Staff levels, poor leadership and care concerns: Keogh report highlights hospital issues

Health Secretary Jeremy Hunt
Health Secretary Jeremy Hunt

The trust in charge of Boston’s Pilgrim Hospital says it ‘fully accepts’ the findings of a report into its high death rates which saw health secretary Jeremy Hunt place them in ‘special measures’.

United Lincolnshire Hospitals NHS Trust was one of 11 handed the grading.

Being in special measures means an external ‘hit squad’ will be sent in to ensure improvements are made, anyone in management that cannot deliver change will be axed and the trust will be partnered with a better performing organisation to help them improve.

The drastic steps come after a report from Sir Bruce Keogh. His report raises a string of concerns about the Pilgrim Hospital over low staffing levels, leadership and care.

It said the complaints process is not fit for purpose, that there is a ‘disconnect’ between the leadership and front line and concerns over how ‘Do Not Resuscitate’ are filled in.

The trust says that it fully accepts the report and says it is already working to tackle the ‘urgent priority actions’ spelled out in the report.

ULHT’s Chief Executive Jane Lewington said: “The safety and quality of patient care is our top priority. We have always seen the review as an opportunity to continue our journey of improvement.

“The review has helped to ensure that our efforts are targeting the changes that will make the most impact on patient care. Therefore we fully accept the findings. Patients are the very heart of everything we do, but others are doing better and therefore we need to learn from them.”

The trust is trying to recruit 200 more nurses to ease staff shortages.

The Keogh review states the team was concerned about staff levels on a number of wards at the Pilgrim, saying: “We recognise that staff are generally caring, committed and incredibly loyal, however we note that there are simply not enough of them to do the tasks that are required.”

The report adds that consultants are asked to work long shifts, that a high number of locums are used and that cover is poor at weekends.

It said: “During the unannounced visit it was also noticeable that, of all the doctors spoken to, the majority were working beyond their expected shift end time.

“When asked about this, these staff noted that there was too much to be done to have left earlier. There was only junior doctor covering the medicals wards and one doctor covering the surgical wards at night and during the weekend.”

Health secretary Jeremy Hunt told the House of Commons yesterday there had been a ‘staggering 12 never events’ – preventable serious incidents that should never happen – at the trust.

The report does also highlight positives about the trust including ‘dozens of examples of good practice’.

Jane Lewington said: “We will be unrelenting in our efforts to improve in the areas which the review panel have identified.

“But it also important that the review has recognised the excellence of much of what we do, and the commitment of so many of our staff.”

Other actions being planned by the trust include public listening events, a patient-focussed overhaul of the complaints system with patients and experts in the field involved in the review, and a series of internal campaigns to promote staff awareness of best clinical practice across a wide range of issues.