Failing NHS bosses will go - Jeremy Hunt

Julie Bailey: "We're really pleased that they are talking about accountability within the NHS"

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Health Secretary Jeremy Hunt has warned NHS managers cannot expect to keep their jobs if they preside over failings in care.

Mr Hunt, writing in the Sunday Telegraph, said "proper accountability" was needed in the health service.

He was writing ahead of a report into failings at Stafford Hospital, which is expected to be published within months.

There were hundreds more deaths than expected at the hospital between 2005 and 2009.

Some of those deaths were caused by the failings at the hospital.

A public inquiry has been looking at how the failures in care were allowed to happen by managers and regulators.

Ahead of its report, Mr Hunt called for "total openness and transparency when things go wrong", and a change of culture to give greater priority to compassion.

'Happy staff'

"Just as a manager wouldn't expect to keep their job if they lost control of their finances nor should they expect to keep it if they lose control of the care in their organisation either," he went on.

"And that means above all happy and motivated staff - something that is always a priority in successful NHS organisations or indeed any other organisation as well.

The stories that have emerged from the Stafford Hospital scandal have been horrifying.

But this is about much more than one bad hospital. It goes to the heart of the NHS.

Why and how is a culture of poor care allowed to develop in some corners of the NHS, and then persist?

Stafford was monitored by local and regional health managers and a host of patient safety agencies and regulators.

Doctors and nurses working there were part of professional bodies.

We know from recent reports from the likes of the Patients Association and Care Quality Commission that such lapses are not unique to this one hospital.

Many are now hoping the Francis Inquiry will provide a clear vision for how such poor standards can be eradicated once and for all.

"Most of all we need a change of culture.

"Patients must never be treated as numbers but as human beings, indeed human beings at their frailest and most vulnerable."

The Patients Association backed Mr Hunt's comments, saying "managers and boards must be held accountable for what goes on within their trusts and the appropriate action must be taken".

The inquiry, established by the coalition in 2010 and chaired by Robert Francis QC, sat for 139 days, cost £10m and considered about a million pages of evidence.

It was prompted by a 2009 Healthcare Commission (HC) report, which listed a catalogue of failings, including receptionists assessing patients arriving at A&E and a shortage of nurses and senior doctors.

Managers were found to have been distracted by targets and cost-cutting, and regulators were accused of failing to pick up problems quickly enough, despite warnings from staff and patients.

Mr Hunt said the events at Stafford represented "the most shocking betrayal of NHS founding values in its history".

He pledged to introduce a system of patient feedback - which would be published - whereby every hospital in-patient will be asked whether they would recommend the care they received to family or friends.

'Robust recommendations'

Timeline

  • May 2008: HC begins its investigation into unusually high death rates
  • Oct 2008: HC demands Stafford hospital takes immediate action to improve its A&E department
  • 3 Mar 2009: Hospital chief exec Martin Yeates and chairman Toni Brisby resign days before HC report published
  • 18 Mar 2009: HC report is published. Labour's health secretary Alan Johnson apologies for hospital's failing and establishes two independent investigations
  • 6 Jun 2010: Following public campaigning, David Cameron launches the first public inquiry in Stafford hospital
  • 20 Jul 2010: Robert Francis QC holds first hearing
  • 8 Nov 2010: Mr Francis makes his opening statement and the inquiry begins
  • 1 Dec 2011: The inquiry ends

BBC health correspondent Branwen Jeffreys says the inquiry report may well call for a rethink on the regulation of healthcare, although our correspondent says there could be a limited appetite for that within government as the NHS in England is in the middle of a massive reorganisation.

Julie Bailey, whose mother Bella died in Stafford hospital, spearheaded the campaign Cure the NHS which demanded the government hold a public inquiry.

She told the BBC that only "robust recommendations" from Mr Francis would solve the problems at Stafford hospital and in the wider NHS.

"We want to see a quality and safety system implemented.

"The regulation of doctors and nurses did not achieve anything; nobody has been held to account for those failings."

Katherine Murphy, chief executive of the Patients Association, said: "The changes necessary will only be achieved through a change in attitude and a commitment from management to training and adequate staffing levels, all within a culture of transparency and accountability - and the patients need to be put at the centre of the service."

Anna Dixon, director of policy at the Kings Fund, a charity that works to improve healthcare in England, said: "Regulation plays a vital role in safeguarding the quality of patient care, but most crucial is frontline staff who need support to do a good job and to speak up and take action when needed."

'Terrible care'

Mid-Staffordshire NHS Foundation Trust looks after Stafford and Cannock Chase Hospitals.

Personal stories: Deb Hazeldine

Deb Hazeldine told the BBC about the death of her mother at Stafford Hospital.

Her mum Ellen was admitted to the hospital in July 2006 after a fall at home. She was in remission from bone cancer.

During her stay, she contracted a hospital superbug which led to her death in December 2006.

"The things I saw on the wards will probably haunt me forever.

"My mum was left without food, fluids... she was unable to get to the toilet," she said.

Furthermore, there was a mix-up at the hospital mortuary in which the undertakers were handed forms saying that Ellen's body was highly infectious, so people should not be allowed to see her.

In the end, Deb did see her - but only for a few minutes when she was in a body bag.

Last month, a panel appointed by the regulator Monitor said the trust was "unsustainable" in its present form.

Lyn Hill-Tout, chief executive at the trust, said in a statement: "The Care Quality Commission lifted all concerns it had about Stafford Hospital in July 2012.

"Our mortality rates are second best out of 41 Trusts in the Midlands and East of England region and have been consistently better than the level expected for the last few years.

"None of our patients has acquired MRSA infection in hospital since February 2012 and our Clostridium Difficile rate continues to fall year on year."

She added that nursing standards had been improved by the introduction of ward sisters, and staffing levels were constantly monitored to ensure enough trained staff are on duty at all times.

"The terrible care received between 2005 and 2009 is not representative of the care patients now receive in our hospital.

"We are not complacent, we know we don't get it right every time, but we do not hide the facts when things are not as good as what we would want them to be."

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