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NMC considers action against nurses as trust admits 'embarrassing' care failures

  • 46 Comments

The Nursing and Midwifery Council is considering action against nurses and nurse leaders at Basildon and Thurrock University Hospitals Foundation Trust in response to reports of poor care standards.

The NMC will carry out an inspection at the trust later this week, which it says will be only the second of its kind, and could also result in the trust being stopped from taking trainees.

A Care Quality Commission report leaked on 26 November said it had found blood-stained curtains, a lack of privacy for patients, soiled mattresses and equipment past its use-by date. Three days later health information firm Dr Foster reported the trust had an unexpectedly high death rate in 2008-09.

In a statement on Thursday the NMC said it had asked the CQC, Dr Foster and foundation regulator Monitor for their evidence that “patient safety may have been compromised due to poor nursing or midwifery care”.

NMC chief executive and registrar Professor Dickon Weir-Hughes said it would then decide “what appropriate courses of action should be taken”. The NMC confirmed this could include fitness to practice cases.

The regulator will inspect the trust on 11 and 12 December and check whether it is providing “a quality learning environment for nursing and midwifery students”. The NMC said the only comparison was an inspection at the North West London Hospitals Trust in 2005 which was prompted by a damning Healthcare Commission report on its maternity services, and resulted in trainees being removed.

An NMC spokesman said: “What has alarmed us is that people from all levels have come to us [since the news reports] and said, ‘We have known there have been problems for months.’ Why didn’t they come forward earlier?”

Meanwhile, Basildon and Thurrock University Hospitals Foundation Trust director of nursing Maggie Rogers has defended the trust. She said the reports did not reflect general standards at the trust. However, she said the problems found by the CQC should have been reported to senior staff by nurses or others.

Ms Rogers told Nursing Times: “There were senior staff who should have escalated that further. That would have been part of their role.

“We rely on the staff and teams to escalate anything they are not happy with because they essentially accountable. There is no doubt if anybody had escalated that level of hygiene deficit we would have acted on it.”

Reporting those conditions was a “joint responsibility of facilities staff and clinical staff”, she said.

Ms Rogers said she had been working to increase nurse numbers at the trust and make sure the mix of experience and skill was right. But she said: “We have been embarrassed by what the CQC found and have learned a very embarrassing lesson.”

  • 46 Comments

Readers' comments (46)

  • So after sitting on its hands throughout the Mid-Staffordshire revelations and then trying to shoot the messenger at Brighton and Sussex the NMC is at last creaking into action – albeit slowly. Perhaps they’re worried that if they get to Basildon and Thurrock too quickly the Trust won’t have had sufficient time to smarten up their act leaving the NMC with a difficult decision to make!

    As for Maggie Rogers (Dir Nursing) reportedly blaming her staff for not escalating problems upwards, she might want to ponder why this is so. What is the culture like at Basildon and Thurrock? Is it a ‘learning organisation’ with a ‘no blame’ ‘my doors always open’ ambience, where staff are supported in raising and dealing with issues that compromise care? Perhaps not. Of course the other way Ms Rogers could have found out about what was going on in her organisation is by leaving her office and going for a look. Given the shock the top team seem to be experiencing one can only assume that she and her fellow directors stayed locked in their offices during the CQC inspection?

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  • I worked as an auxiliary nurse at a hospital in Essex (not Basildon) several years ago, and was horrified to see the abject neglect of many elderly patients. Thirteen patients in the geriatric wing died in one weekend, and the barrier nursing of MRSA-affected patients was almost non-existent. Many of the staff were dishevelled and downright lazy, and expected the auxiliaries to do all the answering of patients' requests for attention. A lack of funding was NOT responsible for this situation; the nurses' attitudes were.

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  • So maggie Rogers blamed her staff for the inadequacy of service!, what had she been doing ? Leadership involves knowing what your workforces doing and setting a standard.
    I do not believe that all nurses were lazy and uncaring but what I do believe is that unless those in charge understand their workforce and the demands put upon them we shall continue to have horrifying issues like this occuring

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  • All I can say is 'bring back traditional training and it's core values' and reinforce the basic skills into people who do not know 'how to care'.
    It's just a pity that the NMC could not have taken a different approach to how it dealt with Margaret Heywood.
    Sadly we have too many blame cultures now.
    Tim Hartley

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  • Perhaps the date has been set so far in advance so that the NMC will have time to put their own house in order before setting out to point the finger.
    It's about time nurses started demanding their rights i.e. support from managers and stopped letting politicians set up even more qangos to tell us what we already know.

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  • I was an in-patient recently at Basildon after a CVA, and the care was patchy. Initial triage assessment in A and E was very competently done, post-admission assessment was done by a Clinical Support Worker while a colleague chipped in with flippant distracting remarks. I told the flippant one to get lost. Patients fare much better if they are assertive, and even better if they know what to ask for.

    I thought that many of the nurses were ageist: I'm 71 (still practising until the stroke) and almost every nurse called the older people in the ward "mate", "sweetheart" or "young man".

    Although doctors were uniformly adult in their conversational approaches to me, most trained nurses answered my reluctant queries or requests from the end of the bed, or the middle of the bay, sometimes over their shoulders, and in a voice so that everyone could hear - the commonplace "sing-song" voice that British nurses tend to use by default when addressing their public. Such a careless response doesn't encourage one to ask for anything, at least it didn't encourage me.

    Apart from doctors, the most sensitive and courteous communicators were the Polish domestic staff, an African student nurse, and a male Ward Manager who I called to complain about the plight of helpless old people in my bay who weren't helped to take a drink, or food left on their lockers for hours at a time.

    Older confused patients (there were lots) are not sympathetically or skilfully handled. I heard many insensitive comments made by nurses and by Clinical Support Workers to very sick people who were not able to make much sense themselves, again this was often done in a raised voice, as if to convey an attitude of "See what I have to put up with?" to anyone and everyone within earshot.

    It's also very true that nurses don't make themselves easily available to patients in bed, and don't answer the patient-call system promptly. I was staggered when I eventually managed to shuffle my Zimmer down to the toilets to see so many nurses at the nurses' station.

    On the whole, I'm grateful for the overall attention I got in hospital, but many of the nurses were not as thoughtful and respectful as the doctors, pharmacists, and radiology staff I met, and tended to defensiveness if asked questions. this was particularly true of the senior nurses (although it's hard to distinguish who is who, except that the more senior staff are much less accessible, except at the nurses' station, it seems).

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  • I despair! Poor care is not acceptable but neither is putting the boot in for colleagues, behaviour needs to be challenged and changed but that includes all healthcare professionals. As nurses we all know how hard one voice is to be heard over many. Group think goes on and it is behaviour that needs to be challenged. Blaming is not going to change the culture but looking at what has allowed this to happen and what will help it change will. This needs to be from top down. however I imagine this may not be the case. What a sad sad case for all, patients and staff

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  • It's not blaming anyone, or putting the boot in, to point out how I felt when I was ill and vulnerable in hospital, with rapidly progressive bulbar neuro signs, and with the thought I might die within 24 hours, not contradicted by my doctors, I should add.

    I more or less staggered across the ward on a walking frame to try to help a cot-sided bloke, semi-conscious and with obvious cerebral irritation, who was trying jerkily to get a feeding cup to his mouth. I managed to get a straw in it and held it to his mouth so he could get a few swallows, he was parched. Apart from myself, no-one gave him a drink for ten hours.

    In such circumstances it's very hard to challenge nursing behaviour (how?), and it ought not to be necessary to try from your sick-bed. Nurses are trained to be reflective (I thought) and that means challenging yourself at the most basic level of motivation. Having a bit of insight and noticing what's going on, what you're doing.

    The culture starts (and finishes) with what lies between the ears of every individual. No need for despair, I reckon, but it's important to listen to what we're told.

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  • Regrettably this is a reflection of the culture we are living in! It is people like Maggie Rogers, the Dir Nursing, who is never easily accessible, and then tries to blame others. Mrs Rogers have failed to take responsibility for her contributions to the problem. My experience is that it is difficult to report such incidents to directors etc., due to the "chain of command" in reporting procedures. The Directors are not accessible. I sent many emails to my previous manager regarding health and and safety, and infection control issues, and retained copies of the emails, that compromised the care of the babies. Very little was done and the clinical director never visited the unit. I became so frustrated and disillusion that I left the unit and I am now working in Research.

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  • I think that nurses seem so unavaliable due to the fact there are so few of them. There are very very few nurses out there that I think would knowingly give bad care (whilst i do know sadly there are the odd few). Low staffing levels has been a fundemental issue in giving poor care for years and everybody knows this what shocks me is that everytime these reports are leaked is that people are suprised its not new news the NHS needs more nurses! Finally in defence of Mid Staffs the NMC did decide not to take action however many other people did and no other trust so far has been subjected to the rubbish that those nurses have and are still suffering now and still holding their head up high and doing an excellent job.

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