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Inspectors did not refer 'uncaring' Whipps Cross staff to NMC

Care Quality Commission inspectors who witnessed “unacceptable behaviour” at Whipps Cross Hospital failed to refer any staff to their professional regulators, Nursing Times has learnt.

The CQC said inspectors made their concerns about individuals known to Barts Health Trust, which runs the hospital, but the trust has confirmed no staff have been suspended or referred to their professional regulators.

The inspectors visited Whipps in June and highlighted serious care failings including that some staff “failed to be compassionate and caring”.

In their report, published earlier this month, they said: “We saw examples of people being treated in an uncaring way…We saw examples of poor care, unacceptable staff behaviour.”

In one incident – reported widely by the national media – a woman in a blood stained gown was found crying in the corridor was spoken to in a sarcastic manner by a midwife when she complained of being in pain.

In another incident, a doctor was observed wearing the same gloves between patients and refused to give their name when asked to do so.

A memorandum of understanding between the CQC and the Nursing and Midwifery Council states that the commission will refer to either body “any concerns and relevant information about a registered nurse or midwife, which may call into question his or her fitness to practise”.

It adds that: “In the interests of patient safety, the referring organisation will not wait until its own review or investigation has concluded.”

The CQC has a similar agreement with the General Medical Council, which regulates doctors.

Better co-operation and information sharing between regulators has become an increasing focus for attention following the high-profile failings at Mid Staffordshire Foundation Trust.

A spokesman for the CQC told Nursing Times that “first and foremost” it was the responsibility of the trust to raise concerns with the professional body, but noted: “CQC will refer if it deems appropriate to do so.”

A spokeswoman from Barts Health Trust said it was made aware of the identities of the individuals mentioned in the CQC report, but confirmed no staff had been suspended or referred to either the GMC or NMC.

She added: “An investigation was undertaken; the individuals were formally spoken to and made aware of the CQC findings. Mechanisms have been put in place to ensure skills and competencies are identified and have been addressed.”

Sarah Page, director of fitness to practise at the NMC, said appropriate referrals were needed to protect the public from nurses and midwives who posed a risk to patients.

“Sometimes incidents of misconduct, lack of competence or bad character – though a breach of the code of conduct – can be dealt with locally through disciplinary procedures and employer action. “However, if there is a risk of patient harm or a concern that the midwife or nurse’s behaviour cannot be remediated, we would expect to receive a referral,” she said.

“We continue to work with other regulators to be sure we are alerted to issues as necessary,” she added.

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Readers' comments (17)

  • Will someone please explain the point of having a CQC inspectorate if they are not reporting their findings. The CQC appears to be a complete waste of valuable resources

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  • I am all in favour of a culture of learning and not in favour of one of blame. However nurses and their managers will surely wonder what this means and it suggests real differences between what individual Trusts are doing in such situations.

    Equally important, what action was taken in respect of those at more senior level whose acts or omissions allowed the shoddy standards found by the CQC to exist?

    In a world of transparency and openness we need rather more clarity from all concerned, surely?

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  • Anonymous | 27-Aug-2013 1:04 pm

    there isn't in my view. using international quality control standards which are self audited and then externally certified are a far more effective, holistic, motivational and no-nonsense way of assuring excellence in service and care right across the board. the results are open, transparent and displayed on the walls of facilities for everybody to see and patients can choose not to go to those which do not have such certification.

    I don't know when the CQC was introduced as I live abroad but compared to other quality control models I perceive it as cumbersome, old fashioned, piecemeal, totally ineffective and demoralising for the staff.

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  • from Anonymous | 27-Aug-2013 1:20 pm

    ...demoralising, and demotivating for the staff.

    I may be wrong but looking on from the outside, I see it as an ill- conceived system thrown together as a sticking plaster because somebody somewhere had to do something about ensuring quality, but the end result does not seem to be altogether systematic with much quality and care and individuals responsible for its delivery slipping through the loopholes and probably costing the NHS a lot of wasted money.

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  • tinkerbell

    unfuppingbelievable!

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  • well, perhaps their skills and duties extend little beyond testing the various types of afternoon tea and fairy cakes!
    :-)

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  • Anonymous | 27-Aug-2013 1:20 pm

    The CQC was created in 2003ish to replace the CHC( except in Wales) a body which represented the views and opinions of patients. There was no discussion about this, the government of the day just closed them down, amid wails of anguish... and set up the CQC which is tied to its paymaster the Party in power( I believe). So the CQC have their hands tied and can only report what is politically expedient. As we have seen.

    I am of the belief that sending in inspectors clutching their clip boards may not actually be the best way of finding out the true situation in any ward or department - if I was organizing the inspection with a view to getting an accurate picture of the true state of affairs, I would send teams of researchers posing as HCA's or nurses to observe all the problems encountered in the wards and get a better analysis of what is going on in these hospitals.( and a more balanced one too). Not to necessarily make the Nurses lives more dreadful than they already are; but to get a grassroots picture of the entire situation. But of course they don't want to know what the real picture is, do they?


    I know that Whipps X along with 11 other hospitals got a poor rating, but it is no surprise to me and I think that if you went into many hospitals ( and I speak from hands on experience of the London East End hospitals), you will find blood etc splattered all over the place and none of the staff are very concerned about it, except possibly the relatives. The Nurses have more pressing things to do. The Domestics actually have cleaning up blood spills written out of their job descriptions specifically or they did when I worked in the Area. So who do you think is going to clear it up? Not the Doctors who contributed considerable to the blood spills in my ward.

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  • There is no excuse for sub-standard, insensitive and maligned care.
    Why on earth would anyone stand by with a clipboard in hand, allow it to happen and not report or act on it immediately? In an observational role or not I would not tolerate the poor treatment of anyone. In what context to the CQC inspectors pertain to care in this instance?
    Blood spills are inevitable on most wards. Irrespective of the cause, a suitably trained nurse/HCA/domestic should be dedicated to resolving the issue and most importantly, available.
    This short article highlights a lack of clinical acuity, insight and most importantly direct assertiveness by the CQC inspectors/observers/_____(fill in the blanks here).
    Furthermore, if any practitioner refused to identify themselves on request I would call security.

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  • So, nurses and HCAs are being told that they must be accountable for their actions. Should this not apply to inspectors too? If they witnessed abuse and did not report it, does that not make them accessories after the fact and due for prosecution?

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  • sending researchers in posing as staff - is that even legal?
    if a member of the CQC or any other inspectors/managers/staff see something they are concerned about why can't they speak to the person in charge at the time who could speak to the individual, isn't that what we should all be doing anyway.
    being observed from a distance is pointless, why not just be more open, transparent and mature about the whole thing - set up staff meetings where staff who actually work in the wards can speak up, say what worries them without any fear of reprisal or reprimand.
    if a doctor isn't changing his gloves why couldn't someone just say to him you need to change your gloves inbetween patients and then speak to him about infection control training?
    what immediate action was taken with the patient who was crying?

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  • exactly, openness, honesty and transparency is the only way to improvement. say what you mean and diplomatically call a spade a spade and what you see is what you get. everybody then knows exactly where they are and what is expected of them. hopefully in this way relationships of trust are built up which perpetuates such positive patterns of behaviour. It can become impregnated into an organisational culture just as negative attitudes can and clearly often do.

    doing and saying things in an underhand way behind people's backs just leads to mistrust, people not knowing what others are thinking, bullying, poor management, poor working environment, lack of motivation etc. and whichever way both impact, either positively, in the first case or negatively in the second on the patient as well as upsetting the staff and a lot of other people.

    ISOs norms as a means of quality control are a far clearer, simpler and more honest way forward and surely more effective in the long run and would eliminate the need for organisations such as the CQC.

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  • I presume that the Inspectors mentioned the problem to "someone" and that that "someone" knows the names of the inspectors concerned. So, whomever reported the fact that a problem was witnessed but that the problem staff were not referred onto the CQC, should give the names of the useless inspectors to someone who can FOLLOW IT UP. Find out why they didn't report the matter to whomever they should have reported to. Maybe there is a need for a more intelligent couple of inspectors, or maybe they didn't read their job descriptions. Whatever, it's not difficult, just FOLLOW IT UP.

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  • Well the CQC are a total waste of time as we all know. They were set up to keep the public happy and that's it! what do they know? Very little as is shown in this not isolated case. Mind you the NMC are just as useless with a listas long as your arm of outstanding business and tot al failures to protect the public. All in all a pathetic state of affairs- thank God I'm out soon that's all I can say!

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  • There might be some Professional Healthcare staff out there who deliberately join up to piss off patients and worse but I think these are few.

    Most of us join up because we want to make a difference, to work together to help those most in need of our care and to work as role models for those who will some day look after US in our dotage but somewhere along the line, so many of us give up, burn out, stop caring and just wait for our release date: out of Stalag NHS.

    This is sad on so many levels.

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  • RE:A culture of learning"


    As a member of the public I would like to ask Roger Kline when he would consider that a team of District Nurses had learned enough about nursing to be able to assess and provide safe care to a Vulnerable Adult ?

    A whole team of DNs were found to be negligent by an independent POVA enquiry investigation into how a VA acquired Grade 4 pressure sores and osteomyelitis over an 8 week period of DN provision . He had to be admitted to hospital as a serious emergency ,requiring blood transfusions and operation to treat the pressure sores He later died in hospital from an HAI ( C difficile infection ) . He was not terminally ill .

    The Team Leader had a Degree , Diploma in Community Nursing, a Certicate in Assessment , and the whole team had over a 100 years of nursing experience between them Their employing Trust treated this " episode" as a "learning experience" and did not report them to the regulatop--the NMC

    As his wife , I reported the nurse to the NMC which was an utter waste of time as there was " no case to answer" in every case bar one .

    Is it any wonder that the public is lacking in confidence in nursing and its "regulator"?

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  • I should like to think that one of the 'inspectors' either helped the patient who was crying or went to find a member of staff, there's no mention of what happened. I would hate to think they just left her there and did nothing.
    With the doctor and his gloves, did he know who they were? did he ask to see their ID or their names?
    Not a very thorough article.

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  • Yes, I'd like Roger Kline to answer Janet Howell's question.
    Can't wait to read the reply.

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