Hospital staff 'bullied' into changing cancer records
Hospital staff in Essex were “bullied and pressured” into changing patient data to help meet cancer treatment waiting targets, according to a scathing report from the Care Quality Commission.
CQC inspectors found a number of cancer patients may have suffered undue delays in treatment and there were inaccuracies with waiting time data relating to cancer treatment.
The concerns were brought to the attention of the regulator by whistleblowers who were praised for their actions.
As a result, the chief inspector of hospitals has recommended Colchester Hospital University NHS Foundation Trust should be placed into “special measures”.
In a report, published today, the CQC said some hospital staff reported they were pressured to change data relating to patients and their treatment to make it seem people were being treated in line with national guidelines.
Staff also reported having raised concerns about the practice, which were not acted upon by the trust.
This week the trust has written to 30 patients offering to review their treatment.
CQC’s inspection, which took place during August and September, followed information received about the treatment of patients from the end of 2011.
Inspectors spent six days at the hospital talking to patients and staff. When inspectors checked the national cancer waiting times system against patient records, they found discrepancies in the records and types of treatment recorded for some cancer patients.
Of the 61 records examined, 22 showed patients had been placed at risk of receiving “unsafe or not effective care” due to delays in receiving appointments or treatment.
The records related to patients receiving treatment for urological cancers, cancers of the lower and upper gastrointestinal systems, and those of the head, neck, breast and skin.
In some cases, CQC identified, people did not get their treatment within the required 62 days and in three cases delays exceeded 100 days.
Even though an internal investigation in 2012 identified concerns, the trust failed to investigate the allegations thoroughly or follow up with the patients who were affected, the CQC report said. Staff alleged they had been pressured or bullied to change data.
Professor Sir Mike Richards, the CQC’s chief inspector of hospitals, said: “It is shocking to think that people’s lives may have been put at risk for the sake of the waiting time figures.
“We have found that the concerns raised by staff in relation to changes made to people’s cancer pathways were not appropriately managed or investigated by senior staff of the trust, which is why I am now recommending that this trust should be placed in special measures.”
The CQC was alerted to the concerns by inspectors following visits earlier this year, as part of Sir Bruce Keogh’s review into trusts with higher than expected mortality levels. They had been contacted by whistleblowers.
Professor Sir Mike Richards said: “We have only been able to consider taking action because of the hospital staff who came forward to raise their concerns in the first place. It’s thanks to them that we can ensure that the service is better in future.”
He said the CQC findings had been referred to the police, NHS England, local commissioning groups and the foundation trust regulator Monitor.
Adam Cayley, regional director for Monitor said it had opened a formal investigation into the trust and would consider putting it into special measures.
Christina McAnea, Unison head of health, said: “Our members took a brave step by reporting to the CQC that they were being bullied and harassed by senior managers to falsify records relating to cancer patients.
“They raised their concerns repeatedly and in e-mails to senior managers, right up to the chief executive, but they were ignored.”
She added: “The NHS needs to promote an honest and open culture.”
Dr Sean MacDonnell, medical director of Colchester Hospital University NHS Foundation Trust, apologised for any “worry, distress and concerns” resulting from the CQC report.
In a statement, he said: “Both myself and staff throughout the trust are shocked and dismayed by the concerns raised in the CQC report… we are taking the findings extremely seriously and are determined to get to the bottom of the issues and sort them out.
“If there is any evidence that any of our staff have inappropriately adjusted and reported cancer figures, the trust will take the strongest possible action against them,” he said.
“Equally, the trust will take action against any employee involved in bullying, harassment or coercion of its staff by other staff, if this appears to have happened in relation to changes made to data,” Dr MacDonnell added.
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