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'Patients are at risk until NHS culture changes'


Last week’s revelations about what went on at the Care Quality Commission to cover up a report into the University Hospitals of Morecambe Bay Trust’s maternity unit has disgusted the public, and rightly so.

The news was unveiled in an independent report ordered by the regulator’s current chief executive David Behan. It found former CQC bosses had suppressed an internal review because it revealed weaknesses in the CQC’s own inspection regime after it failed to identify neglect at the maternity unit at Furness General Hospital.

Quotes that were allegedly made by senior NHS managers, who didn’t want the public to ever see the report were morally repugnant. They are said to include: “Are you kidding me? This can never be in a public domain nor subject to FOI [Freedom of information request]. Read my lips.”

What senior people in the NHS and the CQC fail to realise is that the NHS is owned by the public. They have a right to know how their money is being spent. And wasted. And none of them would want their money to be used to conceal the truth from them.

It’s telling that Gary Walker is the only one prepared - or able - to critique the NHS. Anyone on the payroll doesn’t feel able to say what they really think

People such as James Titcombe, whose son Joshua died at Morecambe Bay, and Julie Bailey and Deb Hazeldine, who lost their mothers at Mid Staffs, are shareholders in the NHS. And yet the organisation is failing them in the worst way imaginable. Can you imagine a business ever doing that to its investors and surviving?

The stories emerging from Morecambe Bay and Mid Staffs seem to show a system that is more concerned about how it appears to be operating than how it really is doing.

Last week, the media did their usual and turned to their health story go-to man Gary Walker, the former chief executive of United Lincolnshire Hospitals Trust who blew the whistle over patient safety concerns. His view is that bad news stories are rationed and those in the NHS are under pressure to conceal when things go wrong because ministers won’t want to hear about it.

Well someone seems to have ripped up the ration book. More and more stories are emerging about refusals to own up to failures. How can the NHS ever learn from its mistakes if it doesn’t admit to them?

It’s telling that Mr Walker is the only one prepared - or able - to critique the NHS. Anyone on the payroll doesn’t feel able to say what they really think. And surely that’s the biggest problem.

We are campaigning for all NHS staff to be able to speak out safely when they spot poor care. And we won’t rest until the culture changes. See for details.

Jenni Middleton, editor Follow me on Twitter @nursingtimesed


Readers' comments (6)

  • Please read contents of an email sent to All Ward Sisters in a Hospital in the SouthWest from a Divisional Manager.
    Dear Ward Sisters,
    We appear to be experiencing ED breaches because some ward staff are refusing to accept patients at certain times due to staff on breaks or staff on drug rounds
    Please note that what when the ED is busy and becoming unsafe patients will be moved from the EMU to make space for incoming ED admissions.
    In future the site team will direct this to happen and will overrule the wards staff decision / statement if they decide the move is required in order to maintain the safety of the patients in ED.
    Please inform your registered staff


    The safety of the patients on the wards is not mention in this email. Absent Nurses due to being on breaks or nurses doing medication does not matter, patients will be dumped not sent. I used the word dumped as the ward nurses find that at this time when they are absent or busy with the medication, it is not a safe time for a new patient to be admitted or safe for the balance of the patients on the ward to be not given medication on time, because of admitting a new patient. Already too many medicine errors are being made, as nurses are having to do several other jobs while also doing the medicine.
    What nurses say will be overruled. Then why employ them, might as well have only Healthcare assistants working on the wards.

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  • tinkerbell

    yesterday i visited another nursing home, 25 patients on one floor, mostly all total needs. Very pleasant young RN nurse spent time with me and i highlighted a couple of things, insulin not signed for, has it been given? Yes. Good. No access to fluids by a ladys bed who can drink independently and is recovering from a UTI. Sorted. In the end i said as i can't seem to stop myself anymore from asking this question 'Do you have enough staff - Yes. How many staff do you have? 5. Does that include you - yes. How many qualified, just me. How many patients do you have - 25. Do you have 5 staff on an early and 5 a late? We work long days.(quick calculation that these 5 staff will need at least a 40 min break throughout the whole day).

    At the end of it all i said 'you must be rushed off your feet'. She answers 'No, not really'. Hmmm!

    So if this RN works regular long days, and her counterpart works long days and they obviously have to have days off which are longer in duration to account for them working long days how will named nurse work, obviously they can share named nurse with named nurse and associate nurse but then, study days, annual leave, sickness, oh never mind.

    I can only say what i see.

    A good hearted, keen young nurse, working flat out, still young enough to be fresh and enthusiastic, doing the best she can, not knowing possibly any different and thinking she's not really rushed of her feet, soon to be seriously 'burnt out'. How do i know cos' i've been that nurse as most of us have.

    We the willing, led by the unknowing, have done so much with so little for so long we are now qualified to do anything with nothing.

    The manchurian candidate.


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  • staff and their working families also pay and 'own' the NHS. why do people seem to forget that? we too have a right to know how our money is being spent or wasted.

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  • one manager's perspective perspective quoted from HSJ!

    BMA calls for regulation of managers

    26 June, 2013 | By The Press Association

    "Anonymous | 26-Jun-2013 11:50 am

    Don't be too hasty in blaming management for hospital failure and poor patient care. What about clinicians? Should they not be accountable? Someone has to take responsibility for patient care and if it isn't the consultant in charge then who is it? The ward nurses? I don't think the buck stops with them somehow. Get a grip all of you and stop wasting tax-payers money."

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  • Patients will continue to be at risk until there are enough staff to look after them properly. Staff who are competent to do their job, staff who are trained to do their job and staff who want to do their job.
    Stop all this fannying about, it's getting us nowhere, we know we need more doctors, nurses, social workers, therapists - in fact we need more of every kind of 'health' worker.

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  • michael stone

    'It’s telling that Mr Walker is the only one prepared - or able - to critique the NHS. Anyone on the payroll doesn’t feel able to say what they really think. And surely that’s the biggest problem.'

    That is the basic problem that needs addressing. Telling staff they have a duty to raise concerns, without putting in place systemic measures that protect staff who do raise concerns and challenge their 'bosses', almost certainly won't work: it can work in 'good' institutions, but it won't work where 'bad' managers are running things.

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