‘Appalling’ treatment of NHS whistleblowers must be investigated: Staff ostracised by hospital bosses demand independent inquiry after ‘whitewash’ Francis Report

 

  • Freedom To Speak Up Review published report revealing culture of fear
  • Sir Robert Francis sought evidence from hundreds of doctors and nurses
  • Concluded whistleblowers ‘bullied and ostracised’ for speaking up
  • Scathing letter from three high profile whistleblowers calls for inquiry
  • Say their careers have been ruined and still no action has been taken 

NHS whistleblowers are demanding an independent inquiry into their treatment by hospital managers after a long-awaited report was declared a ‘whitewash’.

In a scathing letter to the report’s author, they accused him of failing to hold any managers to account and leaving patients at risk of serious harm.

The NHS’s ‘Freedom to Speak up Review’, which was published a fortnight ago, told how whistleblowers have faced a culture of ‘fear, bullying and ostracisation’ for daring to speak out.

But whistleblowers whose careers have been ruined said still no action has been taken to address the concerns about patient safety that they have been making for years.

Despite hearing awful reports about failures and cover ups over patients’ deaths, the report’s author Sir Robert Francis has ‘ignored’ their stories, they said.

Scroll down to read the letter in full  

NHS whistleblower Dr David Drew

NHS whistleblowers Sharmila Chowdhury

NHS whistleblowers Dr David Drew (left) and Sharmila Chowdhury (right) have written to Sir Robert Francis demanding an independent inquiry into their treatment by hospital bosses, after they spoke out to raise concerns over patient safety

‘We expected that you would have taken action in these matters which involved patient harm, death and fraud,’ the whistleblowers have written to Sir Robert.

‘Those responsible have not been held accountable. Lessons have not been learned. Patients and their relatives have not been told the truth.

‘We consider this failure to address our concerns a serious flaw in your review.’

The letter, which has been signed by three NHS whistleblowers, added: ‘We feel that we have not been taken seriously, which has been our experience as whistleblowers all along.

‘It seems appropriate to us that you allow independent scrutiny of all the submissions so that these matters can be addressed.’

Sir Robert was commissioned last June by the Government to head the review into whistleblowing in the NHS.

He previously led two inquiries into the scandal at Mid Staffordshire hospital, where 1,200 patients died needlessly.

Some 600 NHS staff spoke to the barrister and his team, who were also overwhelmed by 19,800 responses from other employees to an online survey.

Sir Robert reported that whistleblowers are too often derided as ‘snitches, troublemakers and backstabbers’.

He said many had, in effect, been blacklisted by the NHS, facing being ‘victimised’ by managers, forced out of their jobs and unable to find other work.

The barrister made 20 recommendations – including a ‘whistleblowing guardian’ at each hospital – which the Government has promised to enforce in an attempt to change the culture of silence in the health service.

Robert Francis QC, pictured, sought evidence from hundreds of doctors, nurses and other employees as part of the Freedom To Speak Up review into the treatment of whistleblowers in the NHS

NHS whistleblowers, however, have since confronted him, outlining their ‘serious concerns’ that his report has failed to address any of the specific concerns made by NHS staff about the alarming treatment of patients.

The letter has been signed by three high profile whistleblowers, including Dr David Drew, a top paediatrician who was sacked after claiming he had witnessed a cover up over a child’s death.

It has also been signed by Sharmila Chowdhury, a senior radiography manager who spoke out about a £250,000 fraud at her Trust, and a third colleague who asked not to be named.

Dated February 23, 2015, the letter states: ‘We have now had an opportunity to digest your report and have a number of serious concerns.

‘More than 600 individuals made detailed submissions to the quantitative review.

‘We suppose that many, like us, assumed that you would take these seriously as disclosures made in the public interest and act on them. That is what you told us when we first met you.

SIR ROBERT’S KEY PRINCIPLES

The Freedom To Speak Up review set out 20 principles to bring about change in the NHS.

They include:

Culture of raising concerns – to make raising issues a part of normal routine business of any well-led NHS organisation. Sir Robert suggests that every NHS trust should have an integrated policy and common procedure for all employees to formally report incidents and raise their concerns.

Culture free from bullying – freedom of staff to speak out relies on staff being able to work in a culture which is free from bullying. The report urges all trusts to consistently show intimidation and victimisation to be unacceptable behaviour.

Training – every member of staff should receive training in their trust’s approach to raising concerns and in receiving and acting on them.

Support – all NHS trusts should ensure there is a dedicated person to whom concerns can be easily reported and without formality. They should also provide staff who raise concners with ready access to mentoring, advocacy, advice and counselling. The report suggests each hospital appoint a freedom to speak up guardian to fulfill that role.

Support to find alternative employment in the NHS – where a worker who has raised a concern cannot, as a result, continue their role, the NHS should help them seek an alternative job.

‘You have allowed situations where patients are at risk and where managers act defensively out of self-interest to continue unaddressed.

‘Amongst the other 600 plus submissions there must be, and we know there are, more examples of fraud and unresolved patient risk.’

They went on to demand that the submissions are now properly dealt with under ‘independent scrutiny’.

After the report was published, there was particular unease about a key clause which advised whistleblowers not to speak to the press, saying they should only do so as a ‘last resort’ to avoid causing ‘considerable distress’.

Dr Drew told the Mail he was publicising the whistleblowers’ letter to Sir Robert because ‘the press seems to be the only way to squeeze the truth out’.

He added: ‘History will judge Francis badly. He failed whistleblowers and offered a get out of jail free for managers. And that adds up to failing patients. The whole point was patient safety but he ignored all our reports.’

In his review, Sir Robert said: ‘What I heard during the course of the review from staff, employers, regulators and unions and others leaves me in no doubt that there’s a serious problem in the NHS.

‘Too often, honestly-expressed anxieties have met with hostility and breakdown of working relationships. Worse still, some people suffer life-changing events, they lose their jobs, their careers and even their health.

‘We heard all too frequently of jobs being lost, but also of serious psychological damage, even to the extent of suicidal depression.

‘In short, lives can be ruined by poor handling of staff who have raised concerns.’

Health Secretary Jeremy Hunt told the Commons: ‘The only way we will build an NHS with the highest standards is if the doctors and nurses who have given their lives to patient care always feel listened to when they speak out about patient care.

‘The message must go out that we are calling time on bullying, intimidation and victimisation, which have no place in our NHS.

‘We will ensure that every member of staff, NHS manager and NHS leader has proper training on how to raise concerns and how to treat people who raise concerns.’

Last night, Sir Robert Francis said: ‘I was asked by the Secretary of State to review the way concerns are handled and how those who raised them are treated.

‘I was not asked to investigate or pass judgement on the concerns themselves and made it very clear to all concerned that I was not going to do so.

‘It would be inappropriate to comment on individual contributions, as these were shared with me in confidence.’

Health secretary Jeremy Hunt  told the House of Commons he accepts the 20 principles laid out in Sir Robert's review. He said legalisation to protect whistleblowers will be fast-tracked

Health secretary Jeremy Hunt told the House of Commons he accepts the 20 principles laid out in Sir Robert’s review. He said legalisation to protect whistleblowers will be fast-tracked

A Department of Health spokesman added: ‘Since Mid Staffs, there have been significant changes to make the NHS the safest and most transparent healthcare system in the world.

‘We are confident Sir Robert Francis’ recommendations will help create a more open and honest culture, and we want to change the law in this Parliament so staff feel more able to raise concerns — creating Freedom To Speak Up Guardians will also support them to do so.’

Responding the Dr Drew’s comments, a spokesman for the Walsall Healthcare NHS Trust said the issues Dr Drew raises have been addressed through two formal legal processes, ongoing since 2009.

He said: ‘In 2012 the case went to an Employment Tribunal and we are satisfied with the outcome of the case and that of the recent Employment Appeals Tribunal that dismissed Dr Drew’s claims.

‘We would like to reiterate that this case did not question Dr Drew’s skills as a paediatric consultant and on behalf of the Trust would like to say that we regret that the situation had to get to the Tribunal stage.

‘As a Trust we actively encourage and support our staff to raise an issue if they are concerned about patient care.’

Meanwhile, responding to Ms Chowdhury’s concerns, a spokesman for London North West Healthcare NHS Trust – which now includes Ealing Trust – said: ‘The Trust commissioned an independent report which was undertaken by Parkhill counter fraud services.

‘They found no evidence of wrong doing on the part of the two consultants named in the allegations.’

THE LETTER IN FULL: THREE NHS WHISTLEBLOWERS RAISE ‘SERIOUS CONCERNS’

Dear Sir Robert

Concerns about the Freedom to Speak up Review.

We are two of the whistleblowers who contributed to your Freedom to Speak up Review. We have now had an opportunity to digest your report and have a number of serious concerns. We deal with one of them in this letter.

More than 600 individuals made detailed submissions to the quantitative review. Most of these, as your report concedes, experienced victimisation after reporting concerns. In some cases you described this as ‘truly shocking’.

The concern we wish to raise with you here is about the disclosures made to you by these individuals. We suppose that many, like us, assumed that you would take these seriously as disclosures made in the public interest and act on them. That is consistent with the review procedure and what you told us when we first met you. Your report, however, makes no mention of the disclosures any of us made or what action you have taken.

Sharmila Chowdhury a senior radiography manager at Ealing NHS reported fraudulent claims by two senior consultants in excess of £250,000. She and two other whistleblowers have written to Sir Robert Francis raising concerns over his recent review of how the NHS treats staff who dare to speak out

Sharmila Chowdhury a senior radiography manager at Ealing NHS reported fraudulent claims by two senior consultants in excess of £250,000. She and two other whistleblowers have written to Sir Robert Francis raising concerns over his recent review of how the NHS treats staff who dare to speak out

Here are thumb-nails of the disclosures we personally made. These are serious and unresolved.

Dr David Drew: The cover-up of a hospital’s and a hospital consultant’s catastrophic failure that led to the non-accidental death of a 16-month-old boy. The hospital’s refusal despite comprehensive evidence to accept or investigate allegations of this cover-up. The failure of a Royal College of Paediatrics review panel to take evidence of this seriously and investigate.

Ms Sharmila Chowdhury: I was senior radiography manager at Ealing NHS when I reported fraudulent claims in excess of £250,000. This involved moonlighting whilst being paid by the trust, double claiming and claiming for overtimes not undertaken. I was dismissed following a false counter-allegation. I won my case at the interim relief tribunal. The large sums the trust was defrauded of have never been returned and the perpetrators and senior managers who covered this up have not been made accountable. I reasonably believe that this fraud may be continuing. 

Even these examples show that you have allowed situations where patients are at risk and where managers act defensively out of self-interest to continue unaddressed. Amongst the other 600 plus submissions there must be, and we know there are, more examples of fraud and unresolved patient risk.

Even if you considered, as you suggest in the conclusion of your report, that re-opening our cases would be too troublesome we expected that you would have taken action in these matters which involved patient harm, death and fraud. Those responsible have not been held accountable. Lessons have not been learned. Patients and their relatives have not been told the truth. We consider this failure to address our concerns a serious flaw in your review. We feel that we have not been taken seriously which has been our experience as whistle-blowers all along. It seems appropriate to us that you allow independent scrutiny of all the submissions so that these matters can be addressed.

We look forward to a speedy and comprehensive response.

Yours sincerely

Dr David Drew 

Sharmila Chowdhury

Read more: http://www.dailymail.co.uk/health/article-2971737/Appalling-treatment-NHS-whistleblowers-investigated-Staff-ostracised-hospital-bosses-demand-independent-inquiry-whitewash-Francis-Report.html#ixzz50zUF1ezB
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Whistleblower forces hospital A&E waiting times review 

STV News  17 November 2017

Hospital: A whistleblower contact Ms Robison in October
Hospital: A whistleblower contact Ms Robison in October CC / Anne Burgess 

The Health Secretary has ordered an independent review after a whistleblower claimed long A&E waiting times at a hospital were being under-reported.

Shona Robison told NHS Lothian to carry out a full investigation after she was contacted about St John’s Hospital in Livingston last month.

The whistleblower suggested staff in the emergency department felt pressured to achieve the four-hour access standard and the number of patients waiting longer than four hours had been understated in performance reports.

Early findings from the internal review showed staff at St John’s have been applying locally-produced guidelines on how to record patients who breach the four-hour access standard which do not comply with national guidance.

It meant some patients who may have been recorded as breaching the waiting-time performance target were not included in departmental performance reports.

These are serious allegations and the early findings are clearly a cause for concern.’

Shona Robison

After the interim findings confirmed areas of concern, Ms Robison asked the Scottish Academy of Medical Royal Colleges, chaired by Professor Derek Bell, to undertake an external review to investigate the full circumstances.

She said: “These are serious allegations and the early findings are clearly a cause for concern.

“That is why I have asked Professor Bell to lead an independent review of these allegations.

“We are working very closely with the board to ensure that lessons are learned from the investigation and recommendations made are fully implemented as soon as possible and shared across NHS Scotland.”

The review will report back to Ms Robison early in the new year.

The initial draft report noted no evidence of bullying or harassment was found during interviews with staff and that busy staff had produced their own reference guides for inputting information into the data recording system.

But the report stressed the guidance sheets were only “created with the best intentions of clarifying arrangements”.

Jim Crombie, deputy chief executive of NHS Lothian, said: “NHS Lothian is committed to the values of openness and transparency, and we have placed them at the heart of our organisation.

“We actively encourage our staff in NHS Lothian to highlight issues relating to patient safety and we take any allegations of misconduct or wrongdoing very seriously.

“We have a robust whistleblowing policy in place to ensure that all our staff are supported and feel able to raise any concerns, and I am encouraged that staff are able to discuss them.”

Mr Crombie said an internal audit team, headed by a senior non-executive director, was appointed as soon as the concerns were raised.

He added: “We will co-operate with and support the work being carried out by the external review team.”

Scottish Labour’s health spokesman Anas Sarwar said: “These are deeply troubling findings that will concern patients across NHS Lothian and beyond.

“It is absolutely right that they are independently investigated.”

‘Despicable’ fraud costs NHS in England £1bn a year

BBC News    1 November 2017

NHS wardImage copyright  GETTY IMAGES

More will be done to protect the NHS in England from “despicable” acts of fraud, the head of the health service’s new anti-fraud body has said.

Sue Frith promised a crackdown as she released figures suggesting the yearly bill for fraud in the NHS topped £1bn.

Cases include patients falsely claiming for exemptions on dental and prescription fees, and dentists charging for work they had not done.

Ms Frith said the fraud takes vital funds from front line care.

Ms Frith, the chief executive of the NHS Counter Fraud Authority, said it would be looking at new ways to fight the crime.

The analysis by her team estimated that £1.25bn of fraud is being committed each year by patients, staff and contractors – the first time the health service has put a figure on total fraud committed itself.

The sum represents about 1% of the NHS budget

Presentational grey line

The most common frauds

The two biggest single areas of fraud were related to patients and procurement of good and services, both of which was likely to cost the NHS in excess of £200m a year each, according to Ms Frith.

She said patient fraud included cases where people wrongly claimed for exemptions for the cost of things like prescriptions and dental fees.

Meanwhile, payroll fraud was thought to be costing £90m a year, while dentists were said to be claiming around £70m in work on NHS patients that has not been done.

Dental fillingImage copyright  DR P. MARAZZI/SCIENCE PHOTO LIBRARY

 

Ms Frith said: “People may think it is just a small amount, but in large volumes it adds up and has an impact. It is criminal behaviour.

“It is despicable people would even claim things they are not entitled to. This is money that should be spent on front line patient care.”

She acknowledged the NHS must do better at detecting and preventing fraud.

Last year investigators successfully pursued cases worth £9.6m, although another £30m of cases are pending.

But this is only a small fraction of what she suspects is out there.

Ms Frith said the £1.25bn was probably on the conservative side – previous estimates by experts have put it even higher.

She believes the new organisation, which is officially formed on Wednesday, will be able to improve on this detection rate.

It has been given independent status and allowed to focus solely on fraud.

Its predecessor organisation, NHS Protect, also covered security.

Responsibility for security has now been devolved down to local NHS trusts and the budget for tackling fraud increased by over 10%.

This will also mean more field officers to be appointed to gather evidence, as well as a greater effort on fraud prevention by reviewing contracts and systems put in place to safeguard against fraud, she said.

Badly-behaved surgeons are ​putting patients’ lives in danger ​due to ‘culture of bullying’, report finds

The Telegraph  Science  

The Royal College of Surgeons Edinburgh (RSCE), which represents members across the UK, said a “visceral” atmosphere of fear among younger surgeons is leading to failures in concentration that directly harms patients

The Royal College of Surgeons Edinburgh (RSCE), which represents members across the UK, said a “visceral” atmosphere of fear among younger surgeons is leading to failures in concentration that directly harms patients.

In a new report, the college also warns the profession’s “macho” attitude makes it difficult to challenge bad practice, a culture which enabled disgraced breast surgeon Ian Paterson to mutilate victims unchecked for two decades.

It follows research published in June which found that one in six trainee surgeons are suffering from battlefield-type Post Traumatic Stress Disorder

Senior doctors have warned that the bullying culture among surgeons is negatively affecting recruitment, making entry into the discipline less competitive.

RSCE is calling for bullies to be removed from their posts and has set up a task force to send into affected hospitals.

The sentencing of surgeon Ian Paterson has once again raised the issue of bullying and undermining in healthcareProfessor Michael Lavelle-Jones

Dr Alice Hartley, a Newcastle-based registrar who co-chairs the college’s trainee committee, said a senior colleague had flung instruments at her during an operation after she asked a question, a situation she described as “not uncommon”.

In another incident, a surgeon slapped her hand as she was preparing to make an incision.

She said fear of older colleagues was forcing junior surgeons to cut corners, such as avoiding asking for advice in complicated cases.

“It’s getting more and more of an issue,” she told The Sunday Telegraph.

“If you’ve been shouted at first thing in the morning you carry that with you for the rest of the day. You won’t be concentrating on your job.”

Last year’s NHS staff survey found that, across all disciplines, one in five doctors had suffered bullying.

However, previous research indicates that surgical trainees are three times more likely to suffer abuse and that as many as 27 per cent of patient deaths during or shortly after surgery can be attributed in part to “disruptive behaviour”.

Victims who gave evidence to the RSCE said they had surgical leaders had spread false rumours and publicly humiliated them after they asked awkward questions.

Earlier this year West Midlands surgeon Ian Paterson was jailed for 20 years after being convicted of deliberately performing unnecessary and incompetent operations on 10 patients, although the true number of his victims is estimated to be several hundred.

Campaigners for the victims have called for the system, which allowed his butchery to go unchallenged in both the NHS and private sector, to be overhauled.

Last night RSCE leaders directly linked the current bullying culture with the risk of another rogue surgeon.

Earlier this year West Midlands surgeon Ian Paterson was jailed for 20 years after being convicted of deliberately performing unnecessary and incompetent operations on 10 patients
Earlier this year West Midlands surgeon Ian Paterson (pictured) was jailed for 20 years after being convicted of deliberately performing unnecessary and incompetent operations on 10 patients CREDIT:JOE GIDDENS/PA WIRE

Professor Michael Lavelle-Jones, President of RCSE, said: “The sentencing of surgeon Ian Paterson has once again raised the issue of bullying and undermining in healthcare, and highlighted the terrible consequences that this behaviour can have for patients.

“We want to change the culture of healthcare to ensure that this kind of behaviour becomes so unacceptable it can no longer go on.

“As professionals, we have a duty to protect our patients from damaging and unnecessary treatments, and, as professionals, we have a right to be protected from being bullied and undermined.”

The college wants the General Medical Council, which regulates doctors, to introduce compulsory training on bullying in Foundation Year training.

Chris Massey, GMC Chief Executive, said bullying and undermining behaviour should “never be tolerated”, but said the organisation’s standards already made it clear that medical training environments should encourage trainees to raise concerns about patient safety.

“We welcome the college’s efforts to build on those standards and tackle bullying and we are keen to support those delivering training to raise awareness of the issue,” he said.

NHS chiefs spend £100,000 on failed bid to stop whistleblowing doctor having his day in court

Mirror  14 October 2017 

Dr Chris Day, 32, says his career was “destroyed” after he raised fears over a short-staffed intensive care unit. Now the huge cost to the taxpayer has been revealed

NHS whistleblower Dr Chris Day has faced a lengthy legal battle

The Tories have secretly blown £3million worth of taxpayers’ cash on consultants in a failed bid to privatise the NHS staffing agency.

Ministers desperately tried to sell off the respected NHS Professionals organisation which supplies doctors and nurses to hospitals.

But they were forced to perform a major U-turn following widespread anger and criticism from MPs, medical chiefs and health unions.

Now we can reveal that the Government spent £2.8million on “external advisers” to work on the planned sale before it was abandoned.

Britain’s most senior doctor branded the “wasted” money “utterly shameful”.

Dr Chaand Nagpaul, chair of the British Medical Association, warned the Government’s use of management consultants meant money was haemorrhaging out of the health service where it was desperately needed.

Hospital
Dr Day raised concerns about alleged understaffing at a London hospital (Image: Getty)

He said: “It is utterly shameful to see politicians and health leaders have wasted yet more millions at a time when patient care is being compromised by frontline services being pushed to breaking point by a lack of resource and rocketing demand.

“The Government must focus on supporting and resourcing health services which need immediate attention rather than squandering money on misguided short-term commercial policies, and take decisive action to support doctors who are stretched to the limit across the country.”

The identities of the consultancy firms hired by the Tories have not been revealed.

Dr Eric Watts, a consultant haematologist and spokesman for campaign group Doctors for the NHS, added: “This shows the complete folly of trying to impose the ideals of a marketplace where absolutely no market belongs: the NHS.

“It does not need privatising and it certainly does not need public money throwing away to fail to prove it might. It needs funding properly. Not giving away.”

In a written statement to parliament, Health Minister Philip Dunne confirmed: “The Department spent approximately £2.8million on external advisers’ costs during the sale process for NHS Professionals until the decision was announced on 7 September that NHS Professionals will remain wholly in public ownership.

“The Government concluded that none of the offers received for NHS Professionals reflected the company’s growing potential and improved performance.”

Justin Madders
Labour’s Justin Madders said the amount of money spent was “astonishing”

The Department of Health said it abandoned the sale of the agency which supplies 90,000 doctors, nurses and other healthcare workers, after failing to receive any adequate bids.

The proposal had been strongly criticised because the use of NHS Professionals saves the NHS £70million a year by supplying staff more cheaply than private sector agencies.

Mr Dunne admitted the £2.8million bill will be paid for by taking a divided payment from NHS Professionals, but insisted “this will not impact on delivering frontline NHS services”.

However, Justin Madders MP, Labour’s Shadow Health Minister, said: “The Tories have starved our NHS of funds, while wasting millions of pounds on trying to force through the privatisation of services in the face of common sense.

NHS staff lay bare a bullying culture

The Guardian       

26 October 2016

A shocking four-fifths of respondents to a Guardian survey reveal they have been bullied, and a third have lost jobs as result

One in 10 bullying victims was subject to violent behaviour and aggression. One in 10 bullying victims was subject to violent behaviour and aggression. Photograph: Peter Byrne/PA

Bullying is a pernicious problem in the NHS. That’s the stark finding from exclusive research by the Guardian. The online survey of more than 1,500 doctors, nurses and other health workers in hospitals, primary care and community settings, found that 81% had experienced bullying and for almost half of them (44%), it is still ongoing. Close to nine out of 10 bullying victims who responded have been left with their cases unresolved.

Although the survey on bullying was self-selecting, the findings underline the results of the official annual NHS staff survey. The 2015 survey of nearly 300,000 healthcare professionals across England found that a quarter of staff in NHS trusts had experienced bullying, harassment or abuse in the previous 12 months.

Some 87% of respondents to the Guardian survey, carried out between August and September, think bullying is a big problem within the NHS, while almost three-quarters said they felt the health service did not take bullying seriously. “The culture is driven by exerting undue pressure on others to get things done. If you don’t, you are targeted and eventually you end up with stress and depression,” one NHS manager said.

“The organisation becomes defensive and takes the corporate line to protect themselves from a legal challenge and puts it down to your perception. You are then managed out of your job through contrived actions designed to make you leave. All this leaves you broken and with no strength to fight. You go if you can find another job. Otherwise you suffer in silence.”

The devastating impact of bullying is all too apparent. A third of victims said they had been pushed out of their jobs, with many developing serious mental health problems as a result, while almost three-quarters reported increased stress and panic attacks. As a result, some 41% said they needed counselling or treatment after being bullied. The survey also shows the adverse impact of bullying on the NHS, with those respondents who have been bullied taking on average 108 days off work and almost a third (31%) saying they were signed-off sick. A further third said they had contemplated leaving their job.

Sue Covill, director of development and employment at NHS Employers, (the employers’ organisation for the NHS in England) admits the results are worrying. “Bullying is completely unacceptable and the ongoing work to tackle it is vital for all NHS organisations, leaders and staff,” she says. “To improve the working lives of our staff and deliver the best possible care to patients, we need to create supportive, positive, open and collegiate cultures in our organisations across the health system.”

According to the 1,355 anonymous survey respondents who said they had experienced or witnessed NHS bullying, the most common forms of abuse are undermining behaviour and persistent criticism. Just over a third said they were persecuted through fear or threats, saying their career was deliberately sabotaged. One in 10 bullying victims was subjected to violent behaviour and aggression.

Asked if a particular incident triggered the bullying, 55% said raising a concern prompted the abuse. Fear of reprisals means that only 54% reported the bullying. For the 43% who chose not to report it, two-thirds felt scared that to do so would make things worse. Of those who did report their bullying, 44% said it persisted afterwards, sometimes for as long as a year.

“My experience left me feeling as though I had been manipulated, that I was a liar and had made it all up,” said one NHS administrator. “I had a meeting with my bully and came away from it feeling worse than before. I’m now left feeling desperately unhappy in a job I now despise.”

Only 17% of those who reported bullying said they received pastoral support from their organisation – and less than a quarter of these were satisfied with the result.

YouGov survey commissioned last year by the TUC showed that nearly a third of people had been bullied at work.

Concerns have been raised by health professionals and academics that the hierarchial structure of the NHS facilitates a culture where bullying can flourish.

“Medicine is a hard taskmaster but made worse by those around you who see you as a threat that rocks the hierarchy where everyone should know their place,” an anonymous hospital consultant says in response to the results of the Guardian survey. He warns: “It may well impact on patient care if those who perpetuate the abuse look for an opportunity to trip you up and blow any minor omission out of all proportion.”

Dr Anthea Mowat, chair of the British Medical Association’s representative body, says the survey results should act as an urgent wake-up call to employers. “If more staff are to speak out, they must be able to raise concerns without fear of being harassed or victimised, and there need to be clear and supportive systems of reporting in place,” she says. “We need to put an end to the climate of fear that has built up in the NHS over a number of years, with those in senior positions in the NHS leading by example to make this a reality.”

The survey, by the Guardian’s Healthcare Professionals Network, was sent out to network members via an email newsletter. It was also promoted via Twitter and Facebook. Network readers were also invited to take part through the website.

Nurse who left the NHS: the loss of my role was like a bereavement

I was an experienced nurse working in a fantastic team of staff. Following a reshuffle, our ward manager was replaced by someone who was known for being a bully. She frequently made comments and used language inappropriate for the role. Her victimisation of me began immediately. On one occasion, due to staff sickness I was expected to do the jobs of four other people and was reprimanded when I objected. I was expected to attend meetings on my days off. I was constantly ridiculed and told that medical staff had criticised me even though, when questioned, they quite clearly had not. On one occasion I was physically pushed out of the way. This went on for over a year and, along with the treatment of me that followed, had a devastating effect on my psychological health. I was having panic attacks and suicidal thoughts.

I took out a grievance and was immediately moved to an area where I had no previous experience or expertise. Unable to continue working I was signed off sick with work-related stress. My bullying complaint was not investigated properly and not upheld. I believed that I had been targeted as I had previously raised concerns about patient care. I appealed against the decision and with the support of a union representative and witnesses, I won. But the bully remained in post and I was offered a job in another area, at a lower grade. I was advised by my union that I was being constructively dismissed and not to return to work. I negotiated an exit strategy with payment of a tax-free lump sum under one of the now-outlawed compromise agreements. I am now in receipt of an NHS permanent injury benefit which guarantees me a tax-free income, in excess of what I was previously earning, for the rest of my natural life. I now work for a private company in a non-clinical setting. The loss of my clinical role has been like a bereavement and not a day goes by when I do not think about the injustice of my case.

NHS manager: the bullies have wrecked my career

There is an endemic culture of bullying at the hospital trust I work at. Colleagues have been suspended for raising concerns over unsafe patient care and allegations of abuse towards patients. One colleague had to leave her job after whistleblowing and is undergoing counselling for post-traumatic stress disorder. In my case, the bullying was incessant – my line manager would call me in the evening at home telling me to take time off work and encouraging me see my GP as, in her opinion, I was unwell – I wasn’t. She insisted that I had to contact her every morning to tell her where I was, even at work. Other senior people soon started to target me and I would be admonished for the smallest of errors and for things I hadn’t done. Because of the seniority of these people, other members of staff began to pull away, and I soon became isolated. By this time, I had gone to see my GP who had diagnosed me with severe depression. I have had suicidal thoughts – occasionally I still do. I’ve been demoted and moved into a job where I have no experience and I’ve been offered no training; I’m being set up to fail. I’m resigned to the fact that I will have to leave the trust at some point, as I can’t carry on. The bullies have wrecked my career in the NHS, and my confidence in my ability has evaporated. The whole experience has had a profound effect on me – cheerful confidence has been replaced by paranoia and distrust; I will never be the same person again. To this day I do not know what I did wrong – if anything.

Why I became a radiology whistleblower

HealthManagement, Volume 17 – Issue 4, 2017

28 September 2017
 Sharmila Chowdhury

Whistleblowers who raise concerns continue to be at risk of losing their jobs. Sharmila Chowdhury speaks the truth behind the life of a whistleblower and the severe consquences she continues to face after being dismissed by the NHS.

I had worked in the UK National Health Service (NHS ) since 1980 and qualified as a radiographer in 1983. I joined Ealing Hospital (London North West Healthcare NHS Trust) in February 2003 as Deputy Imaging Manager and was promoted to Imaging Manager in May 2008. I was in charge of 60 members of staff in the department, not including consultant radiologists. As the budget holder for the department I was responsible for signing off additional work and attendances of all staff, including the consultant radiologists. I raised concerns that very substantial sums of money were being paid to two consultants, who were also working over several years at a private hospital. The manager at the private hospital confirmed that they had attended that hospital since April 2006 for times whilst also being paid by the Trust. The concern escalated up the management chain—all agreed this was a problem. Additionally, consultants were claiming  for overtime not worked. The practice was not stopped and I was dismissed after false counter allegations were made. I was escorted out of the building in front of my staff.

 

While I won at the interim relief hearing and disciplinary appeal, the Trust refused to let me return as they advised my post was now ‘redundant’ due to technology. Although the Trust apologised, I have been unable to find work. One job offer was withdrawn when they discovered I was a whistleblower. I have had interviews cancelled and posts withdrawn. In one instance, the Care Quality Commission intervened, but without success. I am now being treated for cancer, that consultants believe may be linked to the stress of my treatment, and I have faced the ongoing threat of losing my home without income.

 

No action has been taken against those responsible for cheating the NHS out of large sums of money nor against those who colluded to victimise me. I have an excellent paper trail to support my claims. I contacted many organisations and politicians about my case. No one bothered to either investigate publicly my raised concerns, despite extensive evidence, nor my treatment as a whistleblower. The Department of Health (DH ), the Prime Minister’s Office and NHS London advised they couldn’t get involved. However, from a subsequent freedom of information request, it transpired that DH were communicating fully with the Trust about my case and settlement. They viewed my payoff as ‘good value for money.’

 

On 30 May 2014, I wrote an open letter to Jeremy Hunt, t he Secretary of State for Health, asking for help. He met me and a few other whistleblowers along with Simon Stevens, Chief Executive of NHS England. Hunt commissioned a review into NHS whistleblowing led by Sir Robert Francis, QC. The published report, Freedom to Speak Up (Francis 2015) has raised awareness. However, this has produced ineffective change for whistleblowers. I wrote an open letter to Hunt, printed in the Health Service Journal in 2016 (Chowdhury 2016), which was the highest-read article in the HS J for 2016. Hunt responded, but the response was unhelpful.

 

Campaigning for whistleblowers

 

I have continued to campaign for help not just for myself but for other whistleblowers, as my website (sharmilachowdury.com) demonstrates. Despite being featured in the media extensively no permanent solution has been found. I am currently working/ helping with NHS Improvement to look into helping NHS whistleblowers back to work, supported by the Department of Health, which unfortunately still has a long way to go to remedy the current situation faced by whistleblowers.

 

There has been no independent inquiry into either my raised concerns or my treatment as a whistleblower. None of the managers at the Trust have been held to account for my treatment, nor have the concerns raised by me been investigated, despite £5.7bn a year being lost to fraud in the NHS as reported in my BB C interview (https://www.youtube.com/watch?v=CgxOvsqo3E4). The reported consultants continue to be employed by the trust. Fraud in the NHS still continues to be ignored. My case is proof that perpetrators of fraud continue to be supported by senior officers turning a blind eye.

 

I am currently working in the private sector, without any long-term security. I consider myself lucky in comparison to other whistleblowers. However, as my NHS pension has been ruined and I have been unable to pay off my mortgage I will have to continue to work until I die. There will be no retirement for me.

 

References:

Chowdhury S (2016) An open letter to Jeremy Hunt from a whistleblower. Health Service Journal, 4 January. [Accessed: 22 August 2017] Available from hsj.co.uk/patient-safety/an-open-letter-to-jeremy-hunt-from-a-whistleblower/7001361.article

 

Francis R (2015) Freedom to speak up: an independent review into creating an open and honest reporting culturein the NHS. London: Freedom to Speak Up. [Accessed: 22 August 2017] Available from freedomtospeakup.org. uk/the-report

https://healthmanagement.org/c/healthmanagement/issuearticle/why-i-became-a-radiology-whistleblower#.Wc0ieNN8rZ0.twitter

The social services boss fired after ‘blowing the whistle on grooming’: Chief seeks £1.4m settlement after being sacked when she raised concerns with her seniors

Mail on Line 25 September 2017  

Tom Payne and Simon Trump for the Daily Mail

  • Maggie Siviter, 56, told a tribunal that boys and girls were plied with drugs
  • The former safeguarding head says she was sacked after raising her concerns
  • She claimed North Somerset Council and police failed to act on evidence
  • It included allegations that child sexual exploitation had happened in buildings linked to three local businessmen who were friends with a local Tory councillor
Maggie Siviter, 56, pictured, former head of safeguarding for North Somerset council, told a tribunal that boys and girls were plied with drugs at seedy premises in Weston-super-Mare

Maggie Siviter, 56, pictured, former head of safeguarding for North Somerset council, told a tribunal that boys and girls were plied with drugs at seedy premises in Weston-super-Mare

A social services chief has claimed that she was sacked after ‘blowing the whistle’ on an alleged child sex grooming gang.

Maggie Siviter, 56, former head of safeguarding for North Somerset council, told a tribunal that boys and girls were plied with drugs at seedy premises in Weston-super-Mare.

Mrs Siviter said she was sacked from her £120,000-a-year job in November 2015 after raising her concerns with her seniors in protected disclosures under whistleblowing laws.

She is claiming breach of contract, arguing that, as a whistleblower, she had legal protection from dismissal. The hearing, which is expected to last at least two weeks, was told she will be seeking a £1.4million settlement if she wins her case.

She claimed the council and police failed to act on evidence of child sexual exploitation in buildings linked to three local businessmen who were friends with a Tory councillor.

They included a massage parlour, nightclub, bottle shop and restaurant owned or run by Alkas Hussain, Kiem Binh Mu and his brother Cam.

The three are said to have had personal and professional links with Peter Bryant, 75, a long-serving Tory councillor who lost an appeal to have his name excluded from the tribunal.

Fears about child sexual exploitation were first raised during an investigation into two houses selling counterfeit tobacco, the hearing was told.

Julian Feltwell, a trading standards officer involved in the investigation, said undercover footage of the properties, run by Cam, showed girls being lured inside. Allegations of abuse later emerged when two of the girls reported those involved.

Mr Feltwell, who was suspended soon after Mrs Siviter was dismissed, said the then safeguarding head and her team were able to link the suspected gang to other premises owned by the three men.

These included Butterflies massage parlour, Dragon’s Kiss nightclub, a restaurant and a bottle shop. Connections were then drawn to Mr Bryant’s links to the men.

Mr Feltwell told the tribunal in Pontypridd, South Wales, that Mr Bryant had asked safeguarding staff about the three men’s involvement in social services investigations, adding: ‘He used establishments which were used by these individuals and was on first-name terms. Where does patronage become protection?’

The three are said to have had personal and professional links with Peter Bryant, 75, (pictured) a long-serving Tory councillor who lost an appeal to have his name excluded from the tribunal

Mr Feltwell also detailed Mr Bryant’s close links to Cam Binh Mu, who was jailed for 16 weeks in February last year for producing counterfeit tobacco.

In 2010, Cam was imprisoned for a year for brandishing a shotgun at a council bailiff. In his trial, Mr Bryant produced a glowing reference for him.

Mr Feltwell said: ‘At no point did I say Councillor Bryant was involved in child sexual exploitation, but I had conversations with individuals about his being at the centre of concerns about exploitation and safeguarding.’

In a written statement for the tribunal, Tony Oliver, independent chairman of the North Somerset Safeguarding Children Board, described Mrs Siviter’s meetings about exploitation as ‘shambolic’ and based on ‘rumours and speculation’.

Avon and Somerset Police said there is no investigation into the three men but confirmed the force is aware of the allegations.

Officers were involved in meetings with Mrs Siviter about the child exploitation claims before her dismissal.

A spokesman said the force would not comment while the tribunal is being conducted.

GPs could be investigated by new patient safety whistleblowing watchdog

Pulse   14 September 2017 By 

whistle - online

A new patient safety watchdog has been given powers to investigate serious incidents or risks to patients in GP practices and NHS trusts under a draft bill laid before Parliament today.

The Health Service Safety Investigations Bill establishes statutory powers of the Health Service Safety Investigations Body, principally investigating ‘safe spaces’

This will mean information from NHS whistleblowers, patients, or their families shared with an accredited body or as part of an investigation will not routinely be made public.

In most cases a High Court order would be needed to make information given to the Health Service Safety Investigations Body public

Health secretary Jeremy Hunt said this was a ‘landmark’ for safety in the NHS and said he hopes that this will encourage staff to raise concerns without fear of recrimination.

Modelled on the ‘no blame’ system in air safety investigations the HSSIB will be independent of the NHS and have powers to investigate NHS bodies and contracted providers.

The Department of Health confirmed to Pulse that GP practices would be within the scope of its investigations, but it was not focused on any one part of the health service.

After each investigation is completed, the HSSIB will publish detailed reports which will:

  • make recommendations for system-wide learning across the NHS;
  • help develop national standards on investigations;
  • provide advice, guidance and training to improve investigative practice across the health service.

Mr Hunt said: ‘When significant errors occur, it is vital that health organisations react quickly and decisively to share lessons and make improvements.

‘To achieve this we need to create an environment where patients, public and healthcare professionals all feel able to speak out about their concerns, without fear or favour.’

 

GPC will put contract offer out to referendum next month

Heart surgeon who became an Uber driver after being fired from £95,000 a year job for ‘bullying’ agrees six-figure settlement after unfair dismissal claim

  • Consultant cardiac surgeon Peter O’Keefe ws accused of bullying colleagues 
  • He was fired from his £95,000-a-year job at the University Hospital of Wales
  • A settlement was reached on the day an Employment Tribunal was due to start
  • Dr O’Keefe claimed he was being punished for being an NHS whistleblower 

A heart surgeon has won a six-figure payout from the health board that sacked him after claiming he was unfairly dismissed for being an NHS whistleblower.

Consultant cardiac surgeon Peter O’Keefe, 52, who went on to become an Uber driver was accused of bullying colleagues at one of Britain’s top teaching hospitals.

He was sacked from his £95,000-a-year job at the University Hospital of Wales after being found guilty of misconduct in the workplace, and now earns around £12,000 in his new career with the taxi app.

But Dr O’Keefe took Cardiff & Vale University Health Board to court for unfair dismissal, and claims they wasted £1m of taxpayers’ money by unfairly sacking him.

Peter O'Keefe, 52, was accused of bullying colleagues at one of Britain's top teaching hospitals and was fired

Peter O’Keefe, 52, was accused of bullying colleagues at one of Britain’s top teaching hospitals and was fired

Dr O'Keefe earned £12,000 in his first year as an Uber driver, a significant drop from his old £95,000 salary

Dr O’Keefe earned £12,000 in his first year as an Uber driver, a significant drop from his old £95,000 salary

 

An out-of-court settlement was reached on the day an Employment Tribunal was about to start.

Dr O’Keefe said: ‘It’s a bitter-sweet outcome for me.

‘It’s an enormous relief not to have the pressure any more, but this has gone on so long and I can’t go back to medicine. I’ve tried to get work but I’m the wrong side of 50.

‘I came to the conclusion that the best thing was to give myself a job, so I’ve become an Uber driver, and I’m loving it.’

The health board had recommended Dr O’Keefe for a National Clinical Excellence Award in 2011 – just months before suspending him from the University Hospital of Wales for alleged bullying.

Dr O'Keefe had been recommended for a National Clinical Excellence Award in 2011 - just months before he was suspended

Dr O’Keefe had been recommended for a National Clinical Excellence Award in 2011 – just months before he was suspended

It was claimed up to 40 colleagues came forward to complain about his behaviour at the 1,000 bed hospital in Cardiff.

Dr O’Keefe felt he was being victimised for raising the alarm about a patient left in a ‘vegetative state’ after becoming disconnected from a ventilator for more than 10 minutes.

An investigation of the patient’s treatment identified more than 20 safety failings.

Other doctors on the surgical wards thought Dr O’Keefe’s career was ended prematurely because of his management style.

At the time of his suspension a friend of the consultant’s said: ‘The allegations against him had nothing to do with his clinical competence as a surgeon.

‘He is a forceful and assertive character. It can be very stressful in an operating theatre, and some people have taken exception to his manner.

‘Ten years ago perhaps people wouldn’t have made anything of it.

‘A lot of people did make complaints against him, but there was a degree of rounding-up that went on, and some were more keen on complaining than others.’

After three years suspended on full pay the father-of-four was sacked in 2015.

The General Medical Council investigated and took no action but Dr O’Keefe’s suspension went on for so long he was unable to retain his licence to practice medicine.

He said: ‘I can no longer work as a doctor which is the only work I have known since I was 22. ‘My mental health has suffered also.

‘When I was working I was a resilient, dynamic, mentally agile individual undertaking a demanding job, but was doing what I had always wanted to do.

Despite his substantially lower income, Dr O'Keefe is enjoying his new career as an Uber driver

Despite his substantially lower income, Dr O’Keefe is enjoying his new career as an Uber driver

Dr O'Keefe reached an out-of-court settlement on the day an employment tribunal was about to start

Dr O’Keefe reached an out-of-court settlement on the day an employment tribunal was about to start

 

‘I was diagnosed with anxiety straight after being suspended, I haven’t slept properly ever since.’

The out-of-court settlement has a confidentiality clause preventing either party discussing its terms.

It is believed to be a six-figure sum but not enough for the doctor to give up work – he still has two children in full-time education.

Dr O’Keefe said: ‘I had to do something and the opportunity of driving an Uber came up – it meant I could be my own boss.

‘I got my licence on August 1 and I’m enjoying it, I’ve met some interesting people and had some interesting conversations.’

The date is significant – it was 20 years to the day that he started work as a houseman in London and 16 years to the day that he became a cardiothoracic surgeon at the University Hospital of Wales.

 

NHS buries 19,000 ‘suspect’ deaths: Expert demands urgent probe into ‘avoidable’ fatalities amid shock claims dozens of hospitals across Britain are ‘potentially unsafe’

  • Sir Brian Jarman – man who helped expose Mid-Staffs scandal – made discovery
  • Lib Dem health spokesman Norman Lamb demanded Jeremy Hunt investigate
  • Sir Brian calculated 32,810 ‘unexpected’ deaths in English hospitals in five years
  • But using the preferred NHS method, 13,627 were classed as such – 19,183 fewer

The NHS has covered up thousands of ‘suspect’ deaths in hospitals across England, sparking calls for an urgent inquiry, The Mail on Sunday can reveal.

According to the expert who helped to expose the Mid-Staffordshire hospitals scandal – where hundreds died due to poor care – health chiefs have systematically excluded up to 19,000 ‘unexpected’ deaths from official statistics over the past five years.

Professor Sir Brian Jarman says his shocking findings mean there are dozens of ‘potentially unsafe’ hospitals that should be investigated over high death rates, but which are being overlooked.

Last night, Liberal Democrat Health spokesman Norman Lamb demanded that Health Secretary Jeremy Hunt look into the claims as a matter of urgency.

Mr Lamb, who was a Health Minister in David Cameron’s Coalition Government, said: ‘These revelation are deeply disturbing. I am writing to Jeremy Hunt and to NHS England chief executive Simon Stevens asking for Prof Jarman’s analysis to be assessed as a matter of urgency and for a full response to be provided.

Scroll down for video 

The NHS method classifies just ten trusts in England (shown in blue) as having death rates above the expected range in 2016. But under Prof Jarman's analysis, another 24 (in red) should also be classified as having high mortality rates
 The NHS method classifies just ten trusts in England (shown in blue) as having death rates above the expected range in 2016. But under Prof Jarman’s analysis, another 24 (in red) should also be classified as having high mortality rates

Why these hospitals should be investigated over ‘avoidable’ fatalities

  His family’s lawyer described the death of Kayden Urmston-Bancroft (pictured) as ‘entirely preventable’

Avoidable death #1

Little Kayden Urmston-Bancroft died of a heart attack last year after doctors at a hospital where death rates are now under scrutiny failed to operate on him for three days. His family’s lawyer described Kayden’s death as ‘entirely preventable’.

The 20-month-old had a life-threatening hernia and was due to have an operation to rectify the problem after being admitted to Royal Manchester Children’s Hospital, above, in April 2016. His grandmother, Julie Rowlands, claimed Kayden was ‘put in a room and left’. He subsequently went into cardiac arrest and died two days later.

‘All we got, nearly every day, was, “He’s not having the operation today,” ’ she said. Surgeons claimed managers had prioritised hitting waiting-time targets for pre-planned operations over emergency care.

The Trust has been ranked as having normal death rates for the past five calendar years. But under Prof Jarman’s analysis, it should have been classed as having high death rates in 2012 and 2016.

'Brilliant mum': Deborah O'Hara with her daughter Caitlin, now 22

‘Brilliant mum’: Deborah O’Hara with her daughter Caitlin, now 22

Avoidable death #2

When mother-of-three Deborah O’Hara died in June 2015, three days after a cancer operation at University Hospital Coventry – one those highlighted by Professor Jarman – her husband Andy believed his wife had been the victim of tragic bad luck.

But the 45-year-old’s untimely death had been caused by a surgical error, which hospital bosses neglected to reveal to Mr O’Hara or the coroner. He found out three months later when told by journalists.

Mrs O’Hara’s death came when the NHS Trust which runs the hospital was classed as having an ‘expected’ mortality rate. However, under Prof Jarman’s analysis, it should have been ranked as having a higher than expected death rate.

During the six-hour operation, consultant urologist Dr Andrew Blacker mistakenly clamped a large artery, causing a lack of blood supply to Mrs O’Hara’s bowel.

At her inquest last December, Mr O’Hara said he and his family had lost ‘a lovely wife’ and a ‘brilliant mum’. The Trust apologised to the family.

‘The concern is that, if Prof Jarman is right, possible causes of unexpected deaths will go unnoticed, leaving NHS patients unacceptably at risk.’

Prof Jarman reached his alarming conclusions after studying official hospital death rate figures using an internationally accepted method – a method used as standard in health systems across Europe and the United States.

He calculated that there were 32,810 ‘unexpected’ deaths in English hospitals over the past five years. But using the NHS’s preferred method, only 13,627 were classed as such – a difference of 19,183 deaths.

In addition, the method Prof Jarman used, which is recommended by the UK’s Association of Public Health Observatories, classified 34 hospital trusts across England – responsible for 87 acute and community hospitals – as having significantly high death rates last year. By contrast, the NHS method counted just ten trusts, covering 18 hospitals, as having death rates above ‘expected’ levels.

When Prof Jarman raised concerns about the Mid Staffordshire NHS Trust in 2007, he was ignored by the Department of Health – but it became one of the most shocking NHS scandals in history.

Now he says NHS officials are ‘fudging the figures’, resulting in potentially fatal problems on hospital wards being ignored. He added: ‘If you use internationally accepted criteria, then 34 hospital trusts have high death rates.

‘But because the NHS is using what might be called a “fudge factor”, they are only identifying ten.

‘As a result, we don’t know if anybody is taking any notice of these other 24 potentially unsafe hospital trusts. This is worrying because there might be serious clinical problems, and issues with patient safety, that are not being addressed.’

Prof Jarman said the NHS had used the internationally recognised system, called Byar’s confidence intervals, in the past.

Until January 2012 it was used in tandem with another method – called overdispersion – which aims to give hospital trusts more leeway before being classed as having high death rates. But the Byar’s method was then dropped, with bosses at NHS Digital, the Health Service’s statistics body, saying it was confusing to have two systems running at once.

They chose the overdispersion method – which results in far fewer hospital trusts being classed as having significantly high death rates. Under that system, a trust is regarded as having a high death rate only if its measure, called the Summary Hospital-level Mortality Indicator, or SHMI, is about 12 per cent or more above the national average.

In contrast, the Byar’s method, which Prof Jarman applied, is much stricter, classing anything with a SHMI of more than six or seven per cent above the national average as significantly high.

Disturbing parallels with the Mid-Staffs scandal

Investigator: Sir Brian Jarman 

Investigator: Sir Brian Jarman 

 

Ten years ago Professor Sir Brian Jarman, sent a series of ‘mortality alerts’ to health bosses about what was then a little-known part of the NHS in the middle of England. Its name? Mid Staffordshire NHS Trust.

He and his colleagues at the Dr Foster Intelligence Unit were concerned that death rates at Mid-Staffs, as it became known, were considerably higher than average. How much higher? About 27 per cent.

‘When we published that, the Department of Health insisted that people take no notice of our data,’ Prof Jarman recalled last night. ‘We asked them, “Why not?”, but we never got a proper explanation.’

But he and his team were on to something big.

Soon afterwards, personal reports of the shocking ‘care’ that patients at Stafford Hospital had received started emerging. Added to the death rate data, the reports led to an investigation by the Healthcare Commission, the watchdog at the time.

Its report, and subsequent official inquiries, revealed a culture pervading all levels of the Health Service, where criticism of the NHS was ignored or suppressed – with lethal consequences.

NHS bosses argued the approach they chose was the more suitable of the two, as it ‘better reflected’ the difficulties in comparing death rates among hospitals which serve very different areas.

Some serve populations that are poorer and sicker than others, meaning that – if the quality of hospital care is the same – they are likely to have higher death dates.

Hospital mortality rates are adjusted to take into account these underlying demographic differences, to create a level playing field. However, NHS Digital argues that these differences produce so much statistical noise, that many more hospital trusts need to be given the benefit of the doubt.

Prof Jarman said: ‘I object to the system NHS Digital is using, because they are applying a method which really just reduces the number of high death rate hospital trusts.’ He claimed even advocates of the NHS approach admitted it was not based on ‘hard science’.

And he said that if a trust was reclassified as having a ‘normal’ death rate, then hundreds of deaths previously classed as ‘unexpected’ would suddenly be recast as normal too.

Worryingly, Prof Jarman’s painstaking research shows a clutch of hospital trusts with consistently high death rates are flying just below NHS Digital’s radar.

Among them is United Lincolnshire NHS Trust, officially categorised as having a high death rate in 2015 only during the five-year period from 2012 to 2016. But under the Byar’s system it would have been marked as a high death rate trust in four of those five years. United Lincolnshire, which runs four hospitals in Lincoln, Grantham, Boston and Louth, was put in special measures for an unprecedented second time in April, after the Care Quality Commission (CQC) found ‘a deterioration across a number of services’.

Warrington and Halton Hospitals NHS Foundation Trust, officially rated ‘normal’ in four of the five years, would instead have been classed as ‘high’ in all five years under the Byar’s method.

The latest CQC reports for this trust, published in July 2015, gave it a ‘requires improvement’ notice – the second lowest ranking after ‘inadequate’.

Last night Shadow Health Minister Justin Madders urged hospitals to be open with their patients about the quality of services.

He said: ‘Jeremy Hunt has claimed transparency as his watchword. He ought to do much more to reassure the public that safety and quality at every local hospital is as good as it can possibly be.’

But Professor David Spiegelhalter, president of the Royal Statistical Society, defended NHS Digital’s approach. Prof Spiegelhalter, who was a member of the team that selected overdispersion, said it rightly gave ‘some additional leeway to hospitals, to allow for the inevitable problems of fairly comparing mortality rates’.

He added: ‘The formulaused to calculate mortality rates is meant to take into account all the real-life differences between populations served by different hospitals, such as age and degree of illness. But it can never do that perfectly.’

Ignoring these comparison problems, as Prof Jarman’s system did, was therefore unjustified, he said.

Dr Richard Andrews, associate medical director of United Lincolnshire Trust, said: ‘We don’t accept Prof Jarman’s interpretation of our mortality figures.’

Professor Simon Constable, medical director of Warrington and Halton Hospitals, said its mortality rates had been falling over the past two years and were now within the ‘expected’ range.

Ministers can’t sweep these statistics under the carpet, writes NHS campaigner Fiona Bell

Imagine for a moment that a fifth of NHS hospitals in England were officially classed as having abnormally high death rates. It would be scandalous.

People would wonder if their local hospital was up to scratch. And they might question how well the NHS was coping after years of financial restraint.

You can see how the powers- that-be might not be too keen on publishing statistics like that. You can see how they might choose to use a method that minimised the number of hospital trusts classed as having high mortality rates.

And that is exactly what Prof Jarman’s excellent analysis has exposed.

He has discovered that, using an internationally accepted statistical method, 34 hospital trusts across England last year had mortality rates above the ‘expected’ range.

By contrast, using its own method, NHS Digital classed ten trusts as having high death rates.

This ‘official’ method meant a hospital trust could have a mortality rate that was 11 per cent above the national average, and still be classed as ‘normal’.

Is this right? Or does it risk sweeping under the carpet very real problems at a significant number of our hospitals?

I know what I think.

Since my grandfather died in 2009, having suffered no fewer than 17 falls at Wansbeck and Blyth hospitals in Northumberland, I have campaigned to improve NHS care. Before he died, he made me promise: ‘Don’t let what happened to me happen to anyone else.’

Sadly, so many times over the past decade I have heard the hollow promise that ‘lessons will be learned’ from some entirely preventable tragedy; or the empty pledge of greater ‘openness and transparency’ after a cover-up.

In fact, Jeremy Hunt has tried to make transparency the byword of his long spell as Health Secretary. He’s sold himself as the man who will not let another Mid-Staffs happen on his watch.

But Mr Hunt and his mandarins risk burying their heads in the sand if they blindly accept statistics that appear to show that all is well in our hospitals.

And if they can’t see the truth of what’s going on – or don’t want to – then that’s a dangerous thing.

Read more: http://www.dailymail.co.uk/news/article-4847184/Expert-demands-urgent-probe-avoidable-fatalities.html#ixzz4ramih9TD
Follow us: @MailOnline on Twitter | DailyMail on Facebook

 

Hospital boss who defrauded NHS is ordered to tell court how she is going to repay it

Devon Live  29 August 2017

Paula Vasco-Knight was given a suspended prison sentence in March

Court artist sketch by Elizabeth Cook of former NHS chief executive Paula Vasco-Knight, 53, being comforted by her husband Stephen Vasco-Knight, after being allowed to walk free from Exeter Crown Court

A former Devon hospital boss who defrauded the NHS of £11,000 has been told to reply to an order requesting details of her financial assets.

Paula Vasco-Knight was given a suspended prison sentence in March after admitting paying her graphic designer husband, Stephen, the NHS cash for work that never existed.

Paula Vasco-Knight, former chief executive of Torbay Hospital
Paula Vasco-Knight, former chief executive of Torbay Hospital

 

At the time she was chief executive of South Devon NHS Foundation Trust and national lead for equalities for NHS England.

After her sentence a timetable was set for the money to be recovered using the Proceeds of Crime Act.

A short hearing took place on Tuesday morning at Exeter Crown Court. Prosecutor Gareth Evans said Vasco-Knight and her husband had not responded to the POCA request and a new timetable would have to be set.

The couple must tell the court whether they agree with the prosecution’s assessment of their financial assets.

Vasco-Knight and her husband were not present for the short hearing.

Recorder David Bartlett gave the pair until to September 16 to respond.

If the couple do not respond they will be required to return to court and explain the delay.

The 53-year-old was given a 16-month prison sentence, suspended for two years, She was also told to do 250 hours of unpaid work.
Stephen Vasco-Knight was jailed for 10 months, suspended for two years, and ordered to do 150 hours of unpaid work.

 

 

 

 

 

 

 

 

 

 

 

Veteran NHS boss claims he was sacked after 52 years at his trust for tackling a Carry On-style sex ring

27 August 2017

  • Sir Leonard Fenwick, the health service’s longest-serving chief executive, claims he was sacked after 52 years when he was hit with trumped-up bullying charges 
  • Moves to oust him began after details emerged of the ‘Carry On’-style sex ring 
  • The sex ring existed at Newcastle’s Royal Victoria Infirmary for four years

A veteran hospital boss who clashed with his trust over the handling of a NHS sex ring has revealed how he was forced out of his job in the wake of the scandal.

Sir Leonard Fenwick, the health service’s longest-serving chief executive, claims he was sacked after 52 years when he was hit with trumped-up bullying charges.

In an exclusive interview with The Mail on Sunday, Sir Leonard bitterly refuted the allegations – and said it was no coincidence moves to oust him began after details emerged of the ‘Carry On’-style sex ring.

Sir Leonard wanted to sack two married senior consultants who used code words such as ‘cappuccino’ and ‘Marmite’ to organise trysts with female staff in consulting rooms adjacent to where patients waited for treatment.

Sir Leonard Fenwick, the health service’s longest-serving chief executive, claims he was sacked after 52 years when he was hit with trumped-up bullying charges

Sir Leonard Fenwick, the health service’s longest-serving chief executive, claims he was sacked after 52 years when he was hit with trumped-up bullying charges

But some members of the board thought the men should be allowed to keep their jobs at his Newcastle hospital. From the moment Sir Leonard refused to back down, he said the ‘writing was on the wall’.

His stance on the matter, he said, was a ‘contributory factor’ in his own eventual dismissal, adding that he was ‘treated appallingly’.

Sir Leonard said: ‘There were both senior and junior staff involved in structured, untoward sexual activity on hospital premises. They were setting up meetings when they were meant to be dealing with patients.

‘If you are lining up sexual activity when there are patients on the couch, when you are meant to be focusing on their clinical needs but are focusing on something else, I simply drew the line at that.

‘It’s not a matter of morality. This wasn’t slipping away into a quiet part of the hospital or even off-site. This was, for a good part, in busy patient areas. You have got to lead by example.’

By rights, Sir Leonard’s last day at work should have been marked with glowing speeches. Bold, plain-spoken and, above all, passionate about patient care, Sir Leonard always enjoyed a reputation for getting things done.

In an exclusive interview with The Mail on Sunday, Sir Leonard bitterly refuted the allegations – and said it was no coincidence moves to oust him began after details emerged of the ‘Carry On’-style sex ring

In an exclusive interview with The Mail on Sunday, Sir Leonard bitterly refuted the allegations – and said it was no coincidence moves to oust him began after details emerged of the ‘Carry On’-style sex ring

He championed change and pioneering treatment that saw Newcastle’s hospitals garner international renown and played a pivotal role in organising the UK’s first successful infant heart transplant.

Yet Sir Leonard recalls how on January 10 this year – just months after he first clashed with the Newcastle upon Tyne Hospitals NHS Foundation Trust chairman Kingsley Smith over the sex ring – his exceptional career was brought to an ignominious close.

For three decades, he had been chief executive of Newcastle’s hospitals but he now found himself being pushed out of the door on ‘extended leave’.

He was ordered to surrender the keys to his office in the city’s Freeman Hospital. The hospital was his life work; he helped plan it, he was its first general manager – at just 30 – when it opened in September 1977, and its wards were as familiar to him as his own home. After filling two bin bags with personal effects, he was escorted out of the building. By any standards it was a humiliating end.

Still bewildered, he asks: ‘Why was this guy with 52 years’ service, and an unblemished record, suddenly crashed out the door?’

He was accused of gross misconduct and finally sacked in June this year. But the allegations against him – said to involve bullying, among other things – were, he says, trumped up. The real reason for his removal, he claims, was that, at 70, his face ‘no longer fitted’.

That, though, would hardly explain his undignified exit.

It seems his strident views, uncompromising manner and failure to toe the line had finally caught up with him. Not that he regrets a thing.

The sex ring, which he believes played a part in his downfall, existed at Newcastle’s Royal Victoria Infirmary for four years. In the hundreds of emails exchanged, ‘going for a cappuccino’ meant intercourse and there were obscure references to ‘spreading Marmite’.

Sir Leonard became aware of its existence in early 2016. He learned that one woman was known as ‘the Madam’ and that there were fears that attempts were being made to ensnare other staff members. He was in no doubt the two consultants had to be summarily dismissed – but the trust board stated his ‘wishes would not be met’.

While the junior staff and non-medical employees resigned, the two consultants held on.

Sir Leonard claims the lacklustre disciplinary proceedings against them were effectively a foregone conclusion: the board had already decided they would keep their jobs.

Believing the proceedings were ‘not professionally handled’, Sir Leonard said he ‘cut across the board’ to commission an independent legal report into the process, which, when published, was critical of its handling. His unilateral action did not go down well with the board, he says, and ‘the mood music absolutely changed’.

But he claims the vast majority of doctors, nurses and other staff in the trust supported him. In the event, the two consultants left voluntarily. ‘They have work in the North East. I have no work in the North East,’ says Sir Leonard. ‘My career is over. They [the trust board] have destroyed my good name.’

The sex ring, which he believes played a part in his downfall, existed at Newcastle’s Royal Victoria Infirmary for four years

The sex ring, which he believes played a part in his downfall, existed at Newcastle’s Royal Victoria Infirmary for four years

Following a board meeting in December, Sir Leonard listened to a scolding statement which said that the trust needed a new chief executive with different skills and abilities. It said that staff were scared for their jobs; there had been bullying allegations and widespread loss of trust among doctors.

‘I have discussed the matter with a lot of healthcare staff since and none of them would agree with that,’ says Sir Leonard. ‘If I was the rotten soul they described, I would have fallen foul of the unions. But they had no problem with me.’

The trust has accused him publicly of inappropriate behaviour but won’t go into details. Sir Leonard says he too cannot divulge too much because ‘it will compromise my legal position’.

At his spacious but modest bungalow in Newcastle, the city where he was born and bred, Sir Leonard stressed he was a ‘12 hours a day, seven days a week’ man who hadn’t taken a proper holiday in 17 years. In truth, not even his detractors would doubt his commitment. He joined the NHS as a management trainee aged 18 in 1965 and rapidly worked through the ranks.

Then and now, he viewed his role as a kind of shop-floor manager, in touch with all levels of his workforce, from consultants to cleaners.

By his own admission he could be abrasive, just as he had a reputation as ‘a risk-taker rather than a box-ticker’. ‘But I’m a chief executive running an organisation with a £1 billion turnover, nearly 14,000 employees – and I can’t raise my voice or flash my eyes?’

Railing against the NHS’s risk-averse culture, he says: ‘There is a diminishing confidence in the NHS – we are losing the dynamics of risk. There’s a great deal of professional self-preservation now.’

He says the NHS is now laden with the ‘burden of bureaucracy’. Thirty years ago, though, it was still possible to achieve results without having to fight through a bureaucratic jungle.

In 1987, Sir Leonard was the driving force behind the country’s first successful infant heart transplant.

Kaylee Davidson was five months old and dying from heart failure. Two previous deaths nationally had led to a moratorium on complex infant heart surgery, but her desperate parents pleaded with Newcastle doctors to operate.

Sir Leonard recalls: ‘She was very bonny: tiny, but absolutely beautiful. The medics were saying, “We’ve got to do it, we’ve got to do it.” ’

The operation got the go-ahead after Sir Leonard persuaded then local health authority chairman Arthur Taylor to meet with then junior Health Minister Kenneth Clarke in a London pub. Mr Clarke gave his permission in a note which read simply: ‘Arthur, tell them to get on with it, Ken.’

The operation was a success, and within weeks the Freeman Hospital was designated a national centre for paediatric heart transplant surgery.

It is a measure of his standing that following his departure in January he was inundated with letters of support, including one from Health Secretary Jeremy Hunt.

And Newcastle MP Nick Brown said: ‘Sir Leonard has been a strong voice for the interests of patients and has built the hospital trust into the internationally renowned institution it is. He has my strong support and backing.’

Since his dismissal, Sir Leonard has thrown himself into his work as chairman of Newcastle’s Freemen of the City. ‘I am still disappointed by what happened,’ he says. ‘But I have a strong sense of civic pride and life goes on.’

A hospital trust spokeswoman said: ‘The trust refutes any suggestion that the hearing, its outcome or Sir Leonard Fenwick’s alleged views about it, played any part in the subsequent dismissal of Sir Leonard Fenwick for gross misconduct.

‘Sir Leonard was dismissed for gross misconduct after allegations of inappropriate behaviour, inappropriate use of resources, and range of governance issues were proven.’

Read more: http://www.dailymail.co.uk/news/article-4826624/NHS-boss-claims-sacked-tackling-sex-ring.html#ixzz4r7l77DIN
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Workplace bullying and mobbing: Toxic systems and the eliminationist mindset

David Yamada's avatarMinding the Workplace

(Drawing by Aaron Maeda, copyright 2016)

Virulent instances of workplace mistreatment often involve an eliminationist intention on the part of the chief aggressor(s). Two years ago I wrote that the eliminationist instinct may express itself in several ways, including workplace bullying and mobbing behaviors. It often reflects a desire not only to eliminate an employee from the workplace, but also to undermine the individual’s livelihood and health even after departure from the organization.

This year I’ve also been thinking a lot about the roles of lead aggressors vs. roles played by other organizational actors in work abuse situations, especially from a systems theory perspective that examines how human roles and interactions culminate in systems that produce certain results. In May I wrote:

Thus, a typical campaign of severe bullying or mobbing at work involves multiple players, including but hardly limited to:

  • The main aggressor(s);
  • The supervisor or boss of the…

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Norwich hospital inspected by CQC after ‘bullying’ whistleblowing claims

NURSING TIMES  16 AUGUST, 2017

Junior nursing staff at Norfolk and Norwich University Hospital felt “bullied” into accepting patients onto their wards at night, according to a report by the Care Quality Commission.

The regulator inspected the hospital, run by Norfolk and Norwich University Hospitals NHS Foundation Trust, “after a number of whistleblowing contacts” in relation to staffing issues.

“A number of staff told us that they felt ‘bullied’ to take patients that they felt were not appropriate for their area”

CQC report

These included regular movement of staff between wards to fill gaps in rotas, insufficient staff in some areas including medical wards, maternity and children’s services, and allegations of bullying, noted Edward Baker, the CQC’s chief inspector of hospitals in a letter summarising the visit.

During their visit in April, CQC inspectors concluded that some of the concerns previously raised by whistleblowers remained, with staffing at night being a particular challenge.

Wards had less nursing cover than planned with “frequent movement of staff between wards to manage shortfalls of shifts”, said their report, which was published by the regulator on 10 August.

“Staff also raised concerns regarding skill mix, particularly when staff were moved to other wards at night,” said the report.

Meanwhile, there was some evidence that staff were being pressured into accepting patients onto wards when they did not think it was appropriate.

“A number of staff told us that they felt ‘bullied’ to take patients that they felt were not appropriate for their area,” said the CQC inspectors in their report.

“This was predominantly out of hours,” said the CQC. “Matrons were able to advocate for junior staff during the day but when not available, staff felt under increased pressure to take these patients.”

“We recognise that there are areas that still require improvement”

Mark Davies

However, inspectors went on to state that they held a “positive discussion” with the trust on what the organisation was doing to address the issues raised by the whistleblowers.

They also found the hospital, which is rated “requires improvement” overall by the CQC, had made progress in recruiting extra nursing staff and deploying other staff to reduce risks to patients.

However, the organisation was told it still needed to ensure sufficient staffing and skill mix at all times.

The report noted that, at the point of inspection, it employed 1,935 nursing staff against an establishment of 2,221.

In addition, some safety concerns were highlighted, including that the proportion of staff completing essential training, including safeguarding training, was “well below” target in some areas.

Ted BakerEdward Baker

 

Inspectors also found surgical safety checks were not being done, despite four “never events” in surgery – two involving “wrong site” surgery.

In addition, the report noted that “almost all” staff who inspectors spoke to were unaware of the trust’s “speak up guardians”, whose role was to support staff to raise concerns.

But the inspectors – who focused on medicine, surgery, children’s and young people services, maternity and gynaecology – also found much to praise at the trust.

This included good examples of multi-disciplinary working and the “excellent” attitude of staff. “All staff were helpful, open and caring in their manner. We found staff to be very ‘upbeat’ locally within ward and clinical teams,” said the report.

Junior nurses in the trust’s medical division described it as a good place to start their career and said they got good support and felt valued by managers. Meanwhile, inspectors also noted a “positive and calm feeling within the team, even during busy periods”.

Other areas of “outstanding” practice highlighted by the CQC included the amount of active clinical research taking place throughout the children and young people’s service, placing it “at the forefront of clinical innovation”.

Inspectors also flagged up innovative training for midwives and others using simulation technology that can replicate changes in a baby’s heartbeat during labour.

Responding to the CQC document, Mark Davies, the trust’s chief executive, said the report documented “significant progress” at the organisation.

Mark DaviesMark Davies

 

“Our staff are amazing and the good progress we are making on our journey of improvement is because of their dedication and professionalism,” he said.

“Of course, we recognise that there are areas that still require improvement and we are committed to working together with teams to make this happen,” he said.

Regarding the highlighting of bullying claims in the summary of the CQC report, a trust spokeswoman said: “In the CQC report’s 87 pages bullying is hardly mentioned.

“The CQC last year recognised the improvement in culture after the leadership changes, and in this current report made very positive comments in paediatrics, source of some initial concerns,” she said.

“We recognise that the hospital is working under significant daily operational pressure, and we are committed to ensuring that staff and are equipped with the right skills and training to deal with this by further encouraging a culture of respect and resilience,” she told Nursing Times.

She added: “Staff are doing a great job operationally – cancelled operations are down 50% compared with last year, the number of patients admitted as emergencies has drastically reduced, and therefore patient flow is much better and staff should be congratulated on all their efforts.”

The hospital opened in late 2001, having been built under a private finance initiative. It has 913 acute beds and 210 day-case beds.

The trust’s last comprehensive inspection by the CQC was carried out in November 2015 when it was rated as “requires improvement”.

In defence of whistleblowers – they should not be treated as dissenters as they are ‘prophets cast into the wilderness of their own truth’

Mail online India   By Shiv Visvanathan

Read more: http://www.dailymail.co.uk/indiahome/indianews/article-4764070/Whistleblowers-not-treated-dissenters.html#ixzz4oznUc99f
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NHS whistleblower who exposed understaffing at intensive care unit claims ‘three years on and nothing’s changed’

MIRROR 5 AUG 2017

BY MARTYN HALLE    
 

Chris Day was removed from consultant training by health chiefs after publicising his fears in 2014 – with his bosses claiming he had “personal and professional conduct issues”

The Queen Elizabeth Hospital in Woolwich, south-east London (Image: PA)

A doctor who exposed understaffing at an intensive care unit says he has been vindicated by a report showing it still remains three years later.

Whistleblower Chris Day was removed from consultant training by health chiefs after publicising his fears in 2014. His bosses claimed that he had “personal and professional conduct issues”.

Dr Day, now a locum, told of his dismay as it emerged a report by NHS inspectors from South London Critical Care Network revealed “significant concerns” about the Queen Elizabeth Hospital in Woolwich.

They found it had just one consultant for 19 critically ill patients, in breach of a recommended ratio averaging about one to five. Their report said bosses had “no clear recognition” of the consistent problem “nor any plans to address this”.

It flagged up a lack of leadership and said the hospital’s death rate for patients is among the highest for units that size.

Dr Chris Day NHS whistleblower from Queen Elizabeth Hospital Woolwich

The report was released to the Sunday People under Freedom of Information laws after a tip-off by a senior member of medical staff at a London hospital.

Dr Day, 32, said: “This report proves I was right. It’s a disgrace that patients are exposed to the same risks three years after I raised concerns.

“Some may have died because the health trust hasn’t acted.

“It beggars belief that the patients are still being exposed to the same risks three years after I raised concerns. It is a disgrace and it seems that nobody really cares.

“They have spent three years and hundreds of thousands of public money trying to silence me. And still they are neglecting the patients.”

He added: “I am so grateful to the doctor who gave the tip-off, otherwise the report would have been hidden.”

Last night Liberal Democrat health spokesman Norman Lamb told the Sunday People: “This is deeply disturbing.

“Patient safety and great care is always enhanced when organisations face up to failures of care, when critical reports are in the public domain rather than kept hidden and when staff feel able to speak out about concerns.”

Father-of-two Chris, whose wife Melissa is a nurse, was removed from consultant training suddenly by Public Education England after raising his original concerns.

Chris obtained the new report with a Freedom of Information request after being tipped off by senior intensive care consultant at a London teaching hospital.

Lewisham and Greenwich Trust said it will “address all issues” in the report.