LO3 – Understand the roles and responsibilities

in the health sectorD1 – analyse the effectiveness of redress

procedures in the health sector

What does redress mean?

To compensate or set a situation right. After an argument, the person at fault might offer an apology in order to redress (put) the situation (right)

For D1 you can use Stafford Hospital scandal as an example

The Stafford Hospital scandal concerns poor care and high mortality rates amongst patients at the Stafford Hospital, Stafford, in the late 2000s. The hospital was run by the Mid Staffordshire NHS Foundation Trust,

and supervised by the West Midlands Strategic Health Authority

Julie Bailey, whose mother died in the hospital in 2007, started a campaign, called Cure the NHS, to demand changes in the hospital.

The scandal came to national attention because of an investigation by the Healthcare Commission into the operation of Stafford Hospital in Stafford, England. The commission was first alerted by the "apparently high mortality rates in patients admitted as emergencies".

When the Mid Staffordshire NHS Foundation Trust, which is responsible for running the hospital, failed to provide what the commission considered an adequate explanation, a full-scale investigation was carried out between March and October 2008.

Cont……

Released in March 2009, the commission's report severely criticised the Foundation Trust’s management and detailed the appalling conditions and inadequacies at the hospital.

Many press reports suggested that because of the substandard care between 400 and 1200 more patients died between 2005 and 2008 than would be expected for the type of hospital, though in fact such ‘excess’ death statistics did not appear in the final Healthcare Commission report

What happened? In June 2010, the new government announced that a

full public inquiry would be held. The inquiry considered more than a million pages of previous evidence as well as hearing from witnesses. UK expert medical lawyers also offered their assistance to distraught and angry families who waited for proof that lessons had been learned. Many families of the victims felt that crucial questions have been left unanswered.

The final report was published on 6 February 2013, making 290 recommendations

Academics at the University of Oxford and King's College London have criticised its recommendations to legally enforce a new duty of openness, transparency and candour amongst NHS staff, arguing that increasing 'micro-regulation' may produce serious unintended consequences

The revelations of the abuse at Stafford hospital were widely considered to be deeply shocking by all sections of the mainstream UK press; for example, patients were left in their own urine by nurses, and forced to resort to drinking from flower vases.

Taken from BBC News on Dec 13th as a result of the public enquiry …. The trust that ran the scandal-hit Stafford Hospital should be dissolved, administrators have recommended. The Mid Staffordshire NHS Trust went into

administration on 16 April after a report concluded it was not "clinically or financially sustainable“

Critical care, maternity and paediatric services should also be cut, the proposals unveiled by Trust Special Administrators (TSA) say.

The trust's two hospitals would come under two other trusts.

Stafford Hospital will be part of the University Hospital of North Staffordshire in Stoke-on-Trent while Cannock Hospital will become part of the Royal Wolverhampton Trust

The proposals include:

Stafford Hospital losing its maternity unit but keeping its accident and emergency department, which will continue to open from 08:00 to 22:00, as it has since December 2011

Downgrading Stafford's critical care unit and losing some emergency surgery

No longer admitting seriously ill children to Stafford. They will instead go to Stoke-on-Trent

Both Cannock and Stafford hospitals will gain some minor operations and more patients will be sent to those hospitals to recover from complicated surgery

Introducing a "Frail Elderly Assessment service", which would mean different sources providing information on older people's needs when they are referred to hospital

What happens now? …..

The proposals will now go to a public consultation, which will end on 1 October 2014

They will then go to health regulator Monitor before being forwarded to the Health Secretary to make the final decision by the end of the year.

If approved, the proposals will be implemented by 2018.

Rowan Draper, from the Support Stafford Hospital campaign, said there had been some "obvious proposals" such as dissolving the trust, but it was "very disappointing" the maternity and paediatric units would be going.

He said: "After the Francis Inquiry and other reports I have read, at no stage were they to do with the issues.

"But now expectant mothers and babies are paying the price for bad management."

Stafford Hospital was the focus of a major public inquiry after it was found poor care may have led to a higher-than-expected number of deaths as a result of maltreatment and neglect.

The Francis Inquiry highlighted "appalling and unnecessary suffering of hundreds of people" under the trust's care, with some patients left lying in their own faeces for days, forced to drink water from vases and given the wrong medication.

Safest outcomes … Julie Bailey, who set up campaign group Cure The

NHS after her mother Bella died at Stafford Hospital, said working closer with the University Hospitals of North Staffordshire would be a "good thing for Stafford Hospital and everyone who relies on it".

She added: "Evidence shows that specialist centres, such as the University Hospital of North Staffordshire, have the safest outcomes for patients."

The administrators said they did not believe other local hospitals would be able to cope with the extra pressure if Stafford's accident and emergency department was completely shut.

Safest outcomes continued … All existing services provided at Cannock Chase Hospital

will continue with the aim of extending them where possible, the TSA said.

Administrator Alan Bloom said: "We are doing this because services will become unsafe if no changes are made.

"I think people's worst fears might have been three to six months ago that we wouldn't even have a hospital here today, let alone the level of acute services and A&E services we are going to have.

"It may be a little bit further to travel, it may be a little inconvenient but we are genuinely recommending this on clinical as well as financial grounds.

Analysis by Dominic Hughes Health correspondent, BBC News ……. This will be the first foundation trust to be dissolved

It's the financial pressures on the trust that have led to where we are today. But the financial pressures that have led to the probable dissolution of the Mid-Staffs Foundation Trust are not unique to this hospital.

The hospital serves a relatively small population, meaning not enough patients are walking through the door.

It also struggles to recruit doctors and nurses to come and work at a hospital with such a dreadful reputation.

Analysis by Dominic Hughes cont …. That too has led to further costs as the hospital employed

expensive temporary staff to make up the numbers. But the squeeze on finances across the NHS in England

means many smaller district general hospitals are looking down the barrel of similar money problems to Stafford.

So the kind of measures seen here may be a blueprint for what happens elsewhere.

BBC News - Stafford Hospital timeline www.bbc.co.uk/news/uk-england-stoke-staffordshire-

20965469 31 Jul 2013 - A timeline on the scandal hit Stafford

Hospital, including the publicinquiry and the latest recommendations from the administrators

D1 – analyse the effectiveness of redress procedures in the health sector

So, what you have to do its to look at the scandal and see what new ideas they have put forward to ‘fix’ the scandal problems and analyse how effective you think they will be –

need to look at will the fix the problems that the scandal brought up? Will it create new problems? Will it make things better or worse for the local people? Put yourself in a position of a pregnant lady – better or worse?

M2 and D1 (plus LO1 and LO2) need to be completed by 26th Feb (the wed we get back after half term) as on the 26th will be moving onto P4 and D2 (then LO4)