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Lack of support for nurses blamed for Mid Staffs failings


The Robert Francis Inquiry says staff contributions confirm that there was a “pattern of sub-standard service delivery”, at Mid Staffs rather than isolated incidents.

But clinical staff at the hospital largely escape blame.

His report says that while some of poor care was due to unprofessional behaviour, “the overwhelmingly prevalent factors were a lack of staff, both in terms of absolute numbers and appropriate skills, and a lack of good leadership”.

Although staff did raise concerns with trust management, both individually and collectively, the poor response they received dissuaded more to report concerns.

But the report does accuse clinical staff of “accepting standards of care…that should not have been tolerated”.

Within the A&E department, the source of much criticism in previous reports on Mid Staffs, Mr Francis’ report says there was a lack of management, and both nurses and doctors felt there was inadequate leadership.

One consultant told the inquiry that nurses were “hung out” in the department, and “not supported”.

One A&E doctor said: “The nurses were so under-resourced they were working extra hours. They were desperately moving from place to place to try to give adequate care to patients. If you are in that environment for long enough, what happens is you become immune to the sound of pain.”

The report found that the lack of staff in A&E contributed to the situation highlighted in the HCC report where triage was provided by unqualified receptionists.

One advanced nurse practitioner, who had worked at the trust for a long time, told the inquiry that triage nurses were moved to other duties because a ‘see and treat’ policy had been introduced. But in fact that had not been put in place, so triage effectively stopped.

“Therefore the waiting room became full of patients who were not being assessed in any speedy manner at all and they waited regardless of their condition,” the nurse said.

Nurses told the inquiry of pressure to meet the A&E four-hour waiting target, with patients being moved out of the department to beat the breach without being fully assessed, and of subsequently being told to “lie” to make sure target breaches were not recorded.

More to follow.


Readers' comments (22)

  • A whitewash of an enquiry set up by lawyers for lawyers.

    A public independent enquiry needs to be held....and those who are accountable made accountable.

    One question. Where were the nursing unions during all of this? Why didn't they respond to the complaints about care they were recieving? The RCN (and unison to an extent) are a shambles when it comes to this type of thing.

    Over 400 deaths at the hospital during that time that estimates have said were probably avoidable. That is criminal. Corporate manslaughter charges should be brought against the chief exec and hospital managers.

    Andy Burnham should do the right thing and hold a full independent public enquiry in to this.....if he wants to restore public faith in the NHS and himself.

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  • This seems to be the way NHS heading in many areas (though hopefully not so extreme). Policy seems to overide people whether they be the patients or those trying to care for them.

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  • it was inevitable that the cost cutting antics by each nhs trust/ Pct would result in such a negative outcome. It is now the norm for money to be trimmed away from the frontline services that need it most when the mid/higher tiers should have been targeted. Sadly, the NHS is nothing more than a business nowadays.

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  • If this report had been about nursing in the private sector...yes the nurses would be hung out to dry even struck why do the NHS get away with covering up their wrongdoing.....

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  • The movement of patients to avoid the 4 hour breach is widespread. Even moving patients that require more intensive nursing to a facility that simply cannot provide it is commonplace in my experience. 4 hour targets are all management care about. Seemingly doesn't matter if the patient doesn't get their treatment or they're still in crashing heart failure, get them out before they breach.

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  • Too often the problems lie in weak nursing leadership.
    The fact is general management has devalued nurses and removed them from the decision making structures.
    It is difficult for a nurse to report issues to lay managers who have little understanding of clinical roles and even less interest other than meeting the government targets.

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  • Yet again targets override patient care and nursing staff numbers. When will the government realise that the only effect that targets have is dilute patient care and place extra pressure on staff, consequently staffing levels decrease because nurses cannot keep up the pace and leave. We are all burnt out. Where are the unions in all of this why arent they shouting out and supporting us.

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  • Anon 4.26pm. I agree completely. Nursing is now a lost cause as far as being in charge of it's own affairs.

    Career desk nurses like Beverley malone are to blame and her cronies. They have about as much leadership capability as a boiled egg.

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  • Nurses are afraid to approach the NMC because of the blatant mis-management and self-absorbtion of that organisation. Failed and abused time and again by this monolith nurses struggle on without realistic support, but facing ever increasing pressures and risks. Nurses have to share the responsibility for poor practices and inexcusably bad care, but we need to drill down to some root causes, and the NMC would feature large in culpability.

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  • Agree with everything that has been said. Certainly the RCN seems very quiet, but so to is the NMC (they are the regulator). NMC is apparantly investigating 1 nurse!!! is this the Director of Nursing (Which one) Mid-staffs had a few it would seem. Was anyone held to account, apparantly not. One point, Beverly Malone is no longer chief exec of the RCN it is Dr Peter Carter. Beveley Malone went back to America some time back.

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