The Keogh review of high death rate trusts has called for urgent action to address insufficient nurse staffing, inadequate supervision of junior doctors, and insufficient access to critical care beds at Tameside Hospital.
The review, led by NHS England medical director Sir Bruce Keogh, investigated 14 trusts with unexpectedly high mortality ratios.
Its report on Tameside Hospital, published this afternoon, called for “urgent action” to address problems with the clinical safety and experience of care it provided for medical and elderly patients admitted through its accident and emergency department.
It states that Tameside’s management had not done enough to implement the recommendations of previous external reviews of its acute medical pathway.
This had led to “a number of systematic issues” that were affecting quality and patient safety, of which some of “the most urgent requiring action” included insufficient nurse staffing levels and the use of nurses in escalation wards who are not regular staff on the wards, and poor infection control practice for patients admitted with Clostridium difficile.
The report goes on to say that “insufficient senior clinical cover, particularly out of hours, is leading to a lack of timely investigations and poor management of deteriorating patients in some areas, particularly the Medical Assessment Unit and Women’s Health Unit”.
It states that Tameside urgently needs to ensure all acute patients receive a daily ward round review by senior medical staff. It also calls for the trust to review its staffing levels and skill mix to improve medical cover arrangements and reduce the use of bank and agency, and locum cover.
The review panel found “acceptance of sub optimal standards of care” across Tameside, including a patient complaints process that was “slow, brief” and “lacking in compassion, candour and accountability”.
Tameside’s interim chief executive Karen James said: “We have accepted the Keogh review recommendations in full and will implement them in full, openly and publicly, without exception. This will fully meet the concerns and requirements both of the Keogh team and Monitor.”
She added: “Standards of care have to be higher and our patients have the right to expect this.”
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