Worcestershire hospitals trust ordered to urgently improve patient safety

The NHS watchdog has ordered a troubled hospital trust to urgently overhaul patient safety or face sanctions weeks after two patients died after enduring long waits on trolleys in a corridor.

The Care Quality Commission has given Worcestershire Acute Hospitals Trust six weeks to make significant improvements at the three hospitals it runs in Worcester, Redditch and Kidderminster.

The regulator has served the trust with a section 29A notice, which sets out changes it must make by 10 March or risk penalties such as a special administrator being brought in to start running it.

Caragh Merrick, the trust’s chair, admitted to staff in an email after the CQC’s move that the trust had “lost sight of the basics [of caring for patients]. As staff we must all be held accountable for our actions,” she added.

Previous lapses means that from now action to improve patient safety will be taken from “the ward to the board” in an attempt to “guarantee consistent high professional standards”, said Merrick.

The trust was in the headlines recently when two patients died, reportedly on 1 and 3 January, in the A&E unit at the Worcestershire Royal hospital in Worcester when it was struggling to cope with the sheer number of patients needing care.

In one of the cases, a female patient on an emergency trolley in a corridor within A&E suffered an aneurysm and died later in a resuscitation bay. The second patient died after suffering a cardiac arrest on another A&E trolley within the department after waiting 35 hours for a ward bed elsewhere in the hospital.

The trust was put into special measures in December 2015 after CQC inspectors raised concerns about safety in its A&E, children’s care, and maternity and gynaecology services.

It was embroiled in another controversy last year when CQC staff found that 10,000 patients’ x-rays had not been assessed, which prompted concern that serious illnesses had been missed.

Worcestershire Royal hospital recently became so busy that it had to divert A&E patients to its sister Alexandra hospital in Redditch during the NHS “winter crisis”.

The trust is due to end 2016-17 with a deficit of £37.5m, down significantly on its £59m overspend in 2015-16.

A major consultation to shake up healthcare at the trust’s hospitals is under way.

Worcestershire’s three NHS clinical commissioning groups (CCGs) launched the consultation in January which, if the option proposed was picked, would move many planned operations to the Alexandra, but concentrate most emergency care at the main Worcester hospital.

More day-case and short-stay surgery would go to the county’s smaller Kidderminster hospital.

Worcestershire hospitals trust ordered to urgently improve patient safety

We want organ donor "opt-out" technique urgently | @guardianletters

7 years ago, the government ordered a review of the UK’s organ donation technique. Figures showed that the charge of demand for organs was far outstripping provide, major to hundreds of needless deaths each yr. The Organ Donation Taskforce identified that countries employing a presumed consent, or “opt out”, program had far increased donation rates. The United Kingdom was not in the prime 10. Tragically, absolutely nothing came of the evaluation. Given that then, seven,000 folks – such as kids – have died. With latest advances in science have come improved prospective, and demand, for transplantation. The gap is right now higher than ever.

In spite of laudable registration campaigns, the opt-in system can no longer be anticipated to fulfil its purpose. Organs are donated from just 1% of the numbers of deceased every single yr, although healthy organs from half a million folks are cremated or buried. As a consequence, currently being on the transplant waiting list has turn out to be a game of Russian roulette. For illustration, if you happen to be waiting for a liver, there is a twenty% chance that it will not reach you in time. For heart individuals, the figure is even increased. Youngsters struggling kidney failure are getting, in some circumstances, to wait for 5 perilous years.

In Wales, they are lastly moving forwards. Following a time period of careful public consultation and debate, an awareness-raising programme is underway ahead of the implementation of a new “opt out” technique subsequent yr. Individuals who object to organ donation can rest assured – as can their relatives – that their wishes will be respected below the new method.

For now, there are 7,000 people in the United kingdom – many younger young children amid them – waiting for a lifesaving transplant. Whilst we wait for the rest of the nation to catch up with the Welsh, we can at least make certain we are appropriately registered on the NHS’s donor database. For specifics, go to www.organdonation.nhs.united kingdom.
Ed Goncalves
Director, KidneyKids United kingdom

We want organ donor "opt-out" technique urgently | @guardianletters

The NHS urgently requirements robust leadership to avert a crisis

The NHS is trapped on a tightrope among cutting spending and keeping quality. Photograph: Stephen Hird/Reuters

The NHS is haemorrhaging its two most valuable sources – money and morale. So who is going to take the difficult choices to avoid a crisis subsequent 12 months?

In its latest monitoring report, the King’s Fund reveals that economic issues are seeping into every part of the technique – trusts, basis trusts and clinical commissioning groups are all sliding toward deficit in significant numbers.

1 in 5 trusts and one in eight clinical commissioning groups say they are at danger of overspending by the finish of this fiscal 12 months. Check has previously reported that an increasing variety of foundation trusts are running up deficits.

The developing fiscal worries revealed by the King’s Fund survey want to be seen towards a backdrop of possibly one more seven years of declining, actual-term NHS spending. Modest sums will no doubt be thrown at the technique from time to time with great fanfare, but that will do virtually nothing to ease the total trajectory.

The extraordinary achievement so far has been the maintenance and even improvement of clinical specifications in the encounter of these pressures. But with both cash and morale heading south, there is rising concern that 2015 will be the year that accelerating fiscal issues drag care top quality down with them.

The strongest indicator that the tightrope between cutting paying and sustaining high quality is wobbling badly, is the severe loss of workers morale all through the NHS. Despite the immediacy of the budget pressures, when the King’s Fund asked finance directors to identify their largest efficiency concern it was this issue, not A&ampE targets, therapy times or delayed transfers, that they most feared.

Although the best trusts work relentlessly to engage clinical staff in programmes of services improvement and modify, numerous clinicians truly feel disconnected from the selections currently being taken around them, and see little relevance to their every day function of the ceaseless output of programs, advice and targets from regulators and NHS England. They do not realize how the program functions, and really feel its presence more as an impediment to very good care than an ally in undertaking their very best for individuals. Too frequently it feels as if they are doing work for the patients, but against the NHS superstructure.

Meanwhile management teams, who have prolonged been undervalued and denigrated by ministers and are frequently struggling to program a viable potential for their organisation, are now severely depleted of employees. But the maze of oversight bodies – clinical commissioning groups (CCGs), neighborhood spot teams, regional teams (keep in mind them?), senates, networks and far more – struggle to provide clear choices on huge service changes that are vital to trusts and CCGs steering clear of economic crisis.

A lot of trusts are bogged down in months of inconclusive meetings with neighbouring hospitals striving to reconfigure providers, as each fights to defend its earnings and the prestige of its consultants. Underneath the previous regime, this is the place strategic well being authorities (SHAs) came in. They had been between the significantly less lamented bodies abolished below the NHS reforms, witnessed in some components of the nation as epitomising the resented leading down, command and control culture. But just as gulag prisoners wept on hearing of the death of Stalin, some are starting to shed a handful of tears at the reduction of bodies with the clout and geographical attain to make the challenging selections about main service changes across regions.

Some thing wants to be accomplished, and swiftly, to get up the mantle of program leadership. In the brief term, CCGs require to collaborate far much more successfully to provide co-ordinated regional choices. In the longer phrase a far more long lasting, but nevertheless clinically led answer rooted in the CCGs, demands to be discovered. The alternative of nevertheless another nationwide upheaval of commissioning structures is as well awful to contemplate.

Taking difficult decisions will not in itself increase morale, particularly amongst the losers. But absolutely nothing saps morale more than uncertainty born of paralysed choice-producing. It prevents everybody from creating a new potential.

“Scale and speed” is the reform mantra, but at the minute it is only the accumulation of troubles, rather than implementation of solutions, which is living up to that slogan.

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The NHS urgently requirements robust leadership to avert a crisis