Disgraced former NHS boss Sir David Nicholson who retired on a £1.9million pension pot RETURNS to a health service job four years after quitting

Danyal Hussain For Mailonline   13 May 2018

  • Sir David Nicholson blamed for an NHS scandal which saw 1,400 patients die 
  • The scandal took place while he was head of West Midlands Health Authority
  • In his new role he is the part-time chair of the failing Worcestershire NHS Trust

A controversial former head of the NHS has returned to a health service job just four years after quitting in disgrace.

Sir David Nicholson, 63, was held responsible for not taking action over the Mid Staffordshire hospital scandal where 1,400 patients died – while he was head of the West Midlands Health Authority.

Sir Nicholson was dubbed the ‘man with no shame’ by protesters, over his refusal to take responsibility for various NHS scandals, especially the neglect of patients at Mid Staffordshire NHS trust.

Sir David Nicholson, pictured, was the head of the West Midlands Health Authority during the Mid Staffordshire hospital scandal


Sir David Nicholson, pictured, was the head of the West Midlands Health Authority during the Mid Staffordshire hospital scandal

He reportedly ignored warnings that patients were dying due to poor care at his former trust.

Nicholson, who earned £290,000 a year and left with a £2 million pension pot, has been advising private sector companies since retiring.

In his new role, he will get £40,000 a year as part-time chair of the failing Worcestershire NHS Trust, which has been placed in special measures by the Care Quality Commission. 

His second wife, 20 years his junior, was one of his former trainees and is now chief executive at Birmingham Children’s Hospital.

Before retiring, Nicholson was also criticised over a £50,000-a-year expenses bill that included first class travel and the use of luxury hotels. 

His new appointment has been slammed by those who called for him to quit as an NHS chief executive.

Julie Bailey, who lost her mum at Mid Staffs and exposed the scandal, said last night that she was ‘appalled’ by Nicholson’s appointment.

‘This man ignored the concerns that were raised about Mid Staffs and refused to meet the families of those who had died or been harmed by dreadful care. He will be good at balancing the books but will do nothing for patient safety.

The Mid Staffordshire hospital scandal saw 1,400 patients die with protesters blaming Nicholson for the disaster


The Mid Staffordshire hospital scandal saw 1,400 patients die with protesters blaming Nicholson for the disaster

Miss Bailey, who headed up the campaign Cure the NHS, added: ‘He left the NHS because of the shocking state it was in and now they are bringing him back

‘The chairman of NHS improvement recently talked about having a ‘morale compass’ over appointments and investigating managers who have done wrong. Now her organisation is bringing back the man who failed hundreds of patients.’

NHS safety campaigner Fiona Bell, who met Nicholson and challenged him over patient deaths at other trusts said: ‘Sir David was at the heart of the culture at Mid Staffs. As usual, the NHS recycle leaders that have failed patients and staff in hope that the public has forgotten past mistakes. 

‘It beggars belief that some with such a disastrous track record is brought in turn around a trust that faces so many challenges.’

Gary Walker, former chief executive of United Lincolnshire NHS Trust, warned Nicholson that lives had been put at risk by unreasonable demands to meet targets, and said his concerns had been ignored by Nicholson.

NHS Improvement chief executive Ian Dalton – who gave Nicholson the job- acknowledged the Worcester trust ‘still faces many challenges’.

Julie Bailey (pictured) lost her mother in the scandal and has slammed Nicholson's new appointment


Julie Bailey (pictured) lost her mother in the scandal and has slammed Nicholson’s new appointment

Defending the appointment he said: ‘David brings huge expertise at both national and regional level. I know he is absolutely focused on improving patient care, and looking forward to getting underneath some of the difficult issues to see what positive changes can be brought about.

‘Making sustainable quality improvements and getting the trust on to a stronger financial footing will be priorities, working closely with the chief executive and wider leadership team.’

While there were some signs of improvement in accident and emergency performance this winter, the trust was still among the worst performers for ambulance delays.

Trust chief executive Michelle McKay said Nicholson’s ‘knowledge and understanding of the challenges we face in this trust and across the wider health and care system will, I am sure, be enormously helpful to our efforts to secure safe, high quality hospital services for the people of Worcestershire, as well as the work we are doing to move to a position of sustainable financial balance’. 


Disgraced NHS boss who retired on £1.9million pension pot four years ago RE-HIRED

Sir David Nicholson left after being held responsible for failing to act over the Mid Staffs scandal

Mirror     Martyn Hall   12 MAY 2018

Chief Executive of the NHS Sir David Nicholson

Sir David Nicholson was in charge of West Midlands Health Authority

A disgraced NHS boss who retired on a £1.9million pension pot four years ago has been re-hired.

Sir David Nicholson left after being held responsible for failing to act over the Mid Staffs scandal where 1,400 lost their lives.

He was in charge of West Midlands Health Authority at the time of the deaths, before leading NHS England.

He will now trouser £40,000 a year as part-time chair of the ­failing Worcester NHS Trust.

NHS Improvement chief executive Ian Dalton said he “brings huge expertise” and is “focused on improving patient care”.

David Nicholson

Mr Nicholson will now trouser £40,000 a year 


But campaigner Julie Bailey, whose mum died at Mid Staffs, is “appalled”.

She said: “The chairman of NHS Improvement recently talked of having a ‘moral compass’ over appointments and investigating managers who have done wrong.


“Now the organisation is bringing back the man who failed hundreds.”

NHS surgeon accused of racism and ‘forced out of job’ after raising concerns about three Asian colleagues

The Telegraph 19 April 2018      

Dr Peter Duffy outside his industrial tribunal in Manchester  

Dr Peter Duffy outside his industrial tribunal in Manchester  CREDIT:  CAVENDISH PRESS/RICKY CHAMPAGNE


An NHS surgeon voted Doctor of the Year was forced to resign after being accused of racism for raising concerns about the abilities of three Asian colleagues, a tribunal has heard.

Peter Duffy, 56, reported one Indian doctor for missing “several” cancers, playing a round of golf when he had been called to treat a patient and being unable to use an ultra sound machine.

The married father-of-three also claimed that two other doctors, from India and Pakistan, had bungled operations, tried to “suppress discussion” over the avoidable death of a man who had had sepsis and were involved in possible overtime fraud.

But Mr Duffy, a consultant urologist, said he was subjected to “malicious, toxic and utterly false” allegations over a ten year period working at Royal Lancaster Infirmary (RLI) and was warned to “watch his back” over his whistleblowing.

It was claimed that one of the doctors vowed he would be “taught a lesson,” while another was said to be “spitting blood” after being suspended.

He claims he was “brutally driven out” by colleagues intent on revenge.

Peter Duffy claims he was forced to quit his job at the RLI 

Peter Duffy claims he was forced to quit his job at the RLI  CREDIT:  CAVENDISH PRESS/MIKE SWARBRICK


In 2015, Mr Duffy transferred to Furness General Hospital, Barrow, where he was voted “Doctor of the Year by patients and colleagues at Morecambe Bay Hospitals NHS Trust.


He was said to have streamlined the care of urology patients and reduced waiting lists to a level that had “not been seen for a considerable time prior to his arrival”.

He was also praised for treating all members of the team equally, “getting stuck in, even mopping the floor between theatre cases.”

But that year, consultant Saleem Nassem, one of the RLI doctors he had complained about, was appointed co-clinical lead for the trust’s urology department.

He claimed that one colleague told him: “You’ve made enemies here. They’ve got the means, the motive and now the opportunity to finally get shot of you.”

Mr Duffy resigned in 2016 complaining that his pay had been cut amid unproven allegations about his own overtime hours.

He is claiming constructive dismissal, alleging he was the victim of a “witch hunt.” He said on his last day senior managers “treated him like he’d got the Ebola virus.”

In a statement given to the Manchester industrial tribunal, Mr Duffy, from Lancaster, said he had been the victim of a “sustained campaign of victimisation, vilification and disinformation.”

“I firmly believe and was warned by colleagues that the campaign waged against me was one of retaliation for my protected disclosures,” he added.


“I was clearly threatened, abused, victimised and briefed against by those individuals who did not share my belief in a high quality clinical service in the best traditions of the NHS and who clearly felt threatened by my protected disclosures.”

Peter Duffy receives his Doctor of the Year' award

Peter Duffy receives his Doctor of the Year’ award CREDIT: CAVENDISH PRESS 


Mr Duffy said that since his “forced resignation” he had discovered that anonymous allegations were made to police suggesting he was a racist bully and that all ethnic minority doctors at the hospital were “in fear of him,” it was said.

A secret meeting was also allegedly held without Mr Duffy’s knowledge in which he was accused of racism by the three consultants, Kavinda Madhra, Ashutush Jain and Saleem Nassem. None of the claims were substantiated.

He added in his statement: “It is difficult to overstate the sheer toxicity of these utterly false allegations. I was warned in my first few months in the Trust that I must at all costs avoid an allegation of racism against me.

“I was told that such allegations, even if entirely unwarranted can destroy careers and that the NHS tended to regard racism allegations as “guilty until proven guilty”.

The urologist, who now works for a hospital on the Isle of Mann, said he had been left “extremely traumatised” by his treatment and felt unable to work for the NHS again.


The hearing continues.

‘Common people’ – play on whistleblowing


First time in history, a play was performed covering stories of whistleblowers with audience participation in order to educate and  raise awareness.

They were represented from UK, Italy and Romania

The play covered stories of 7 whistleblowers:

Ciro Rinaldi, Ornella Piredda – from Italy

Eileen Chubb, Sharmila Chowdhury and Ian Foxley – from England

Liviu Costache, Alin Goga and Glaudiu Tutulan – from Romania

The play was held at National Radu Stanca theatre in Sibiu,  titled, ‘Oameni Obisnuiti’, which translated means ‘common people’, because the play was about ordinary people who had decided to speak up and as a result faced detriment.

Sibiu is one of the most important cultural centres of Romania and was designated the European Capital of Culture for the year 2007, along with the city of Luxembourg. Formerly the centre of the Transylvanian Saxons, the old city of Sibiu was ranked as “Europe’s…

View original post 742 more words

Dentist May Hendry who sued NHS Ayrshire and won faces huge legal bill despite damning findings against executives

The Herald 24 March 2018

Exclusive by Helen McArdle Health Correspondent

May Hendry, a dentist based in Troon, won her employment tribunal against NHS Ayrshire and Arran (Pic: Colin Mearns)May Hendry, a dentist based in Troon, won her employment tribunal against NHS Ayrshire and Arran (Pic: Colin Mearns)

A RESPECTED dentist who successfully sued her health board after she was victimised for exposing misconduct has revealed that her legal costs outweigh her compensation despite a damning judgement against the NHS.

Dr May Hendry and her solicitor, Stephen Miller, said the case underlines how difficult it is for ordinary members of the public to pursue legal action against the “unlimited budgets” of the NHS.

Analysis: Case that exposed dysfunction riddling NHS management culture

Dr Hendry, 57, was vindicated at an employment tribunal against NHS Ayrshire and Arran in 2017 in a determination that condemned senior executives for trying to cover up wrongdoing.

Dr Hendry was awarded £80,000 damages for constructive dismissal but this will be slashed after tax, and she also incurred £85,000 in legal costs and expenses.

Whereas successful claimants in negligence cases are entitled to have their legal costs reimbursed this does not apply to employment tribunals, posing a major obstacle to staff who may wish to raise grievances for workplace bullying or harassment.

Although Dr Hendry, a part-time dentist in Troon, will have some her legal fees covered by insurance, she is still liable for much of it personally. Many NHS staff will have no insurance at all.

Read more: Dental firm suspected of misclaiming up to £300,000 avoided fraud probe on instructions of senior NHS executive

Mr Miller, a specialist employment lawyer at Clyde & Co, said NHS A&A had also wasted around £90,000 of taxpayers’ money on a case they were certain to lose.

He said: “The evidence against them was overwhelming, but the board were able to pursue a case knowing that the worst they could lose was £70-80,000 and even if the case took twice as long they wouldn’t have to pay May’s costs.

“So there is a definite point that goes well beyond May’s situation, which is that one of the dangers is that even if you win hands down you could end up having to nurse your own legal expenses.

NHS whistleblowers will get compensation if blacklisted by health service

The Telegraph 20 March 2017

A doctor holding a stethoscope 

Staff who blow the whistle will get more protection to ensure they are not victimised for disclosing bad practice  CREDIT: PA

NHS whistleblowers will be entitled to compensation if they are stopped from getting new jobs in the health service because of their disclosures, the government will announce today.

Last year a Telegraph investigation found that those who won tribunals after blowing the whistle were being effectively blacklisted from future jobs in the NHS because staff records wrongly said they had been dismissed.

Whistleblowers also claim they have been barred from positions, despite being fully qualified, because they are viewed as troublemakers.

But under new proposals announced on Monday jobseekers who believe they are suffering such discrimination can take NHS bodies to tribunal, even before they have worked for trusts. If upheld, they will be entitled to compensation.


Jeremy Hunt will announce that whistleblowers can take the NHS to tribunal if they are denied work

Jeremy Hunt will announce that whistleblowers can take the NHS to tribunal if they are denied workCREDIT: PA


Jeremy Hunt, the Health Secretary, said: “Today we move another step closer to creating a culture of openness in the NHS, where people who have the courage to speak up about patient safety concerns are listened to, not vilified.

“These welcome changes will prohibit whistleblowers being discriminated against when they seek re-employment in the NHS, ultimately ensuring staff feel they are protected with the law on their side.”.

Last year Sir Robert Francis published a review which found a number of people struggled to find employment in the NHS after making disclosures about patient safety.

Sir Robert warned of a culture of ‘fear, bullying and ostracisation’ within the NHS that punished doctors and nurses who exposed failings.

He said whistleblowers were derided as ‘snitches, troublemakers and backstabbers’.

 Jennie Fecitt at home in Cheshire,Jennie Fecitt at home in Cheshire CREDIT: JON SUPER, TELEGRAPH


Last year a former NHS human resources director told The Telegraph that staff records were being used to blacklist whistleblowers.

She said that anyone whose record states they have been dismissed from a previous role “would find it very hard to get work”.

Jennie Fecitt, who was dismissed from her post as a senior nurse at a walk-in centre in 2010, after raising concerns about a nurse who had lied about his qualifications.

Ms Fecitt went on to win an unfair dismissal case against NHS Manchester, which found she had been bullied and victimised by her colleagues.

But she later discovered that her employment record continued to state her reason for leaving as “Dismissal – Some Other Substantial Reason”.

Ms Fecitt, who went on to become the director of the whistleblowing organisation Patients First, said that many of her 200 members have reported problems with their staff records, and believe these are preventing them from finding work in the NHS.

The announcement comes ahead of a speech by Mr Hunt at the Learning from Deaths conference which is bringing together senior NHS leaders to find better ways to investigate complaints and learn from the death of patients.

A consultation on the new proposals is now open and will run for eight weeks, closing on 12th May 2017.


Ex-teacher sues for £700k after headmistress bullying ordeal

Evening Standard   9 March 2018      ANNA DAVIS 

Quit profession: Caroline Hadley told the court  that “teaching was my life”Quit profession: Caroline Hadley told the court that “teaching was my life” NEV AYLING

A former teacher who endured years of bullying by her headmistress is suing for £700,000 in damages

Caroline Hadley, 40, was the assistant headteacher of Gearies Primary School, Ilford, working under Anupe Hanch. 

Ms Hadley’s barrister Andrew Buchan said she was “exposed to a hostile working environment” over a four-year period and bullied between June 2010 and July 2012. She became “a direct target” after successfully steering the school through an Ofsted inspection, Central London county court heard. 


Mrs Hanch “undermined her career” by branding her a “rogue member of staff”, Mr Buchan claimed. She told the school finance officer that Ms Hadley “could not be trusted”, spread gossip about her and asked the caretaker to lie about her behaviour, the court heard. 

Mrs Hanch was eventually suspended and in May 2015 was found guilty of unacceptable professional conduct by the National College for Teaching and Leadership, said Mr Buchan. The panel found she said she would like to “chop off” a colleague’s head and once locked a teacher in an office for three hours. 

She was dismissed and, in June 2015, barred from teaching for life by the Government. Ms Hadley became head of a primary school in Camden but suffered depression and quit the profession, the court heard. 


She returned to her native Lancashire, where she cares for her mother. She is now suing the borough of Redbridge, which runs Gearies Primary School, over the bullying and harassment. The council has admitted breach of duty but is disputing the amount of compensation due to her.

Visibly upset in court, Ms Hadley said: “Teaching was my life… I tried going back several times and fought so hard for my career. But desire doesn’t have anything to do with it — there’s no way I could ever go back to teaching now.”

However after hearing all the evidence over two days, Judge Heather Baucher highlighted problems in the preparation of the case and directed a re-hearing of the claim.

She told Miss Hadley: “It’s not a decision which a trial judge takes lightly.  I know it’s very distressing for you, but it’s the right way forward.” 

The case is expected to return to court in September.

Mrs Hanch, 53, had no part in the case and was neither present nor legally represented in court.  

Healthcare company misled regulator about pensions

FT Aadvisor 8 March 2018

Healthcare company misled regulator about pensions

A healthcare company and its managing director have been found guilty of misleading The Pensions Regulator (TPR) about providing their staff with a workplace pension.

Birmingham-based Crest Healthcare and managing director Sheila Aluko admitted recklessly providing false or misleading information to the regulator and wilfully failing to comply with their automatic enrolment duties before Brighton Magistrates’ Court yesterday (7 March).

Ms Aluko had lied to The Pensions Regulator in March 2016 about informing and enrolling 25 staff into a workplace pension scheme.

But in reality, the court heard, the employer had not written to or enrolled any staff, it had not even fully set up a pension scheme and no pension contributions were paid.

What is more, Crest began deducting pension contributions from the wages of some workers but kept them in the company’s bank account and did not pay them into a pension scheme for more than eight months, the court heard.

It was only after a whistleblower raised the alarm that the pension scheme was set up and the contributions were paid in.

This was the first time the The Pensions Regulator has prosecuted an employer for knowingly providing false information in relation to auto-enrolment.

Darren Ryder, The Pensions Regulator’s director of automatic enrolment, said: “Sheila Aluko tried to conceal her company’s non-compliance by hiding behind false information and misleading her staff that their pensions were up and running.

“It was only after we intervened that the employer finally complied with its duties and provided its staff with the workplace pensions they were entitled to.”

He said the case should send a “clear message that it is unacceptable to dodge your pension responsibilities” and that further action would be taken against anyone failing in their duties.

Crest Healthcare and Aluko each pleaded guilty to one charge of knowingly or recklessly providing false or misleading information to the regulator and two charges of wilfully failing to comply with their automatic enrolment duties.

Both charges carry a maximum sentence in a magistrates’ court of an unlimited fine.

If tried in a Crown Court the maximum sentence for each offence would have been two years’ imprisonment.

The case was adjourned for sentencing until 15 May.



Liverpool NHS scandal shows how culture of denial harms patients

The Guardian   

If staff do not feel able to speak out about their concerns, something is rotten at an organisation’s coreView more sharing options

 ‘Staff tried to keep services going but morale collapsed and sickness absence rose.’ Photograph: Christopher Furlong/Getty Images

The two most shocking revelations to emerge from the investigation into Liverpool community health NHS trust are that every part of the system failed, and it happened even as the trust was considering what it should learn from the Mid Staffordshire scandal.

The independent review by Dr Bill Kirkup into events at the trust between 2010 and 2014 shows the root cause of the trust’s problems was an inexperienced and bullying leadership obsessed with achieving foundation trust status, irrespective of the effect on patients. This toxic culture seeped into every part of the organisation, breaking the morale of frontline staff and inflicting serious clinical harm.

Those brave enough to raise concerns risked bullying, harassment and suspension.

It was a dysfunctional organisation from the moment it was created in 2010 with an inexperienced and inadequate management team. Two clinical commissioning groups and NHS England pushed it to achieve significant savings, which had a serious cumulative impact, but the trust made matters far worse with self-imposed cost cuts in pursuit of its managers’ dream of foundation status.

Kirkup points out that achieving annual cost improvements of 4% is the outer limit of what can reasonably be achieved; Liverpool tried to deliver a 15% cut in one year, apparently oblivious to the risks.

Governance was a mess. At times the finance director was responsible for clinical quality and the nurse director was the chief operating officer, so no one was championing patient care.

Staff tried to keep services going but morale collapsed and sickness absence rose. Pressure sores, falls and extractions of the wrong teeth were among the consequences. Reporting of serious incidents was discouraged. Middle managers under pressure to do the impossible lashed out at junior staff. There was a climate of fear, intolerance, disbelief and insecurity.

HR records reveal appalling treatment of staff, including arbitrary disciplinary processes and prolonged suspensions without reason. It was not uncommon to see staff crying in the car park.

Among the most egregious examples of abuse were the so-called scoping meetings, supposedly convened to investigate safety incidents. In practice they were “an interrogation and a frightening experience”. Staff reported feeling physically sick beforehand and approached them with trepidation. Across the organisation shouting and finger-pointing became the norm.

In what appears to have been an attempt at empire building, the trust took on responsibility for health services at Liverpool prison – which was recently condemned by inspectors as having the worst conditions they had ever seen. The trust’s failures in the prison harmed more patients.

Liverpool’s board discussed severe cuts to its workforce – notably nursing – at the same meeting it considered the findings of the Francis inquiry into Mid Staffordshire, the lessons from it apparently eluding them.

The strategic health authority failed to spot the problems. Subsequently the NHS Trust Development Authority identified concerns, then inexplicably reversed its assessment. The Care Quality Commission also failed to identify the problems until it was alerted by local Labour MP Rosie Cooper after staff spoke to her.

The trust has been broken up, but the lessons from its collapse need to live on. It shows again how, controlled by an oppressive culture pursuing unrealistic financial goals, an organisation can quickly mutate into one that harms the very people it is there to serve.

Senior clinicians need to keep a clear focus on their professional responsibilities and not be swayed by board denial or groupthink.

Non-executives need to get out from behind their board papers and keep in close touch with staff and patients. They are there to offer constructive challenge to the trust leadership, not to assist them in pursuing impossible goals.

But above all, the Liverpool scandal demonstrates yet again that an open culture which listens to staff needs to be at the core of every NHS institution. Instead, dissent was crushed and a culture of denial allowed patient harm to proliferate. A cursory glance at the annual staff survey would have been enough to reveal that something was badly wrong.

If staff do not feel able to speak up, something is rotten at an organisation’s heart.



NHS bosses who cover up serious failings could be banned from taking another hospital job


  • Cuts at Liverpool Community Health NHS Trust caused ‘unnecessary harm’
  • But its former chief executive and chairman were allowed new NHS jobs after 
  • Health Minister Stephen Barclay has announced review in response to news  


Health chiefs who cover up serious failings could be banned from taking another NHS job.

The move to end the ‘revolving door’ scandal comes after it emerged that two bosses who ran a failed trust where patients suffered ‘significant unnecessary harm’ have found new health service roles.

A damning independent report has said that the board of Liverpool Community Health NHS Trust was ‘out of its depth’ when it launched a misguided cost-cutting drive.

The cuts left pensioners suffering crippling bed sores and fractured hips from needless falls, while others had the wrong teeth taken out.

Despite these failings, the former chief executive and chairman of the trust are still working directly or indirectly for the NHS.

And it was reported last night that regulators even helped the chief executive find another six-figure NHS job.

The move to end the 'revolving door' scandal comes after it emerged that two bosses who ran a failed Liverpool trust where patients suffered 'significant unnecessary harm' have found new health service roles


In response, Health and Social Care Minister Stephen Barclay will announce a review of the ‘fit and proper person’ test. 

It was brought in following the Mid Staffordshire scandal, in which hundreds of patients died needlessly amid appalling failings in care.

He wants to see it toughened up to end the ‘revolving door’ controversy – where failed executives are shifted into other parts of the NHS – once and for all. 

Liverpool Community Health (LCH) runs elderly care, walk-in centres and dentistry services for about 750,000 people on Merseyside.

The report by Dr Bill Kirkup, which was commissioned by the NHS Improvement quango, found the board attempted to ‘conceal’ the problems. 

And whistleblowers who attempted to expose the truth were bullied.

The report said standards at LCH deteriorated dramatically after managers attempted to cut costs by 15 per cent in a single year in an attempt to chase foundation trust status.

Chief helped into fresh post – by watchdog 

Bernie Cuthel (pictured) stepped down as chief executive of Liverpool Community Health NHS Trust in 2014 over her failings, but she walked into a new NHS job soon after

Bernie Cuthel (pictured) stepped down as chief executive of Liverpool Community Health NHS Trust in 2014 over her failings, but she walked into a new NHS job soon after

Bernie Cuthel, the £130,000-a-year chief executive of Liverpool Community Health NHS Trust, stepped down in disgrace in 2014 after her failings were exposed.

But she walked into a new NHS job soon afterwards and regulators helped her to get the position.

Emails seen by the BBC show that the Trust Development Authority, an NHS regulator, found her a position at Manchester Mental Health and Social Care Trust on a 12-month secondment.

The TDA also provided her with ‘coaching support’, and said ‘the secondment would provide her with a period of rehabilitation, enabling her to reflect on learning from her experiences in Liverpool’.

Her salary at Liverpool was reduced by 10 per cent in Manchester because she was no longer in an executive position.

Now she works at the Betsi Cadwaladr NHS board in North Wales. She is also on the governing body of Nugent, a charity in Liverpool that offers a range of services to children and adults.


This makes a trust semi-independent of Department of Health control and gives boards greater power over their finances and the setting of executive salaries.

The report found that LCH was a ‘dysfunctional’ organisation. 

In an echo of the Mid Staffs scandal, the report said LCH had acted ‘inappropriately’ in pursuit of foundation trust status – setting ‘infeasible financial targets that damaged patient services’.

Dentistry budgets were cut by 44 per cent and 50 district nurses were made redundant.

Dr Kirkup’s report said the senior leadership at the trust did not realise it was ‘out of its depth’. 

It added: ‘Staff were overstretched, demoralised and – in some instances – bullied. Significant unnecessary harm occurred to patients.’

Dr Kirkup said the chief executive and chairman of the LCH board were in ‘denial’ about their role in the affair between 2010 and 2014 – and had refused to co-operate with the review.

A damning independent report has said that the board of Liverpool Community Health NHS Trust (pictured) was 'out of its depth' when it launched a misguided cost-cutting drive

Bernie Cuthel, the chief executive, resigned after the failings were exposed. 

But emails seen by BBC News show that the Trust Delivery Authority, an NHS regulator, found her a position at Manchester Mental Health and Social Care Trust on a 12-month secondment.

Chairman Frances Molloy is now boss of the Liverpool-based Health and Work charity, which has contracts with the health service.

Every LCH board member bar one refused to co-operate with Dr Kirkup’s inquiry. Mr Barclay is set to refer all of them to the Care Quality Commission regulator to see whether they fill the ‘fit and proper person’ test.

Shamed exec got new health deal 

Frances Molloy was the trust's chairman, but had to step down after her failings were exposed. She now runs a Liverpool-based charity with NHS contracts 

Frances Molloy stepped down as chairman of Liverpool Community Health NHS Trust in 2015 – a year after failings at the trust were exposed.

She now runs a Liverpool-based charity that has contracts with the NHS.

Her Health at Work organisation provides experts in improving health in the workplace, reducing absence and staff turnover. 

The charity describes her as its ‘inspirational and influential’ chief executive. 

The organisation’s website says its delivers ‘public sector contracts for NHS commissioning groups and Public Health England’.

Mrs Molloy lost her son Michael, 18, in a coach crash in 2012. She campaigns for changes in the law to stop buses and coaches using old tyres.


Sources said he believes it is wrong that people who tried to cover up the scandal, continued to deny it was a problem and then refused to co-operate with the official review into the failings should be allowed to work in the NHS.

Mr Barclay will also ask Dr Kirkup to consider whether the test should be rewritten to make it clear that such people should not be able to work anywhere in NHS England – or for any companies which supply it.

Rosie Cooper, Labour MP for West Lancashire, was instrumental in forcing an investigation into the failing trust after nurses looking after her father complained about their managers.

Last night she agreed that ‘faceless NHS bureaucrats’ responsible for serious failings should not be allowed to walk straight into another NHS job.

‘It is time for the ‘fit and proper person’ test to be significantly strengthened to prevent this happening,’ she added.

LCH declined to comment. It is now in the process of being wound up, with most services passing to another NHS trust, MerseyCare, in April.

Read more: http://www.dailymail.co.uk/news/article-5365303/NHS-bosses-cover-failings-banned-new-jobs.html#ixzz56jxR34JF
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Independent Review of Liverpool Community Health NHS Trust


Parliament logo     www.parliament.uk   House of Commons Hansard

Acute and Community Health   8 Feb 2018


    • With permission, Mr Speaker, I wish to make a statement on the independent review of Liverpool Community Health NHS Trust, which was conducted for NHS Improvement by Dr Bill Kirkup and published today.

      What happened to patients of Liverpool Community Health NHS Trust is, before anything else, a terrible personal tragedy for all families involved, and the report also makes clear the devastating impact on many frontline staff. On behalf of the Government I apologise to them, and I know that the whole House will want to extend our sympathies to every one of them.

      As Mr Speaker correctly identified, I wish to pay tribute to the hon. Member for West Lancashire (Rosie Cooper). The people of Merseyside know only too well the cost of attempting to silence the victims and campaigners for those seeking justice. As the report makes clear, her personal commitment to get to the truth on behalf of the victims of Liverpool Community Health NHS Trust, her personal courage in asking difficult questions of those in senior positions within the NHS, and the persistence and precision of her search for accountability, are all vindicated today. We in this House, and across the wider health and social care services, owe her a debt. I also thank Dr Kirkup and his team for this excellent report. As with his report on Morecambe Bay NHS Foundation Trust, it is a clear, forensic, and at times devastating account of failures in the care of Liverpool Community Trust by its management, its board, and its regulators.

      The report covers the period from the trust’s formation in November 2010 to December 2014, and it describes an organisation that was, “dysfunctional from the outset”. The consequences of that for patient care were in some cases appalling, and the report details a number of incidents of patient harm including pressure sores, falls leading to fractured hips, and five “never events” in the dental service—an incredibly high number for one organisation.

      The failings of the organisation were perhaps most starkly apparent in the services provided at Liverpool Prison, where the trust failed to properly risk-assess patients, including for nutrition and hydration, and it did not effectively manage patients at high risk of suicide. The review also identified serious failings in medicine management at the prison. There are many more examples of poor care and its impact on both patients and staff in the report, but what compounds the shock is the lack of insight into those failings displayed by the organisation at the time. This was the very opposite of a culture of learning, with incidents under-reported or played down, warning signals ignored, and other priorities allowed to take the place of patient safety and care for the vulnerable.

      We have seen this sort of moral drift before, most obviously at Mid Staffordshire and Morecambe Bay. As with Mid Staffordshire, the management at Liverpool Community Health NHS Trust put far too much emphasis on achieving foundation trust status. The review states that,

      “the trust undertook an aggressive cost improvement plan, targeting a £30 million reduction over five years. This represented a cut in resources of approximately 22%. We were surprised that such an ambitious financial reduction was not scrutinised more closely—by both commissioners and regulators.”

      There is a direct line from the decision to pursue foundation trust status in that reckless manner to the harm experienced by patients. Indeed, an earlier report by solicitors Capsticks reported in March 2016 that the interim chief executive who took over from Bernie Cuthel found in her first week that

      “there was an underspending by £3 million on district nursing. These teams were devastated because they weren’t allowed to recruit, some of them down to 50%”.

      This is a district nursing service in which Dr Kirkup reports that patients were experiencing severe pressure sores, up to what is clinically called grade 3. That was accompanied by many of the hallmarks of an organisation that has lost sight of its purpose. As Dr Kirkup states,

      “the evidence that we heard and saw amply confirmed the existence of a bullying culture within the Trust, focused almost entirely on achieving Foundation Trust status. Inadequate staffing levels, poor staff morale and appalling HR practice went unheeded. This was the end result of inexperienced leadership that was not capable of rising to the challenges presented by the Trust.”

      Following the Mid Staffordshire report, Dr Kirkup recognises that steps have been taken to introduce independent, clinically-led inspection by the Care Quality Commission. The Government have also introduced the special measures regime within NHS Improvement. Alongside this, we have put in place a number of measures to create a wider culture of learning and improvement. The Secretary of State has offered a great deal of personal leadership in helping to create this culture, including the establishment of an independent chief inspector for hospitals, whom I met yesterday and spoke with again this morning, and the recent introduction of measures to support trusts to learn from deaths and to improve patient safety.

      I am sure I am not alone in finding it astonishing that Dr Kirkup found there was a

      “small minority of individuals who refused to co-operate”

      with the review. I wholeheartedly agree with his view that

      “it remains the duty of all NHS staff to assist as fully as they are able with investigations and reviews that are directed toward improving future services”.

      All but one of the board of the Liverpool trust shirked their legal and moral responsibility to be candid about the organisation they governed. In large, complex organisations, responsibility and accountability are always distributed to some degree. It is the case that the higher up in an organisation someone is, the greater their degree of responsibility. In this case those individuals were Bernie Cuthel as chief executive and Frances Molloy as chair. It is clear from reading the report that they each must take a significant share of the responsibility for these failures.

      Hon. Members will, I am sure, have noted the conclusion to the clinical governance section of the report, which highlights the responsibility of the former chief executive of the trust for the system of clinical governance and its failures. It would appear from the report that while the former chief executive, Ms Cuthel, is now able to see that there were failures in clinical governance, she does not have as strong a sense of her own responsibility as one might expect. I understand that she is no longer employed in the NHS in England, but she does continue to hold a role working with the NHS in Wales.

      In response to this report, the Government intend to take a number of actions. First, the Government accept the recommendations in full. While this was a report commissioned by NHS Improvement, I will write to all the organisations named in the recommendations set out at section six of the report, asking them to confirm what steps they will take to implement the recommendations, or to set out their reasons for not doing so. I will ensure copies of that response are shared with the Health Committee.

      Secondly, one recommendation is specifically for the Department of Health and Social Care, as set out in paragraph 6.5 on page 64. This relates to a review of CQC’s fit and proper person test. I intend to discuss the terms of that review with the hon. Member for West Lancashire and will appoint someone to undertake that review within the coming days. I believe that review will need to address the operation and purpose of the fit and proper test, including but not limited to: where an individual moves to the NHS in another part of the United Kingdom; where they leave but subsequently provide healthcare services to the NHS from another healthcare role, such as with a charity or a healthcare company; where differing levels of professional regulation apply, such as a chief executive who is a clinician compared to one who is a non-clinician; where there is a failure to co-operate with a review of this nature and what the consequences of that should be; and reviewing the effectiveness of such investigations themselves when they are conducted. I will be pleased to hear the views of the hon. Member for West Lancashire, and those of the Health Committee, on these issues.

      Thirdly, I have asked the Department to review the effectiveness of sanctions where records go missing in a trust, or where records appear to have been destroyed.

      Fourthly, I have asked the Department for advice on what disciplinary action could be taken against individuals in relation to the findings of this report. Clearly due process needs to be followed, but it is important that we address a revolving door culture that has existed in parts of the NHS, where individuals move to other NHS bodies, often facilitated by those who are tasked with regulating them.

      Fifthly, I will ask NHS Improvement and NHS England to clarify the circumstances under which roles were found or facilitated for individuals identified in the report as bearing some responsibility for the issues at the trust.

      Finally, I have spoken with colleagues at the Ministry of Justice and confirm to the House that they intend to investigate the issues arising from this report in respect of HMP Liverpool specifically and the prison estate more generally.

      All organisations and individuals make mistakes. Where this is used as an opportunity to learn and improve, we will do all we can to provide support. Where, however, there is any kind of cover-up or a blinkered denial of what has happened, Members of this House and the victims of that wrongdoing have a right to expect accountability. The hon. Member for West Lancashire has done the NHS a great service. I will place a copy of the Kirkup review in the House of Commons Library. The Government are acting in full on the findings of the report.


    • May I start by adding my appreciation for the tenacity my hon. Friend the Member for West Lancashire (Rosie Cooper) has shown in pursuing this matter over a number of years? She has led the way in tackling this injustice fearlessly and relentlessly. In that respect, she is an example to all right hon. and hon. Members in this place. I agree with the Minister that the report is a vindication of her courage, but is it not shameful that this scandal only came to light because a Member of Parliament was prepared to give a voice to those who were afraid to speak out?

      Today’s independent report on the Liverpool Community Health Trust lays bare a catalogue of failure that caused harm to patients across Merseyside between 2010 and 2014. It is a grim example of a repeat of the regulatory pressures and board management failures at Mid Staffs. What is of huge concern is that some of the failures came after the final publication of the Francis report. As we have heard, incidents identified in the report include the deaths of inmates at HMP Liverpool, patients having the wrong tooth extracted by trust dentists, and patients on intermediate care wards suffering repeated falls and broken bones or ending up with pressure ulcers. We have to make sure that the pain experienced by so many patients and their families is properly detailed and recognised. We must make sure the NHS is able to learn from these events and that systems are put in place to ensure they never happen again.

      I put on record our thanks from the Labour Benches to Dr Bill Kirkup and his team for the work they have done in carrying out this investigation and helping us to understand what has gone wrong. Today’s report says that patients of community services suffered unnecessary harm because the senior leadership team was “out of its depth”. Let us be clear what lies at the heart of this: unrealistic cost-cutting by the trust without regard to the consequences that led directly to patients being harmed. The report exposes serious problems around the scale of cost-cutting being imposed on NHS trusts. In the case of Liverpool Community Health, the motivation was the drive to achieve foundation trust status. The trust disciplined and suspended staff who blew the whistle about poor care and its controversial plans to slash staff to save money. What guarantee can the Minister offer that trusts are no longer being allowed to prioritise financial savings over patient care? What protections have been put in place for staff who raise concerns about cost-cutting?

      Today’s report notes the irony of staff reductions being agreed at the same board meeting that had earlier considered the implications of the Francis report. That alone should have raised alarm bells about the capacity of board members to challenge the trust. The NHS still faces huge workforce shortages, so what update can the Minister give us on how the 10-year workforce strategy has been received? What additional measures will the strategy include to guarantee safe levels of staffing in all areas of the country, in community as well as acute services?

      I am pleased that the Minister recognises concerns that managers responsible for these extreme failures can often go into leadership roles in other parts of the health service, or indeed for private providers to the NHS in another capacity. Will he advise the House how many people who refused to co-operate with the investigation are still employed in some part of the NHS? Is there anything in the existing terms and conditions or structures that can be used to require future co-operation? Is there any redress in existing policies and procedures that we can use against these people?

      The report said that regulators were distracted by higher-profile services such as acute care. The Health Service Journal said today that oversight failures were partly attributable to organisational changes that were taking place under the Health and Social Care Act 2012, so what will the Government do to ensure that national priorities are not allowed to interfere with local oversight?

      Finally, the report raises serious concerns about the quality of healthcare in prisons. HMP Liverpool still has significant challenges, and the new provider of the prison’s health service—the Lancashire Care NHS Foundation Trust—has just said that it cannot continue with the contract on the level of funding currently available. The Ministry of Justice will investigate these matters more generally, but will the Minister assure us that prison healthcare is properly supported and resourced in Merseyside and elsewhere across the country?

      Paragraph 1 of the review’s findings sums up the devastating impact of these multiple failings:

      “Staff were overstretched, demoralised and—in some instances—bullied. Significant unnecessary harm occurred to patients.”

      In the unprecedented financial squeeze that the NHS currently faces, we need assurances from the Minister that patients and staff will come before finance and that today will be the last time we hear such a damning message about what is going on in our NHS.

    • I thank the shadow Minister for his questions and the manner in which he put them before the House. His first key question was to what extent measures are in place to address this sort of issue, should it arise again. Post Francis, and following Sir Bruce Keogh’s review of 14 trusts with high mortality rates, a new regime has been put in place. There is a new chief inspector of hospitals, Professor Ted Baker, and a specific regime involving NHS Improvement, which commissioned this report. NHS Improvement has a new chair, Dido Harding, a very senior figure from the business community.

      That regime has put 37 hospitals into special measures so far. The methodology that is used to alert regulators to areas of concern has also been revised. For example, far more importance is now placed on staff and patient surveys. However, it remains to be explained why a trust could pay so many compromise agreements, for example, in response to so many staff disciplinary issues. I assume that many concerns were raised by trade unions locally, as no doubt the hon. Gentleman is aware. We must also consider the extent to which earlier reports, such as the Capsticks report, raised concerns that should have been addressed. That is why, in my statement, I signalled my desire to look at those issues and ensure that they are addressed by the fit and proper person test in particular. As he will be aware, though, that test pertains only to board-level appointments in the NHS, not to all roles. We will need to look at that scope, at the effectiveness of the investigation and particularly at the revolving door element of the problem, which he recognised.

      Turning to the other issues that the shadow Minister raised, we clearly need to ensure that due process is followed. I do not need to remind the House of the difficulties of any enforcement against for instance, Fred Goodwin in financial services or Sharon Shoesmith in child services. People rightly expect due process, and all hon. Members would ask for that. The victims will rightly ask, “How can the chief executive, with this catalogue of issues, move within the NHS rather than be fired?” I know that the hon. Member for West Lancashire (Rosie Cooper) has many concerns about that, as do the Health Committee and many other Members.

      I look forward to working with the hon. Member for Ellesmere Port and Neston (Justin Madders) in the spirit in which he raised these issues. We share concerns, and I know the House as a whole wants us to get to the heart of them.

    • I pay tribute to my colleague on the Health Committee, the hon. Member for West Lancashire (Rosie Cooper). She is a remarkable parliamentarian and advocate for patient safety. All of us on the Committee look forward to working alongside her to examine in full the Kirkup report’s recommendations, and I welcome the Minister’s commitment to a review of the fit and proper person test.

      On the wider issues that the report raises, it is clear that when staff and funding continue to be cut from community services, there are terrible consequences for patient care. Will the Minister assure the House that he will work closely alongside the Care Quality Commission to identify other trusts in which issues such as this are likely to arise because of the workforce and funding pressures that are now being faced?

    • I am very happy to work with my hon. Friend on this. As she will be aware from reading the report, it is explicit that the finances were there for the existing service. That is stated at the outset of the report. What drove the problems was a wholly unrealistic attempt to seek foundation trust status, with a cost improvement plan that was simply undeliverable. There was a massive reduction, without any attempt to reconcile that with serious issues on staff levels and vacancies. As the report explicitly sets out, when staff raised those concerns, they were bullied, harassed and on occasion suspended without due cause. The culture has changed significantly, and measures have been put in place for how the regime involving NHS Improvement would address such issues and look at cost improvement plans.

      On the extent to which the culture was driving the problems, I refer to the remarks I made in my statement. According to the report, the interim chief executive went in and found a significant underspend—£3 million—in the district nursing budget, at the same time as there were significant vacancies and patient harm. That culture was driving the issue, and that culture is what we need to put an end to.


    • I thank the Minister for early sight of his statement. I certainly echo his comments about our sympathy for the families and staff members who have been involved over the years. I pay tribute to the hon. Member for West Lancashire (Rosie Cooper), although the tenacity required from her perhaps sums up what is wrong with the present system.

      On Dr Kirkup’s observations and recommendations, as the Minister has acknowledged, some individuals did not co-operate with the investigation. Is there therefore a case for a law change to prevent that from recurring in the future, or at the very least for employment and registration sanctions ultimately to be applied to such personnel?

      On the fit and proper person test that the Government have pledged to undertake, will any agreed new standards be applied retrospectively to board members who are currently in place? Again, the Government have acknowledged the revolving door culture, so it is important that the test is done properly. Will they review executive pay for chief executives and senior staff? After Mid Staffordshire and this, what will be done to properly protect whistleblowers in future to allow them to come forward?

      Funding and resources are clearly really important. Dr Kirkup’s report lays bare the fact that the defining strategic objectives were foundation status and a £30 million saving, or a 22% reduction in resources, rather than the true goal of clinical quality. What will be done to ensure that regulators pick up on such contrasts in future, and what responsibility do the Government take for funding and the drive for efficiency savings?

      Lastly, does the Minister agree that this situation confirms the failings of the trust system, and that any privatisation of the NHS and profit before care cannot be allowed under future free trade deals?

    • The hon. Gentleman raises a number of important points, but particularly regarding whistleblowers. That was one warning signal that clearly failed here. The regulations have been changed, as he will be aware. In the past, there was a culture in which compromise agreements were applied with gagging clauses attached. That prevented visibility of the compromise agreements. That is why I asked, on receipt of the report, why the compromise agreements that were paid were not escalated to the board, and indeed what sight, if any, regulators had of those compromise agreements. Clearly financial payments will have been made, so there should be an audit trail.

      The hon. Gentleman asked what changes had been made. An area on which my right hon. Friend the Secretary of State has placed a huge amount of importance, and in which he has given a huge amount of leadership, is patient safety guardians and ensuring that there are people in trusts tasked specifically with giving voice to patients. One of the many sensible pieces of advice that my predecessor, my hon. Friend the Member for Ludlow (Mr Dunne), gave me was that when visiting a trust, I should have a one-on-one meeting with that individual, not only because of their status within the trust but to gather information from them. He did so assiduously on all his visits.

      The wider point is how, from a regulatory structure point of view, we can ensure that there are safeguards when there are cost improvement programmes and ask what visibility there is of them. NHS Improvement has set out a series of measures to ensure that trusts learn the lessons of Francis. Obviously the period covered by the report goes back as far as 2010, but it is important that the NHS learns from the issues that Dr Kirkup sets out.

    • May I add my tribute to the hon. Member for West Lancashire (Rosie Cooper)? She is a formidable parliamentarian and has done some very good work on this. The report is shocking. Back in March 2015, following other incidents, the Public Administration Committee produced a report investigating clinical incidents in the NHS, in which it recommended the setting up of the health service’s safety investigation branch. The Government have now published the draft Bill for that. When will it enter pre-legislative scrutiny, so that we can change the culture and have the open learning culture that we should have in our NHS, very much as is seen in the airline industry?

    • My right hon. Friend raises an important point on the draft Bill and the consultation. I am not in a position to announce a date; that will be announced by business managers in the usual way.

      My right hon. Friend is right to allude to that Bill as one of a suite of measures following Sir Bruce Keogh’s review and the Francis report, which are all part of changing the culture. I acknowledge the importance of those measures, but I want to signal to the House today that Dr Kirkup’s report identifies remaining issues that need to be tackled. He has done us that service, and that is where I am keen that we focus as a Government.

    • Thank you for your indulgence, Mr Speaker. I do not intend to test your patience today by dealing with the details of these matters; I will do that through Adjournment debates, questions, the Health Committee and other mechanisms available to me.

      I thank the Minister for his kind words and his comprehensive statement in response to the excellent work of Bill Kirkup and his team. I pay tribute to Dr Kirkup for his thoroughness and independence, and I thank him most sincerely, on behalf of the staff and patients in Liverpool who suffered really badly at the hands of what I want to call a dictatorship—the regime. Whatever it was, what was done was done in our name and the name of the NHS, and those people deserve justice.

      After the ACAS review, the CAP6 report and now the Kirkup report, with a National Audit Office report on the way and Nursing and Midwifery Council hearings due soon, it really is important that the NHS ensures that justice is not only done but seen to be done. Under Governments of all parties, the higher echelons of the NHS have closed ranks to protect themselves. That has got to stop. That senior people were able to inflict such harm on staff and patients and then just walk into other senior NHS jobs with six-figure salaries, and that in this case it could be arranged by the north regional managing director of NHSI, Lyn Simpson, is simply staggering.

      I still cannot answer the question that the Minister posed—why were the chief executive and the board not fired? Why were they not sacked? It is incomprehensible. Nothing has been learnt over the past four years. As of only a few weeks ago, NHSI is presiding over another potential LCH, over in the Wirral’s hospitals trust.

      I will obviously continue to pursue these matters with vigour on behalf of the staff and the patients, and I want to place it on the record for everyone who is affected that I do not see the Kirkup report as the end—far from it. The Minister has a legal and forensic background. How will he assure the House that these matters will be dealt with properly, and that cover-ups and backdoor deals have ended once and for all? The Secretary of State has said so many times, “This will stop. We are not going to keep moving failed executives around,” yet it continues to happen.

      I will say quite honestly that I asked a question of a Minister last year and he answered me in good faith. He said, “NHSI doesn’t participate in moving staff around.” Not only can we now prove that it is true that it does, but it nearly happened in the Wirral a few weeks ago. The message has got to go out: “If you do this kind of stuff, you are responsible. You will not escape.” The NHS must be accountable, and those in it held responsible.

    • I thank the hon. Lady for those comments. As I said, I have asked NHS Improvement and NHS England to clarify the circumstances under which roles were found or facilitated for individuals identified in the report as bearing some responsibility for the issues at the trust. I await the answer to that central question, which the hon. Lady posed.

      On the sense of cover-up, the Secretary of State has provided leadership in bringing about the culture change on patient safety. Following the awful situation in Mid-Staffordshire, it was recognised across the House that changes needed to be made on patient safety, and I think the NHS itself has recognised that. NHS Improvement has new leadership, who commissioned the Kirkup report themselves.

      On the changes that have been put in place, I alluded to the CQC regime and the chief inspector and the methodology. I spoke to the chief inspector yesterday. Every hospital has now been visited, using that new methodology, and obviously that programme will start to accelerate and target as further work visits are done. The methodology used for that has also evolved to include staff surveys, for example. So a number of measures have been taken, and the special measures regime is also very much at the heart of that.

      A number of steps are being taken, but the approach that underpins those is that although we must create a duty of candour, enabling people to learn from the mistakes that will happen in an organisation employing more than 5 million people, there should not be the sense that people can escape their responsibility by moving within the system. I have discussed that with people in the NHS, and I believe there is a wide recognition that the culture has changed significantly. But clearly, as we consider the issues that emerge from the Kirkup report, the House will need to see further reassurance.

      The hon. Lady asked how I and the Government will ensure that these issues are addressed, not covered up. First, no one doubts that the hon. Lady will use all the parliamentary tools to pursue this matter, including in her role as a senior member of the Health Committee. I am aware that other members of the Committee, such as the hon. Member for Liverpool, Wavertree (Luciana Berger), a former shadow Health Minister, will take a significant interest in this issue. I know that the Chair of the Health Committee will do so. I have regular discussions with her, and as we address the “fit and proper” test and other issues, I look forward to benefiting from the expertise on that Committee.

      It is clear that measures have been taken, and it is right that we recognise that much work has been done in the NHS to change the culture, to ensure that the warning signs are seen, and to ensure that something like this never happens again, but it is also clear that there are specific issues in the report to be responded to, and I very much share the desire of the hon. Member for West Lancashire that we do that.

    • Order. I remind the House that there is another ministerial statement to follow, and that although the debate on matters to be raised before the forthcoming Adjournment is not now intended to take place, no fewer than 19 Members wish to take part in the debate on community banking, so there is a premium on brevity. These important matters having been preliminarily aired, I now appeal to colleagues to ask single-sentence, pithy questions, without a great preamble, then we will progress towards other matters. I now call Sir Oliver Heald.

    • My hon. Friend will be aware, and indeed has said, how bad the situation was at Liverpool prison, where the trust had no understanding of what was required of it in its role as health provider. That put healthcare staff in a very difficult position. Does he feel that there is a need for better liaison between health and justice in relation to prison health facilities? Is the CQC really in a position to inspect them, or should there be joint inspections by Her Majesty’s inspectorate of prisons and the chief inspector of hospitals?

    • I spoke to colleagues in the MOJ yesterday about the issue that my right hon. and learned Friend raised in the first part of his question. I agree with him that the standards of care for those in prison should be the same as those in the NHS more widely. As he will know, NHS England took over commissioning for healthcare services in prisons in 2013; that is one of the changes that have been made. He will also know that the Dr Kirkup’s report drew attention to local factors, including a personal conflict of interests that goes to the heart of the relationship between the trust and the prison. However, he is absolutely right to allude to some wider issues from which we need to learn.

    • How many members of the board failed to co-operate with this scathing review, and can the Minister name them?

    • Only one member of the board co-operated with the review, from which we can deduce that all the rest did not. Given that I am relatively new to the Department, it would probably be wise for me to seek clarification on the extent to which individuals should be named, but I am happy to confirm that the chair of the board did not co-operate.

    • Does the Minister agree that the report shows that leadership really matters in our local NHS? What further steps can he take to ensure that hospital trusts fully understand the importance of transparency to clinical quality and patient safety?

    • My hon. Friend is absolutely right. That is why we are increasing the number of doctors in training by 25%. We are also looking into how we can increase the number of clinicians in leadership positions in trusts, and how we can reduce variance. That is one of the key issues. The NHS has some brilliant leaders, but the variance between trusts is far too wide.

    • Given that health is devolved to the Scottish Government, Mr Speaker, you may wonder why I am asking this question. Will the Minister reassure me first that the report will be shared with NHS Scotland and the Scottish Government, and secondly that, as and when senior appointments are made, there will be an ongoing, constructive and informed dialogue across the border? Now you will see why I asked the question, Mr Speaker.

    • I am happy to reassure the hon. Gentleman, but he has raised an important point. The question of people moving within the United Kingdom is not the only issue; another potential issue is the question of people moving to a charity or a private company that is providing services for the NHS, or taking up other roles in the healthcare landscape.

    • May I press the Minister a little further on his worrying suggestion that revolving doors are often facilitated by those who are tasked with regulating them? Will he also look at democratic accountability not just in the appointments of officials, but more widely in the NHS?

    • I referred earlier to my desire to work on these issues with members of the Health Committee, who include my hon. Friend, and I shall be happy to look into the points that he has raised. The previous statement was about the culture in the House of Commons. I think that what goes to the heart of my hon. Friend’s question and the matters that we are discussing is that issue of culture, and the need for the culture in pockets of the NHS to change. My right hon. Friend the Secretary of State has done a great deal to bring about such change, particularly in respect of patient safety, but I shall be happy to work with my hon. Friend to take that further.

    • What lessons can be learnt by Liverpool Community Trust—and, indeed, by other underperforming trusts—from the successful turnaround of some 20 trusts under the Government’s new special measures scheme?

    • My hon. Friend is right: although 37 trusts have gone into special measures, a significant number have not just moved out of special measures, but moved from “room for improvement” to “good”. That is relevant to a much wider challenge in the NHS, whether it involves procurement, workforce planning, or mentoring for junior doctors. I met the family of a junior doctor last week to discuss mentoring and support, particularly for those in their first year out of medical college. Trusts have shown leadership on a number of issues, and I think that the special measures regime has shown the scope to spread that best practice much more widely across the system.

    • I agree with the Minister that it is vital for us to expose and tackle failings in the NHS, especially when they put people at risk of harm. Does he agree with me that this case highlights the fact that money is not always the only answer? Effective leadership and responsible management are also important.

    • My hon. Friend is right. I think that at the heart of Dr Kirkup’s findings was the conclusion that what drove these events was not money—and he made that point specifically in relation to the finance for the initial services—but the desire to seek foundation trust status, which led to a wholly unrealistic cost improvement plan and an unwillingness to address the issues that arose as a consequence.

    • I thank my constituency neighbour, the hon. Member for West Lancashire (Rosie Cooper), for all the work that she has done on this issue.

      As has already been said, it is important for the right culture to exist in our NHS. However, it is also important for those who compromise patient safety to be brought to book and punished, and for us to know what action was taken, because otherwise the same thing will keep happening.


  • My hon. Friend is right. Professor Ted Baker, the chief inspector of hospitals, has drawn attention one of Dr Kirkup’s findings, which is that the CQC is now in a much better position to challenge and fine those responsible for unsafe care and poor standards. That also reflects the excellent work that Professor Baker and his team have been doing to ensure that inspections become much more rigorous in identifying issues such as those that we have been discussing today.

  • I am a member of the Justice Committee, which has taken a particular interest in Liverpool prison. Will my hon. Friend assure me that there will be a review of the suicidal potential of prisoners to ensure that the systems are right?

  • My hon. Friend is right to allude to the importance of learning lessons, especially given that there are many vulnerable people in prisons, and given the risks that accrue as a result. Yesterday I spoke to the Under-Secretary of State for Justice, my hon. Friend the Member for Bracknell (Dr Lee), who is responsible for offender management issues, and the Prisons Minister, my hon. Friend the Member for Penrith and The Border (Rory Stewart), visited Liverpool prison last week. I know that they have both taken a great interest in the report, and that they will take any further action that is needed.

  • Does my hon. Friend envisage an ongoing oversight role for Dr Kirkup that would enable him to help to put these failures right?

  • I should be happy to discuss any such future opportunities with Dr Kirkup. His excellent report builds on the work that he did at Morecambe, and I think there is a huge amount for us to take forward from its findings.


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Liverpool NHS trust ‘dysfunctional’ and unsafe, report finds

The Guardian 8 February 2018          Denis Campbell Health Policy Editor

Patients suffered ‘significant harm’ and staff who raised concerns were bullied, inquiry concludes

A nurse on a ward at a hospitalLiverpool Community Health NHS trust provided poor, unsafe and ineffective care to patients, the scathing report concluded. Photograph: Peter Byrne/PA


Patients suffered “significant harm” because of multiple serious failings by a “dysfunctional” NHS trust, an independent inquiry has found.

Liverpool Community Health NHS trust (LCH) provided poor, unsafe and ineffective care to patients, including inmates at HMP Liverpool, the scathing report concluded.

An independent panel, commissioned by the regulator NHS Improvement, also found that the trust had “a climate of fear” as a result of the harassment and bullying of staff who raised concerns.

The findings of the panel, led by Dr Bill Kirkup, are among the most damning of an NHS trust’s actions since Robert Francis QC’s landmark report into the Mid Staffs care scandal, published five years ago.

“The trust not only failed in its duty to provide safe and effective services, it concealed this from external bodies. Both patients and staff suffered harm for too long as a result,” said the panel, which investigated LCH’s conduct between 2010 and 2014.

The trust’s board “became blind to the real concerns that began to arise throughout the organisation” as staff voiced anxiety about plans to reduce its headcount and the impact that would have on patient care.

“Serious incidents causing patient harm were not reported, not investigated and lessons not learned. The result was unnecessary harm to patients,” the report added.

The panel highlighted a catalogue of failings by LCH, including that:

 It sought to achieve unfeasibly ambitious savings targets in a bid to become a semi-independent NHS foundation trust. While 4% is the usual upper limit of annual gains, it tried to save 15% of its budget in one year.

 The “drastic cost improvement measures” it decided to pursue mainly involved cutting staff, even though it was already understaffed.

 Staff who raised concerns about those plans suffered harassment, bullying and “extreme action”, including being suspended for months at a time without being told what they had done wrong.

But mounting problems at LCH went undetected for four years because NHS local and national bodies, including the Care Quality Commission and NHS England, failed to monitor it properly, the inquiry found.

“Patients put their faith in the NHS, and they should be able to trust that dangerous and dysfunctional services will be dealt with immediately. Sadly that has not been the case here and it took the help of a local MP to sound the alarm, and many years for the full facts to emerge,” said Jeremy Taylor, chief executive of National Voices, a coalition of more than 150 health and social care charities.

Ian Dalton, NHS Improvement’s chief executive, said he would not comment on Kirkup’s findings until March, despite their seriousness.

The Department of Health and Social Care said: “The leadership failings identified at Liverpool Community Health trust before 2014 were unacceptable and highlight the importance of fundamental reforms to patient safety that the government has made, including the CQC’s independent inspection regime and the special measures programme, which identifies quickly where hospitals have difficulties and puts in place a comprehensive package of support to help improve care for patients.”

The healthcare provided to prisoners at the Liverpool jail is being overhauled in light of flaws identified in care provided by LCH, NHS England said.



NHS staff call whistleblower line as bosses ‘ignore issues’

The Scotsman  Tuesday 30 January 2018

Use of an NHS whisteblowing hotline is on the rise. Picture: TSPLUse of an NHS whisteblowing hotline is on the rise. Picture: TSPL

NHS staff are turning straight to a “whistleblowing” hotline because they are being ignored when they raise issues with their bosses, a new report out today has indicated.

Fewer NHS staff bother to go to managers in the health service because nothing gets done, the evaluation of the NHS Scotland Confidential Alert Line suggested.

Some staff have said they are victimised if they raise concerns over patient safety. The hotline was launched in 2013 and aimed to improve hospital safety after hundreds of incidents of concern, including more than 100 deaths, came to light.

It comes after a whistleblower recently exposed the fact that A&E staff at St John’s hospital in Livingston were wrongly recording the waits faced by patients, which made it easier to meet national NHS waiting times targets.

The latest evaluation of the hotline’s work in the six months from February and July last year indicate just 17 callers got in touch with the hotline. Although this was up slightly on the previous six months, it compares with 73 calls in the opening half-year after it was launched.

The latest report said: “In many cases individuals are contacting us because they have already raised their concern and feel it is being ignored and would like further advice on options for escalation or they feel they have experienced victimisation due to raising an issue.”

Of the total 17 public cases, seven callers had already raised their concern before contacting the Alert Line,” the report stated. “This is in keeping with general trends we have seen in previous reports and largely reflects the majority of calls we receive to the advice line generally,” the report added.

Patient safety was the “predominant concern” raised with the alert line. This has been a consistent trend across the six-month reports provided over the past three years, the report added.

A number of callers also got in touch in 2017 with concerns about abuse of a vulnerable person. But the report said there has been a “decrease in the number of staff who had reported their concerns before contacting the alert line compared with the previous report.”

“This is in keeping with general trends we have seen in previous reports and largely reflects the majority of calls we receive to the advice line generally,” the report added.

Patient safety was the “predominant concern” raised with the alert line. This has been a consistent trend across the six-month reports provided over the past three years, the report added.

A number of callers also got in touch in 2017 with concerns about abuse of a vulnerable person. But the report said there has been a “decrease in the number of staff who had reported their concerns before contacting the alert line compared with the previous report.”

Of the seven individuals who had already raised their concern before contacting with the hotline, three stated their concern had been ignored and only one said their concern had been denied.

Callers can seek advice from us even where concerns are admitted, for instance if they do not know how the concern is then resolved or if they are at risk of victimisation,” the report said.

Four of the calls from staff who worked with NHS Greater Glasgow and Clyde, while three came from other health boards in Scotland. T

he hotline was launched in 2013 after more than more than 300 reports into the most serious incidents in Scotland’s hospitals in 2011, including 105 deaths, were published by the BBC, and after the Francis Inquiry, which uncovered failings at Mid Staffordshire NHS Foundation Trust in England.

Read more at: https://www.scotsman.com/news/politics/nhs-staff-call-whistleblower-line-as-bosses-ignore-issues-1-4676704

Damning dossier from ambulance trust whistleblower claims Christmas and new year deaths were due to delays

East Anglian Daily Times  20 January, 2018    Michael Steward     michael.steward@archant.co.uk    @MichaelReporter


One patient is said to have gone into cardiac arrest at Colchester General Hospital after taking themselves to A&E due to ambulance delays. Picture: LUCY TAYLOR

One patient is said to have gone into cardiac arrest at Colchester General Hospital after taking themselves to A&E due to ambulance delays. Picture: LUCY TAYLOR

A damning dossier compiled by a senior whistleblower from the region’s ambulance trust has claimed at least 40 patients died or were harmed due to delays over Christmas and New Year – including one person who froze to death.

The damning dossier has been compiled by a senior whistleblower at the East of England Ambulance Service. Picture: SIMON FINLAY

The damning dossier has been compiled by a senior whistleblower at the East of England Ambulance Service. Picture: SIMON FINLAY

The region’s NHS came under intense pressure in less than three weeks between mid-December and early January, with ambulances queuing outside A&E departments and patients reporting they were treated in corridors.

But the whistleblower, who wants to remain anonymous, revealed 19 people died in the east of England during the period and they expected the total number of patients harmed or killed due to delays to soar to around 80 when all cases had been reviewed.

A copy of the dossier seen by this newspaper included a man who waited 16 hours for an ambulance in Lowestoft on December 27.

The man was outside and no ambulance was sent when the first call was made by police.

Suffolk Police made a second call when they found the man, who apparently appeared to have frozen to death.

East of England Ambulance Trust (EEAST) said when the call was first made they were told the man was conscious and breathing and had no obvious injuries. Therefore the call was categorised as a non-emergency call.

When they received the second call a paramedic arrived within eight minutes but the man was dead.

In north Essex and Suffolk the whistleblower’s document claimed six people died and one was harmed as a result of the delays in that period.

These included:

• December 19, in Newmarket, a patient waited four hours and 20 minutes and there was evidence of harm due to the delay.

• December 25, in Maldon, it took six hours, 39 minutes for back-up to arrive to assist with a sepsis patient.

• December 26, in Stowmarket, a call for an ambulance was made on Dec 24 and no ambulance was sent. The patient died on Dec 26 after a cardiac arrest.

• December 26, in Ipswich, a sepsis patient waited four hours and 43 minutes.

• December 29, in Clacton, a patient with a serious spinal injury waited seven hours and 56 minutes.

• December 29, in Thetford, a patient died after going into cardiac arrest and waiting one hour and 12 minutes.

• December 30, in Walton on the Naze, an ambulance was called to a fractured ankle with an obvious deformity – a limb threatening injury – and took six hours 11 minutes.

• December 31, in Maldon, a patient arrested on arrival to hospital after waiting six hours and 46 minutes with asthma-related symptoms

• January 1, in Bury St Edmunds, a patient who had a seizure waited three hours and 41 minutes.

• January 2, in Tiptree, a patient died after going into cardiac arrest and waited for 47 minutes.

• January 2, in Clacton, a patient died from a cardiac arrest after waiting three hours and 45 minutes.

• January 2, in Chelmsford, a patient having a stroke waited 16 hours 49 minutes.

• January 2, in Colchester, a patient went into cardiac arrest after self-presenting at Colchester hospital A&E due to ambulance delay.

After years of missed targets EEAST changed its response programme last year, but in the most serious cases crews are expected to arrive within seven minutes.

The whistleblower also accused senior executives of being on holiday during the crisis, and said some of the trust’s £2.5m surplus should have been spent on hiring extra staff.

EEAST denied this was the case and a spokesman said: “The trust absolutely refutes claims that there were no senior managers in over the Christmas period. In line with all ambulance trusts, this trust operates a gold command system, which consists a 24/7 on-call rota of the most senior operational managers who are highly experienced and well trained.”

He added: “The trust is on the public record stating that it has a gap between funded capacity and demand. It is good financial planning to ensure that the trust is in a position to hire any additional resources that may become available across the months of January, February and March. The trust is well placed to buy such resources where available. We are aware of the claims made by MPs but note no complaints have been received from patients or their families at this time. Nor have any concerns been expressed internally through our line management, whistleblowing or freedom to speak up processes.”

Trust had ‘plans in place’

A trust spokesman added they “had plans in place however experienced extreme levels of demand over the new year period in particular.

“The trust was unable to respond to a very small number of the 50,000 calls we handled over a 15-day period as quickly as we would like. The trust is undertaking a rigorous analysis of that small proportion of calls.

“Where any suspected cases of potential harm are identified, then the trust will exercise it’s duty of candour to notify patients or their families. It is worth noting that any cause of death not certified by a doctor can only be established if there is a coroner’s case. It is best practice to always review the effectiveness of any plans and the trust will be doing that.

“Depending on any preliminary insight, the trust will invite an independent review of our decision making process. The trust has also requested a system wide review of these periods of high demand and lost capacity.”

Call for independent review

Former health minister Norman Lamb said the whistleblower had raised “very serious issues” with him.

Mr Lamb, the MP for north Norfolk, said: “It’s really shocking in my view, these are all suggestions which have been put to me but they are things which have to be fully investigated. I think there needs to be a urgent review by someone outside the trust.”

Sandy Martin, MP for Ipswich, said: “It is almost impossible to prove that anyone may or may not have died as the result as a result of an ambulance delay.

“However, it is clear that a better resourced ambulance service would lead to less unnecessary death and life-changing situations.

“It is time for the government to get to grips and to give our NHS the £30billion that the practitioners themselves say that the service needs.”

Giles Watling, MP for Clacton, said: “I shall be calling for an inquiry. If it is a question of funding then I shall be calling for more funding but I will wait for the findings of the inquiry.

“But we do need to get to the bottom of this.”

Suffolk health watchdog responds

Andy Yacoub, chief executive of Healthwatch Suffolk, said: “Healthwatch Suffolk is fully aware of the severe pressures all our health [and social care] providers have faced together this winter.

“I believe that at times the ambulance service has looked after and transported well over 4,000 patients a day, which would put a strain on any service. That said, each and every patient that requires an ambulance in an emergency, should rightly expect a service that is responsive and of a good quality.

“Planning and the best use of resources, in collaboration with hospitals and other providers, is essential, especially for the pressures that winter periods bring.

“For example, at a time when our hospital’s A&Es are as busy as they have been, ambulances can at times be held up, before their patient can be safely moved into the care of the hospital staff.

“The best use of what limited resources there are helps to respond to our region’s patients’ needs in as timely a fashion as possible.

“Communication is a key to this, because when ambulances are ‘delayed’, the patient and their carer(s) desperately need to know. The appropriate use of the amazing First Responder volunteers is also essential.

“Healthwatch Suffolk is currently asking the public to share stories about the ambulance service they have received recently, whether this is good, bad or indifferent. Your voice matters and any themes and trends we identify will be raised directly with the trust’s quality and governance committee.”


Letter to CEO at Ealing Hospital

Sent via email

1 March 2015

Mr David McVitte

Chief Executive

Ealing Hospital NHS Trust


Dear Mr McVittie,

Re: Dr Sunil Ranjan Chowdhury DOB 4.9.31

My father, Dr Chowdhury, who was a retired doctor, suffering from multiple system atrophy (MSA), was taken to Ealing hospital by ambulance on Wednesday 21 January, when he suddenly became unconscious. My mother called the emergency service.

Although Central Middlesex hospital is the nearest hospital, A&E there has recently been shut down.

On arrival at A&E, mum and I were present and we advised the A&E of the medication my father was on. This included the type and dosage of insulin – he was diabetic. After several tests, the doctors advised us that his condition was OK and there was nothing that they were worried about. However, they would admit him.

On Thursday 22 January, I received a phone call from the pharmacy querying the type and dosage of insulin my father was on. I advised him.

On Saturday 24 January, when I went in to visit dad, I was advised that dad had not been fed for 2 days. They thought he may be aspirating. I was concerned and asked if that was the case why they had not fed him either intravenously or via a nasogastric tube. They did not reply, except to say that they were unable to do anything until the consultant returned to work on Monday. So, they had planned to starve a vulnerable adult for 4 days, before deciding on a feeding plan. After much fuss (from me), the senior staff decided to try and feed him with semi-solid food. Dad had this without any coughing or any problems – the nurse agreed that dad was not aspirating. So, they then commenced his feeding after 2 days of starving him.

In addition, I discovered on the same day, that he was not been given any fluids either. The drip remained unconnected. I queried this. The staff advised me that the there was a problem with the drip monitor. After complaining 3 times, staff eventually got this to work.

On Saturday 31 January, dad looked really poorly and was on oxygen. He did not have any lunch. However, his blood sugar was high at 15. We queried if he was given his insulin. The nurse couldn’t find anything regarding his insulin in his notes. It transpired that dad hadn’t been given any insulin for the last 10 days he was in the hospital.

I asked to speak to his doctor. I was advised that his consultant would not be in until Monday and that there was a locum covering. I asked to speak to her. She said there wasn’t anything she could do as his insulin was not written up in his notes.

Whilst looking through his notes, I came across another patient’s paperwork. A Chaudry with a different first name. I brought it to the attention of the ward sister, who removed and took the paperwork away.  How could this have happened? In addition, worryingly were my father’s details on insulin entered in another patients notes?

On Monday, the consultant spoke to my mum and said he did not know that dad was on insulin. This was despite the fact the doctor in A&E was advised and I had received a phone call from the hospital pharmacy. He was also worried that I would be putting in a formal complaint. One would have thought as a consultant he would be more worried how such a thing could have happened in the first place and investigate.

After discussing the matter with the consultant, mum asked me not to make a complaint while my father was still in the hospital as it could be detrimental to his ongoing treatment. She was clearly worried

His insulin started on Monday 2 February. Dad perked up on Tuesday and Wednesday. He was eating and chatting. However, sadly he passed away on Thursday 5 February.

As well as coping with his death, I had to repeatedly call the ward and patient services to get his death certificate. So that his death could then be registered and we could organise his cremation. It took 2 days and end of Friday to get this and this was only after I ended up physically in the ward to approach the team after my PET CT scan. Due to running around and dehydration, I ended up with severe haematuria and bladder infection and I ended up at Northwick Park hospital.

It is shameful that my father who had worked as a doctor for nearly 50 years and was really valued both by his patients and staff to the point that they remained in contact with him even after retiring for 15 years should have ended his days at Ealing hospital with such poor treatment.

I would like a clear explanation of how these failures occurred, and I expect that I should be properly involved in any root cause investigation

With regards

Sharmila Chowdhury

Whistleblower claims 20 people died where ambulances were late

Norwich Evening News   17 January 2018    


 Clive LewisClive Lewis
Clive Lewis told the House of Commons a whistleblower had come to him with the shocking claim after 12 days of increased levels of calls.

The whistleblower alleged that senior operations managers wanted to move the East of England Ambulance Service to the highest state of alert on December 19 but a final decision was not made until New Year’s Eve.

The Resource Escalation Action Plan (REAP) – which has four levels – was finally enacted although bosses decided against calling in help from elsewhere which could have seen the military answering 999 emergencies.

Raising a point of order the Norwich South MP said: “I hope to get your advice on an exceptionally serious issue that’s been brought to me by a whistleblower in my constituency relating to the East of England Ambulance Service.

“It has been put to me that the service became critically over-stretched due to high demand on December 19, and at that point senior operational managers wanted to move to REAP 4, the highest state of emergency, and seek mutual aid, most likely from the armed forces.

“However, that decision was not taken until 31 December, some 12 days later, and even then aid was not requested by senior management.

“I’ve been informed during this period that 20 people died in incidents where ambulances arrived late.”

It is not known whether the number stated by the whistleblower is for the whole eastern region or just Norfolk.

A spokesman at East of England Ambulance Service Trust said: “We recognise that some people experienced a delay in their care over the festive period and we, along with the wider health care system, experienced significant pressure.

“We always monitor our demand and capacity and take necessary actions to protect patients. The trust has a robust internal process and we are investigating appropriately. Since Christmas we have responded to in excess of 50,000 patients – less than 0.2pc of patients have experienced a significant delay.”



Letter to Prime Minister from consultants in 68 Acute hospitals in England & Wales

10th January 2018

 Dear Prime Minister, 

 We are writing to you as Consultants in Emergency Medicine, Fellows of the Royal College of Emergency Medicine and as Clinical Leads (Consultants in charge) of our Emergency Departments, representing 68 Acute Hospitals across England and Wales.

 We note your recent apology to patients and thanks for how hard we and other NHS staff are working.

 We feel compelled to speak out in support of our hardworking and dedicated nursing, medical and allied health professional colleagues and for the very serious concerns we have for the safety of our patients. 

 This current level of safety compromise is at times intolerable, despite the best efforts of staff. 

 It has been stated that the NHS was better prepared for this winter than ever before. There is no question that a huge amount of effort and energy has been spent both locally and nationally on drawing up plans for coping with NHS winter pressures. Our experience at the front line is that these plans have failed to deliver anywhere near what was needed.

 We acknowledge that our Trusts and local CCGs are doing everything they can to create capacity and more beds in the short term, and we are grateful to them for their continued assistance in such a time of crisis. We also acknowledge the help and support given to the Emergency Departments by our colleagues in other specialties and disciplines across our hospitals.

 The facts remain however that the NHS is severely and chronically underfunded.

We have insufficient hospital and community beds and staff of all disciplines especially at the front door to cope with our ageing population’s health needs.

 As you will know a number of scientific publications have shown that crowded Emergency Departments are dangerous for patients. The longer that the patients stay in ED after their treatment has been completed, the greater is their morbidity and associated mortality. 

 Recent media coverage has reported numerous anecdotal accounts of how appalling the situation in an increasing number of our Emergency Departments has become. These departments are not outliers. Many of the trusts we work in are in similar positions.

 Last week’s 4 hour performance target was between 45 and 75%.

Thousands of patients are waiting in ambulances for hours as the hospitals lack adequate space. 

 Some of our own personal experiences range from

• Over 120 patients a day managed in corridors, some dying prematurely
• An average of 10-12 hours from decision to admit a patient until they are transferred to a bed
• Over 50 patients at a time waiting beds in the Emergency Department
• Patients sleeping in clinics as makeshift wards

 We have known for a number of years that recruitment of staff to Emergency Departments has been challenging. The recent collaboration between the Royal College of Emergency Medicine and NHS England, Health Education England and NHS Improvement will provide a medium term solution to grow our clinical workforce as well as decrease the attrition rate.

 So as a matter of urgency we ask that you consider supporting strategies that will reduce crowding in our Emergency Departments. 

These include;

1. A significant increase in Social Care Funding to allow patients who are fit to be discharged from acute beds to be cared for in the community. 
2. A review of the number of hospital beds that are available for acute care. A number of independent organisations have confirmed that the UK has an inadequate acute bed base to meet the needs of its population. 
3. Prioritisation to implement the workforce strategy that has been agreed between the Royal College and the relevant arms length bodies.

In the meantime we would like to apologise to our patients for being unable to fulfil our pledge for a safe efficient service and acknowledge the hard work and dedication of the staff.

 You will understand with the public interest in this matter that we have released this letter to the press also.

 We remain hopeful and committed to improving the care of patients in Emergency Departments throughout the UK.

 “The NHS belongs to the people….it touches our lives at times of basic human need when care and compassion are what matter most”

The NHS Constitution, 1948.   

Note: we sign this on behalf of ourselves and our departments but this does not necessarily represent the views of our individual Trusts. 


Shaz Afzal – County Durham and Darlington NHS Foundation Trust 

Shariq Ahmed- WrightingtonWigan and Leigh NHS Foundation Trust

Vazeer Ahmed – Cambridge University Hospitals NHS Foundation Trust 

Abosede AjayiCharing Cross, ICHNT

Andy Ashton – St Helens and Knowsley Teaching Hospitals NHS Trust 

Ravi Ayya– West Suffolk Hospital

Ahmad Aziz – Mid Essex Hospital Services NHS Trust, Broomfield Hospital

Bill Bailey – Chesterfield Royal Hospital

Tom Blyth – Heart of England NHS Foundation Trust (Solihull) Birmingham

Dan Boden – Derby Teaching Hospitals NHS Foundation Trust

David Clarke – Royal Berkshire NHS Foundation Trust 

Jonathan Costello – Royal Free, London

Jim Crawfurd – James Paget University Hospital, NHSFT

Susan Dorrian – Heart of England NHS Foundation Trust (Heartlands) 


Ola Erinfolami – Heart of England NHS Foundation Trust, Birmingham

Jane Evans – Norfolk and Norwich University Hospitals NHS Foundation Trust 

Shindo Francis – Milton Keynes University Hospital 

James Gagg – Musgrove Park Hospital, Taunton & Somerset NHSFT

Steve Haig  – Great Western Hospitals NHS Foundation Trust, Swindon

Elaine Harding – Lewisham and Greenwich NHS Trust

Miriam Harris – London North West Hospitals NHS Trust 

Ed Hartley – University Hospitals Coventry and Warwickshire NHS Trust 

Katherine Henderson – Guy’s and St Thomas’ NHS Foundation Trust

Chris Hetherington – South Warwickshire NHS Foundation Trust 

Caroline Howard – Southend University Hospital NHS Foundation Trust

Ann Hicks – Plymouth Hospitals NHS Trust 

Hywel Hughes – Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital

Nickie Jakeman

Ruchi Joshi – Walsall Healthcare NHS Trust 

Meg Kelly – United Lincolnshire Hospitals NHS Trust 

Tarek KherbeckThe Norfolk & Norwich University Hospital

Liam Kevern – Northern Devon Healthcare NHS Trust 

Milena Kostic – The HillingdonHospitals NHS Trust

Subramanian Kumaran – Shrewsbury and Telford Hospitals NHS Trust

Nick Laundy – Countess of Chester Hospital NHS Foundation Trust 

Stuart Lloyd – Bedford Hospital NHS Trust 

Stephen Lord, York Hospital, York Teaching Hospitals NHS Foundation Trust

Andres Martin – North Middlesex University Hospital 

David Matthews – Mid Cheshire Hospitals Foundation Trust 

Nick Mathieu – Torbay and South Devon NHS Foundation Trust

Ann-Marie Morris – University Hospitals of North Midlands 

Rachel McColm – Wye Valley NHS Trust

Lisa Niklaus – Barts Health NHS Trust

Julie Norton – University Hospitals of North Midlands 

Tom O’Driscoll – Betsi Cadwaladr University Health Board, Glan Clywd

Nick Payne –Frimley Health NHS Foundation Trust 

Rob Perry – Betsi Cadwaladr University Health Board, Ysbyty Gwynedd (GwyneddHospital), Bangor, North Wales 

Shewli Rahman – Burton Hospitals NHS Foundation Trust

Junaid Rathore – Royal Liverpool and Broadgreen University Hospitals Trust

David Raven – Heart of England NHS Foundation Trust, Birmingham

Ben Rayner – Hull and East Yorkshire Hospitals NHS Trust 

Tim Rogerson – Aneurin Bevan University Healthboard, Royal Gwent Hospital, Newport

Emma Rowland

Mustafa Sajeel – Heart of England NHS Foundation Trust, Good Hope, Birmingham

Ramy Saker – Frimley Health NHS Foundation Trust, Wexham Park 

Ravi Sant – United Lincolnshire Hospitals NHS Trust, Pilgrim Hospital, Boston

Matt Shepherd – Harrogate and District NHS Foundation Trust

Toby Slade – Royal Cornwall Hospitals NHS Trust 

Dave Snow – Southport and Ormskirk Hospital NHS Trust 

Lisa Somers – Whipps Cross University Hospital, Barts Health NHS Trust 

Sarah Spencer – Abertawe Bro Morgannwg University Health Board, Princess of Wales Hospital, Bridgend 

Jo Taylor – The Dudley Group NHS Foundation Trust 

Nam Tong – The Queen Elizabeth Hospital, Kings Lynn NHS Foundation Trust 

Will Townend – Hull and East Yorkshire Hospitals NHS Trust 

Malcolm Tunnicliff – Kings College Hospital NHS Foundation Trust 

James Williamson – Warrington and Halton NHS Foundation Trust

Libby Wilson – University Hospitals Aintree NHS Foundation Trust

Athar Yasin – North West Anglia Hospital NHS Foundation Trust, Peterborough City Hospital