the existing system.
3. A sample of the official Care Quality Commission reports for hospitals named above reveal the failings witnessed by inspectors that caused hospitals to be considered non-compliant on essential standards.
Reports for all inspections can be found on the CQC website.
Bradford Royal Infirmary
An inspection in October 2013 found:
“We looked at the duty rota for nursing staff covering a four-week period. We noted that there were shortfalls in nursing staff every day. One week there were 18 shifts not covered by a registered nurse and nine shifts not covered by a healthcare assistant. All the nursing and medical staff we spoke with said that they did not think there were enough nursing staff to adequately care for people in the department.”
“There were two occasions during our inspection when the ambulance triage area was not staffed; one for ten minutes and one for 12 minutes. This meant that the two patients who arrived by ambulance had to wait longer to be triaged than they should have.”
Source: http://www.cqc.org.uk/directory/rae01
Dorset County Hospital
An inspection in June 2013 found:
“One patient who had been admitted late the previous evening had not had a thorough assessment of their needs. The patient, therefore had not received their medication for diabetes.
“Patients who had been deemed at risk of falls, pressure area damage and malnutrition’s needs had either not been assessed or not were assessed in the appropriate timeframe. For example, one patient had been identified as being at high risk of a fall was required to be reassessed within 48 hours, however the most recent assessment had been more than three weeks earlier.”
Source: http://www.cqc.org.uk/directory/rbd01
The Queen Elizabeth Hospital, King’s Lynn
An inspection in August 2013 found:
“Evidence from NHS England Rapid Responsive Review team found between December 2012 and March 2013, […] the incidence of reported pressure ulcers increased from 71 to 217 in the same year. This could denote there were insufficient staff to provide care to patients in order to minimise pressure ulcers from occurring.”
Source: http://www.cqc.org.uk/statement/13/315156
Wexham Park Hospital, Slough
An inspection in October 2013 found:
“While the standard of care on A&E was satisfactory, there were some staff practices which concerned us. A patient told us that on two occasions, after arriving at A&E with chest pains, they were asked by reception staff to have a seat in the waiting room and wait there to be seen by a doctor. These instructions were contrary to a sign at reception which indicated people attending reception with chest pains should be seen by a doctor immediately. The ward sister also told us the receptionist was new and had induction training but was not able to explain why the receptionist failed to follow the hospital’s policy.”
“Patients who were at risk of malnutrition or dehydration were not always given assistance to eat and drink.”
Source: http://www.cqc.org.uk/node/315160
King George Hospital, Ilford
An inspection in October 2013 found:
“The accident and emergency department does not provide safe care all of the time. There is a lack of senior medical staff supported by middle and junior grade doctors, and an over-reliance on locum doctors.
“We could not be assured that patients always received safe and effective care on surgical wards, and medical wards. The completion of nursing documentation was inconsistent and if patients were transferred to King George Hospital there were no documented handovers.”
Kings Mill Hospital, Nottinghamshire
An inspection in June 2013 found:
“We looked at the care being provided for patients who were not on the appropriate specialty ward for their condition (outlying patients). It did not appear that there was a routine review of all outlying patients at weekends, with outliers only reviewed if specifically requested. This was different from all other medical wards where patients would be routinely reviewed at the weekends.”
“One patient said, “Staffing levels on here are abysmal, they are rushed off their feet all the time.” Another patient said, “At 10am I was still sitting in my nightie, all I needed was some help to get my wash things into the bathroom. There are not enough nurses to help you.” A patient’s relative said, “This morning my wife rang me in tears because she could not get any one to help her, they are so busy.”
“The trust had a significant backlog of x-rays and CT scans to be reported on. We were told that this issue had been caused by a lack of sufficient staff. The trust told us that there were plans in place to address this staffing issue.”