Politics: Mid-Staffordshire Hospital Scandal

NHS: Mid-Staffordshire Hospital Scandal

     

      Described as the NHS's "darkest day" the recent publication of Robert Francis's damning report of his thirty-one month long public enquiry has catalysed a return of the Mid Staffordshire NHS Trust scandal to re-emerge at the forefront of the public consciousness. Francis's scathing report has revealed "shocking" failings in the care provided by the Stafford Hospital, which is believed to have led to the unnecessary deaths of between 400-1200 patients. Failings in the standard of care provided by the hospital is believed to have been caused, primarily, by the hospital's cost-cutting in pursuit of foundation trust status. 

       Although concerns surrounding the Stafford Hospital's unusually high mortality rates in 'emergency' cases was first recognised in mid-2007 it is believed the hospitals decline in quality of care provided began to manifest in early 2006. By January 2008 the HealthCare Commission (HCC), a healthcare watchdog, and its developing suspicions were fuelled by the triggering of several patient safety alerts at Stafford Hospital. The first warning signs of problems at the trust. The hospitals explanation to the HCC, that such figures had been 'coding errors', did not hold water with the HCC. The HCC assigned Heather Woods the task of launching the first of five enquiries into the hospital and the standard of care it was providing. 

Robert Francis, QC

      The ensuing investigation uncovered what it described as "appalling" care at the Stafford Hospital. Staff were inadequately trained and too few in number, junior doctors were left unsupervised and forced to administer care beyond their experience and receptionists with no medical training were required to assess the urgency of cases entering A&E. The Francis investigation detailed how patients were left “unwashed, unfed and without water” while staff treated them and their relatives with “callous indifference”. The firsthand accounts of many of the hospitals former patients formed the basis of Francis's investigation which details a culture where “the most basic standards of care were not observed".The enquiry further placed the blame principally on "A chronic shortage of staff, particularly nursing staff, [which] was largely responsible for the substandard care." The resulting pressures on remaining staff led to a deterioration in morale and to many staff exhibiting a "disturbing lack of compassion towards their patients". The enquiry also placed a significant amount of blame on the trust's ruling board and their decision to attempt to save £10 million pounds between 2006-2007 in their bid to obtain foundation trust status by jeopardising the standard of care their institution provided. 

      Almost every level in the NHS's chain of monitoring and regulation had failed in some aspect of their role in order for the substandard care at Stafford Hospital to go unnoticed for such an extended period of time. All political and medical bodies agree that the Mid-Staffordshire Hospital scandal must never be allowed to happen again. Indeed, the publication of the new Francis report will outline measures in order to ensure that such a failing in the NHS's system of care is prevented. MP's and other NHS representatives have already begun debates as to what such safeguards should consist of. A legal minimum of staffing levels on NHS wards, a legally-binding "duty of candour" on all NHS staff to admit to mistakes and a blacklist of failed NHS managers are just some of the measures being considered in the wake of the Francis report. However, with the governments commitment to secure £20 billion in efficiency savings, it would be idealistic to believe this will not have severe repercussions in front line care hospitals provide. Parallels can be drawn between the £20 billion pounds in cuts to the NHS budget and Stafford Hospital's attempts to save £10 million in funds, which played a significant role in facilitating a decline in the quality of care provided at the hospital. This raises a significant question. How can the NHS be expected to maintain exemplary standards of care with further cuts to its budget increasingly likely in the future? 

-Adam