A Word in Your Shelford-Like, Mr Behan

By Dr Minh Alexander 7 July 2016

David Behan Chief Executive of the much-criticised and “ineffective” [1] Care Quality Commission was the appointing officer for the former National Guardian for whistleblowing, Dame Eileen Sills, and was embarrassed by her resignation less than two months later. [2] [3]

The Dame blustered that she wouldn’t be “dropping any balls” despite combining the National Guardian role, on a seconded two day basis, with her substantive role of Chief Nurse at Guy’s. [4] But within two weeks of this assertion she was gone, citing unmanageable workload.

CQC continued whistling in the dark and insisted in spite of the resignation fiasco that Eileen Sills’ appointment had been robust and entirely appropriate. [5]

A look at Guy’s record on whistleblowing governance suggested otherwise. The trust was unable to demonstrate that it had put in place the systematic whistleblowing monitoring arrangements set out in NHS good practice guidance introduced in 2010. [6] The trust could not produce analysed data on whistleblowing events, and stated:

“Where information has been collected it exists in different reports some of which are confidential in nature and therefore not publically available”

The trust reportedly set up a Speaking Up scheme in 2015 after publication of Robert Francis’ Freedom to Speak Up Review report, but upon enquiry trust documents did not suggest that there was a great deal of substance to this, and the trust advised in April this year that it had not yet audited the effectiveness of its Speaking Up initiative. [7]

Guy’s also disclosed via FOI that over a five year period, it had entered into 50 compromise agreements with staff, all featuring non-disparagement clauses. [8] The trust appeared to admit that it had super-gagged all 50 staff with clauses that made the existence of the compromise agreements secret, but its reply was ambiguously worded, and Guy’s has since failed to reply to a request for confirmation. Very significantly, Guy’s admitted that it had settled with whistleblowers. The trust couldn’t get it sums right, and indicated that there were either two or four. It hasn’t clarified that discrepancy either. Lastly, the trust still has to answer a question first put to it last year – has it suspended, disciplined or sacked any staff after they raised concerns? Some might conclude that Guy’s silence speaks for itself.

Nevertheless, why does Guy’s behave unaccountably, and why did Mr Behan think that the Chief Nurse of a super-gagging trust, who was the trust whistleblowing lead, was a suitable National Guardian? Did he ensure due diligence – or perhaps more likely, did he not bother because the appointment was more about PR than substance?

Whilst those questions remain unanswered, what is known is that Guy’s is a member of the Shelford Group of ten teaching hospitals. The exclusive club members modestly describe themselves thus: “ Shelford Group comprises ten leading NHS multi-specialty academic healthcare organisations. We are dedicated to excellence in clinical research, education and patient care. We aspire to demonstrate system-wide leadership for the benefit of patients and the prosperity of our country.” [9]

The Group was established to network with Important People: “The group was formed in 2011 to benchmark and share best practice in key service areas across the membership through working groups, and constructively engage with Government, Parliament and industry to represent the interests of large tertiary centres and the wider National Health Service.”

The behaviour of some of the other Shelford group members in response to questions about their use of gags certainly suggests that they are disinclined to account to the public.

Central Manchester took the approach of simply ignoring FOI requests for months. The trust Chair, in fairness, apologised when informed of this failure. Newcastle disclosed 22 super-gags and when questioned about this, insisted that super-gags had been mutually agreed – but then fell silent when asked if it was the trust who had proposed the super-gags. Kings College admitted to 29 super-gags but claimed that it was too difficult to identify whether any whistleblowers had been gagged. Sheffield which has had multiple whistleblowers, disclosed a whopping 228 compromise agreements, and claimed that only one came with a super-gag that was unrelated to whistleblowing. Imperial and Addenbrookes, also had difficulty with the maths and both under-declared their numbers of compromise agreements. Addenbrookes revised the number of its compromise agreements from 1 to 29, all with super-gags. Like King’s, Addenbrookes refused to say how many super-gags applied to whistleblowing cases. Imperial revised the number of its compromise agreements from 9 to 125, the majority of which are thought to contain super-gags, because Imperial advised that super-gags were “standard” in its agreements. Oxford, chaired by data governance Tsar Dame Fiona Caldicott, was the worst and tried a flat refusal on grounds of cost. The trust eventually admitted that it had used gags but has resisted disclosing how many were implemented. Only UCH and Birmingham were straightforward in their responses, and neither of these trusts reported super-gagging their staff.

In total, the Shelford Group have accounted for at least 572 compromise agreements, 266 super-gags and 281 non-disparagement clauses in the last five years. Without independent verification it is hard to know how close this is to the real numbers. On that matter, CQC have advised that it has no specific methodology for inspecting compromise agreements and no intention to systematically review providers’ compromise agreements.

CQC, whose Chief Inspector of Hospitals is himself a Guy’s man, has recently favourably rated three members of the Shelford group – Guy’s and Sheffield were declared ‘Good’, and Newcastle was declared ‘Outstanding’. The usual fanfares were tooted in the Health Service Journal, for example “Shelford Group Trust rated ‘Good’ across the board”. [10] But to what extent are these CQC ratings the product of Important People relating more sympathetically to other Important People who have a similar world view?

So, CQC be counted on to appoint a National Guardian who will be fair and isn’t there to be just another clubbable, Important Person looking after other Important People? Or will Mr Behan’s new choice of National Guardian announced today, Dr Henrietta Hughes the Medical Director of NHS England North Central and East London region, prove to be part of the clubbable bubble? [11]

[1] Public Accounts Committee Inquiry on CQC, 12th report of session 2015/2016 http://www.publications.parliament.uk/pa/cm201516/cmselect/cmpubacc/501/501.pdf

[2] Hunt humiliated as NHS Whistleblowing Tsar quits http://www.mirror.co.uk/news/uk-news/jeremy-hunt-humiliated-nhs-whistleblower-7513425

[2] No one believes Jeremy Hunt on patient safety and whistleblowers – not even his own appointees https://www.opendemocracy.net/ournhs/minh-alexander/no-one-believes-jeremy-hunt-on-patient-safety-and-whistleblowers-not-even-his-#.VuLP8Vb5NRs.twitter

[4] Minute of a meeting with Eileen Sills 24 Feb 2016

http://twitdoc.com/view.asp?id=254322&sid=5G8I&ext=PDF&lcl=Eileen-Sills-meeting-notes-23-02-2016-.pdf&usr=alexander_minh&doc=303188932&key=key-Ouv41peeWNZ2vhXqJMtl

[5] Letter from Rebecca Lloyd-Jones CQC Director of Legal Services 24 May 2016 https://twitter.com/alexander_minh/status/737159490399801344

[6] Speak Up for a Health NHS. Social Partnership Forum 2010 http://www.pcaw.org.uk/files/SpeakupNHS.pdf

[7] FOI disclosure from Guy’s and St. Thomas’ NHS Foundation Trust 11 April 2016 http://twitdoc.com/view.asp?id=283551&sid=62SF&ext=PDF&lcl=Response-re-audit-of-speak-up-initiative-11-04-2016-FOIA-53771-Alexander-Final-Response.pdf&usr=alexander_minh

[8] FOI disclosure from Guy’s and St. Thomas’ NHS Foundation Trust 21 March 2016 http://twitdoc.com/view.asp?id=283552&sid=62SG&ext=PDF&lcl=Compromise-FOI-response-FOIA-53147-Alexander-Final-Response.pdf&usr=alexander_minh

[9] Shelford Group website http://shelfordgroup.org/

[10] Shelford Group Trust rated ‘Good’ across the board. Health Service Journal 13 June 2016 http://www.hsj.co.uk/7005533.article

[11] Joint letter by David Behan and Sir Robert Francis to NHS trusts about appointment of new National Guardian 7 July 2016 http://www.nhsemployers.org/~/media/Employers/Publications/20160707%20Letter%20from%20Sir%20Robert%20Francis%20and%20David%20Behan%20re%20National%20Guardian%20appointment.pdf

New National Guardian appointed to lead the NHS in speaking up freely and safely

 

PRESS RELEASE

FOR IMMEDIATE PUBLICATION: Thursday 7 July 2016

The Medical Director for NHS England’s North Central and East London region and practising GP, Dr Henrietta Hughes has been appointed as the new National Guardian for speaking up freely and safely within the NHS.

Dr Hughes is a practising GP with over twenty years of experience across primary, secondary and community healthcare. She has been Medical Director for NHS England’s North Central and East London region since April 2013, in which she provides system leadership across 12 clinical commissioning groups and 12 NHS trusts, and she is the Responsible Officer for nearly 3,000 GPs.

Dr Hughes’s selection for appointment was made by a panel consisting of representatives of CQC, NHS England and NHS Improvement, as co-sponsors for the National Guardian’s Office, as well as the Patients Association and Sir Robert Francis QC, whose independent review from February 2015 into ‘whistleblowing’ across the NHS instigated the creation of the National Guardian role.

As the National Guardian, Dr Hughes will help to lead a cultural change within NHS trusts and NHS foundation trusts, so that healthcare staff feel confident and supported to raise concerns about patient care at all times.

This will include leading, advising and supporting the growing network of ‘Freedom to Speak Up’ Guardians within NHS trusts who are responsible for developing a culture of openness within their hospitals. Also, as the National Guardian, she will share and advise on good practice in responding to staff concerns, and provide challenge and support for the system so that it has a truly safe and open culture.

Dr Hughes is expected to take up the role in October 2016. She will be supported by a small office of staff, which is already in operation with an interim team.

Commenting on the appointment, David Behan, Chief Executive of the Care Quality Commission, said: “I am very pleased that Henrietta has accepted the position of National Guardian.

“The need for the NHS to have a positive reporting culture, which encourages and supports its staff to raise concerns about care without fear of reprimand has been stressed time and time again and now must become common practice.

“Leading the healthcare system on this journey alongside the Freedom to Speak Up Guardians within NHS trusts will be a core aim of the National Guardian and her office, so that ultimately, patients can get the safe, high-quality and compassionate care they deserve.

“The role requires strong leadership, trust and a clear understanding of the NHS and the challenges its staff face in raising concerns. I am confident Henrietta will bring all of these qualities in abundance as the National Guardian and I look forward to working with her in this capacity.”

Dr Henrietta Hughes, incoming National Guardian for the NHS said: “I am very excited to be appointed as the National Guardian and recognise that supporting and protecting staff across the NHS who wish to speak up is a huge and tremendously important responsibility.

“It requires a great deal of courage, honesty, and selflessness to ‘blow the whistle’. People should never feel that they are at risk of punishment when advocating better and safer care for patients.

“As a practising GP and with my experience in the NHS, both on the frontline and at leadership levels, I understand the challenges that lie ahead.

“Together with my office, the growing network of Freedom to Speak Up Guardians in NHS trusts, our national partners, and anyone else who has an interest in supporting and protecting staff who wish to speak up, I look forward to driving forward this agenda of openness.

“I want staff to always feel listened to regardless of where they work within the NHS, so that we can see real improvements in patient safety and staff experience. This is a real opportunity to work towards making that a reality.”

Health Secretary, Jeremy Hunt said: “The appointment of Dr Henrietta Hughes as National Guardian is an important step in our ambition to create a more open and honest culture in the NHS.

“Dr Hughes will support staff so they can raise concerns without fear of discrimination and ensure the NHS is one of the safest healthcare systems in the world.”

Sir Robert Francis, CQC board member and author of the ‘Freedom to Speak Up’ review, said: “No service can be effective without listening to and acting on the concerns raised by its staff, let alone one which employs such skilled and dedicated people as the NHS. They are the lifeblood of the service, and the lifeline for their patients.

“However, the evidence clearly shows that many staff are fearful of speaking up. It is important that every part of the NHS develops a culture in which it is entirely normal to raise issues about safety, quality and effectiveness of the service, for those issues to be addressed and for those who raise them to be protected from any adverse consequences arising out of their disclosures.

“I believe that the National Guardian, her office and the network of Freedom to Speak Up Guardians all have an invaluable role to play in supporting these changes.

“I would like to congratulate Henrietta for her appointment as National Guardian. She displays a genuine commitment to want to make a real difference to the lives of NHS staff and their patients. With her leadership, I am confident that she and her office can make great strides in achieving that.”

Ruth May, Executive Director of Nursing at NHS Improvement, said: “I would like to welcome Dr Henrietta Hughes as the new National Guardian. Her extensive clinical experience and expertise means she has the know-how to encourage the growth of the Freedom to Speak up Guardian’s network. Alongside the guardians, I am sure she will provide the leadership to ensure that a culture of openness within NHS trusts flourishes.

“Whistleblowers can play a crucial role in making sure that the NHS delivers the highest standard of care to patients day in, day out. If we all continue to do our part to safeguard the freedom to speak out, NHS staff will feel more confident to share vital information that can prevent the risks of harm to patients.

“I look forward to working closely with Dr Hughes, and our partners, to help NHS staff feel free and safe to speak out.”

Professor Jane Cummings, Chief Nursing Officer of NHS England, said: “I welcome the appointment of Dr Henrietta Hughes as the new National Guardian and look forward to working with her. The experience she brings to this role will be key in delivering an open and transparent health service. Providing all staff with the confidence and means to speak up is an essential part of providing high quality care to all.”

Katherine Murphy, Chief Executive of the Patients Association, said: “The Patients Association endorses Henrietta’s vision for NHS where staff feel valued and supported and where patients are treated safely and with dignity. Through our national helpline we not only hear from patients but also increasingly professionals working within services who feel they have nowhere else to turn. We welcome Henrietta’s appointment to this important national role and look forward to working closely with her to help deliver her vision.”

ENDS

For media enquiries about the Care Quality Commission, please call the press office on 020 7448 9401 during office hours. 

Also, follow the team on Twitter for the latest national announcements: @CQCPressOffice.

Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here:www.cqc.org.uk/media . (Please note: the duty press officer is unable to advise members of the public on health or social care matters). 

For general enquiries, please call 03000 61 61 61.

Notes to Editors

1. For further information about the National Guardian’s office, please visit: www.cqc.org.uk/content/national-guardians-office

2. Biography: Dr Henrietta Hughes is Medical Director for North Central and East London at NHS England and a practising GP. Her role at NHS England is a commissioning and assurance role as Responsible Officer for nearly 3,000 GPs, with 12 clinical commissioning groups and 12 acute, specialist and mental health providers. She is the clinical lead for mental health for London region in NHS England. Prior to that, Dr Hughes was the Acting Medical Director in the North Central London Cluster, the Associate Editor of the Journal of Family Planning and Reproductive Healthcare, and the Lead Appraiser at Camden Primary Care Trust. She has experience in hospital and community roles as well as in primary care.  Dr Hughes is passionate about improving the quality of care for people in England by disseminating good practice, improving the skills and reflection of staff and by managing variation in quality. She has experience of working with individuals and organisations in difficulty and brings a formative, learning and reflective approach which helps to create a sense of calm and purpose to support staff morale and bring improvement. She has published articles on a wide range of health related issues and written chapters in two books.

3. Dr Henrietta Hughes will serve as National Guardian for four days a week, primarily from the office in London and she will continue to work as a GP and GP appraiser. Her salary as National Guardian will be £105,040 per annum.  She replaces Dame Eileen Sills who stood down as National Guardian in March 2016.

4. The need for an independent National Guardian for the NHS was highlighted in Sir Robert Francis’s ‘Freedom to Speak Up’ review in February 2015, which found that patients could be put at risk of harm because vital information about mistakes and concerns was not being raised by NHS staff routinely. The review found that reporting systems were either insufficient or not used or because healthcare professionals did not feel able to speak up. The creation of the National Guardian was one of the key recommendations from this; an arrangement which the Secretary of State for Health confirmed in July 2015. For further information about Sir Robert Francis’s Freedom to Speak Up review, please visit: https://www.gov.uk/government/publications/sir-robert-francis-freedom-to-speak-up-review

5. There are 57 NHS trusts across England that have appointed Freedom to Speak Up Guardians. For further information, please visit NHS Employer’s website: www.nhsemployers.org/your-workforce/retain-and-improve/raising-concerns-at-work-and-whistleblowing/freedom-to-speak-up-guardian-hub/guardian-map

 

 

 

Hospital boss ‘secretly quits’ as report finds patient ‘lay dead’ in London A&E for four hours before being found

The Telegraph News    6 JULY 2016        Cristina Criddle
North Middlesex University Hospital's A&E unit was criticised by inspectors. 
North Middlesex University Hospital’s A&E unit was criticised by inspectors.  

A hospital’s chief executive has “secretly quit” after a patient reportedly lay dead for up to four-and-a-half hours before being discovered at an A&E unit.

The emergency department at North Middlesex University Hospital, one of London’s busiest, has been ordered to make improvements after regulators found that there were not enough doctors to meet demand.

Inspectors with the Care Quality Commission (CQC) rated the hospital’s urgent and emergency care services as “inadequate”.

Staff at the hospital told inspectors they were worried about patient safety because of the competency of middle-grade doctors. These doctors were often left in charge of the emergency department overnight – with no consultant presence in the department after 11pm,inspectors were told.

The hospital’s chief executive, Julie Lowe, is believed to have secretly quit following the findings.

Staff have said Ms Lowe is on “leave” but a source inside the hospital claimed she was, in fact, ousted by NHS chiefs appalled at her leadership.

The hospital was given a surprise inspection in April after staff put out a tannoy announcement in February telling patients to go home unless they were “dying”.

North Middlesex University Hospital.
North Middlesex University Hospital

Inspectors also found vital equipment, including a portable resuscitation trolley, was often missing or broken.

Walk-in patients were seen by a receptionist, who judged if they were suitable for the urgent care centre or needed to go to the main emergency department, according to the CQC’s report.

The unit logged 22 serious incidents in the past year, the BBC reported, including the failure to discover the dead patient.

When we inspected we found that patients were waiting for a long time to be seen, without being assessed by a doctor in the first placeSir Mike Richards

Others included a patient being left sitting on a bedpan for more than an hour, the broadcaster reported.

In August 2014, David Burrowes, MP for Enfield Southgate, told the Mail on Sunday how, despite arriving with a burst appendix, he was left on a trolley “curled up in pain” for 12 hours in the “chaotic” A&E before being treated.

The MP said he was “dismayed but not surprised” by the report.

“Whilst I recognise that the hospital has now turned the corner with new clinical leadership and consultants and doctors, it has taken far too long to respond to the siren calls made for over two years,” he added. “It is hugely disappointing that the CQC has found that the A&E has got worse since 2014.”

He said his constituents had been let down and said assurances of support must be “urgently delivered”.

 

The report added: “Members of staff told us there was a culture of not calling consultants out at night. They said that middle grade doctors seemed to assume that it was acceptable to leave patients in ED (emergency department) overnight, thus treating it as if it were a hospital ward.”

Meanwhile nurses told inspectors they spent a “substantial amount of time supporting and advising more junior doctors”.

In recent weeks it has emerged that the General Medical Councilissued preliminary warnings to North Middlesex Hospital leaders because of a lack of training for junior doctors.

Sir Mike Richards, CQC’s chief inspector of hospitals, said: “People going to the emergency department at the North Middlesex University Hospital NHS Trust are entitled to a service that provides safe, effective, compassionate and high quality care. When we inspected we found that patients were waiting for a long time to be seen, without being assessed by a doctor in the first place.

“North Middlesex University Hospital is one of the busiest A&E departments in London – so it is worrying that we found that there were not enough experienced doctors on call to deal with demand. We have strongly encouraged the trust to engage with other organisations across the local health and social care system to resolve this challenging issue.”

He added that a new leadership team was in place and the trust has called on consultants from within the hospital to provide routine daily support to A&E.

“The evidence from our latest inspection last week is that North Middlesex’s emergency department has turned a corner, but there is still much more that needs to be done. We will be watching their progress very closely,” he added.

 

North Middlesex University Hospital said it would receive support in making further improvements in A&E from the Royal Free London NHS Foundation Trust.

“Chief executive Julie Lowe is currently on leave,” the hospital added in a statement.

“In her absence, Libby McManus, currently at the Royal Free London NHS Foundation Trust and previously the interim chief executive at Chelsea and Westminster Hospital NHS Foundation Trust, has agreed to take on the role of interim chief executive at North Middlesex from Thursday July 7, with David Sloman, chief executive of the Royal Free, taking on the role of accountable officer on an interim basis.”

Dr Cathy Cale, the North Middlesex University Hospital medical director, said: “We are extremely sorry for the current problems in A&E and for the long waiting times for some patients.

“We are committed to getting back to the standards that we and our patients expect and, working with our health partners, are taking all the necessary steps to address the concerns raised, particularly the shortage of doctors which lies at the heart of it.”

In a joint statement, Niall Dickson, chief executive of the General Medical Council (GMC), and Professor Ian Cumming, chief executive of Health Education England (HEE), said: “Significant concerns have been raised about the care provided in the emergency department at North Middlesex University Hospital Trust and about the lack of proper support for and supervision of doctors in training.

“We are pleased to see that a number of key improvements have already been made and a programme of further measures is being put in place over the next few weeks.”

Accepting “there is more to be done” to cope with pressure, they added:

“In the meantime the GMC and HEE – the two organisations responsible for postgraduate medical training – have placed conditions on the continuation of medical training posts in the emergency department and the situation will be closely monitored with daily rigorous checks.

“We have made it clear that we will not hesitate to act if we consider patients or staff are being put in unsafe situations.”

Julie Lowe has been approached for comment.

A new way forward for disciplinaries: the whistleblower’s view

5 Comments
HSJ  28 JUNE, 2016 BY ,

The ways in which the NHS deals with disciplinary staff problems is a mess: antiquated, costly, legalistic, full of double standards, prone to conscious and unconscious bias, and – on occasions – deadly unfair. Here senior NHS HR director Dean Royles and sacked whistleblower Narinder Kapur join forces to make the case for major reform.

 

The Problem

Justice, fairness, truth, and compassion are emotional words. The very mention of them demands a response and they are all concepts we have seen working for good, and we have experienced what happens when they are disregarded or abused.

We both have many years’ experience in the NHS, are passionate about preserving an institution free at the point of need and often talk up the wonderful things the NHS has achieved for our society. We both know it’s not perfect and we have enjoyed debating ways to make the NHS fairer.

Dean Royles

One of the areas that has taxed us is disciplinary and capability procedures for staff and for doctors in the NHS. For doctors and dentists, this is known as Maintaining High Professional Standards (MHPS), and is a nationally negotiated policy. For other NHS staff, be they nurses or neuropsychologists, employers are free to draw up their own procedures. There is much we agree on:

  • There are clear double standards in the NHS, with one set of policies and procedures that apply to doctors and dentists, and another set of procedures that apply to other NHS staff. This ‘apartheid’ clearly sows the seeds for justifiable complaints of unfairness.
  • Current procedures are antiquated and are now not fit for purpose (MHPS is over 10 years old).
  • Neither employers nor employees have confidence in their ability to help resolve concerns quickly and fairly.
  • There is a disproportionate impact on BME staff.
  • They take too long to get issues resolved.
  • Delays impact negatively on doctors, their family, patients and on employers and the public purse.
  • The procedures have become damaging to morale and motivation, and have negative effects on trust and confidence between employers and employees.
  • They represent an unsatisfactory process for resolving issues in the case of staff raising concerns and whistleblowing.
  • They need a significant overhaul.

Although we have different (but often overlapping) solutions to the problems that exist, we both see the urgent need for change. The status quo is untenable with regard to positive employee relations, and without change, concerns and injustice will continue to exacerbate.

It is not fair that there are two separate systems to manage important issues like conduct and capability. It is in the interests of all concerned – NHS employers, NHS staff, patients, the government, the public purse and the reputation of this country in the eyes of the world – for the current system to be subject to a major review and for improvements to be put in place.

Narinder’s Solution

I would like to start with a brief mention of the case of Amin Abdullah. Amin was of Indian origin and grew up in an orphanage in Malaysia. He fulfilled his dream of becoming a nurse in the NHS, and during his training he won an award from the hospital that later employed him.

In Malaysian tradition, he regarded the NHS as part of his ‘family’. On February 9, 2016, not long after he qualified and a few weeks after going through a harrowing and drawn-out dismissal procedure, he set himself on fire outside Kensington Palace just days before an appeal hearing against his sacking. He died a slow, agonising death.

Amin was an outstanding nurse but was being disciplined because of the way in which he stood up for a colleague — he was one of 17 NHS staff who signed a petition in support of the colleague when a patient complained, but he was the one singled out for punishment.

Sadly, Amin Abdullah’s case is far from an isolated incident. There are numerous other cases, going back as far as the landmark case of Graham Pink in 1990, the nurse sacked after raising concerns, and who wrote of his experiences in his book, A Time to Speak.

Health secretary Jeremy Hunt’s statement in the House of Commons on March 9 2016 — that a “culture change must also extend to trust disciplinary procedures” — is at long last a clear recognition that there are sometimes major flaws in how staff are treated in the NHS.

Jeremy Hunt’s public support for Professor Nadey Hakim, the surgeon unfairly sacked by the same trust as Amin Abdullah, is to be welcomed and admired, but as a newly qualified nurse Amin did not have the financial resources of a senior surgeon with a private practice who could probably afford an expensive legal team – yet another example of disparities in the current system.

The NHS spends millions of pounds each year on legal fees relating to ‘problem staff’, and thousands of man-hours of staff time are spent on protracted legal and non-legal proceedings arising from the handling of such staff

In his 2015 report on whistleblowing in the NHS, Sir Robert Francis heard that some disciplinary hearings are little more than one-sided kangaroo courts: “Repeatedly we hear of unaccountable managers protecting themselves and undertaking biased investigations, character assassination, lengthy suspensions, disciplinary hearings which resemble kangaroo courts, and ultimately dismissal of staff who previously had exemplary work records” (p. 162).

Sir Robert Francis also documented staff being driven to consider suicide. There must be something wrong with a system that results in unfair dismissal judgments for a world leading transplant surgeon (Nadey Hakim), a young talented pancreatic consultant surgeon (Aditya Agrawal), and a past-president of a national society (Narinder Kapur), to name but a few recent cases.

There is no requirement for any staff involved in dealing with a dispute to undergo training in conscious or unconscious bias, even though there is ample evidence from a variety of sources, including employment tribunal judgments that bias is likely to occur in such settings.

Unconscious bias is now widely recognized as a major issue in healthcare, and even in the highest levels of the British justice system (Lord David Neuberger, Head of Supreme Court, 2015).

There must be something wrong with a system that results in unfair dismissal judgments for a world leading transplant surgeon

The NHS spends millions of pounds each year on legal fees relating to ‘problem staff’, and thousands of man-hours of staff time are spent on protracted legal and non-legal proceedings arising from the handling of such staff.

This is money and time that the NHS can scarcely afford in these times of austerity and which could instead be allocated to patient care. Currently, the only beneficiaries are lawyers’ bank accounts.

When things go badly wrong for patient safety, there are often extensive efforts to ‘learn lessons’, whether it be a local Root Cause Analysis or external independent inquiries, depending on the seriousness of the incident. There is now even a separate body, the Healthcare Safety Investigation Branch, to investigate major patient safety incidents.

Is it not equally vital to learn lessons when things go badly wrong with regards to how staff are treated? If someone dies as a result of an unfair dismissal decision, should that not be classed as a form of ‘Never Event’? Can we justify one set of standards for patients and another set of standards for staff?

What is needed is a fundamental review of current procedures, something that BME leaders and leading whistleblowers have been repeatedly requesting

For remedies to this situation, I look to great leaders such as Mahatma Gandhi. Gandhi often pronounced that the problems human beings face, and their solutions, are as old as the hills. For Gandhi, there were two basic truisms to enlightened existence – ‘Truth’ and ‘Love’.

Keeping these ‘basics’ in mind, when dealing with staff who are classed as ‘problems’ the NHS should respect three principles for investigation – Independence, Expertise and Plurality.

Thus, Independence means that an investigatory or disciplinary panel should have members that are independent of the employer, to help prevent conscious and unconscious bias and to prevent kangaroo courts and witch-hunts.

Expertise means that there should be relevant expertise brought to bear, whether it be in the speciality of a staff member under investigation, or more generally expertise in wider issues.

Plurality simply means more than one person on an investigatory or dismissal panel, since at present NHS Trusts are; for example, free to have just a single dismissing officer to decide the fate and livelihood of a member of staff.

When deciding on ‘treatment’ or ‘punishment’, there should be respect for two key principles – Proportionality and Compassion.

Unconscious bias

Proportionality would take into account the past record of staff, whether patients were harmed, whether wrongdoing was deliberately enacted, whether the person shows insight and remorse if he / she has done wrong, how likely it is that a future similar offence will be committed, how likely it is that remediation would help, etc.

At present, NHS employers are in a difficult position, as they often only have a choice between retaining someone and sacking them. A system that respects proportionality could involve staff losing one, two or three months’ salary for offences categorized in a reformed framework as serious at graduated levels, but not classed as dismissible.

Such a system could also involve having a ‘Two Written Warnings’ rule for some cases that are currently classed as ‘gross misconduct’. Compassion would involve not only psychological support, but also an ‘Impact Assessment’ of the planned punishment on the individual – family, finances, well-being, etc and would also include support for redeployment.

What is needed is a fundamental review of current procedures, something that BME leaders and leading whistleblowers have been repeatedly requesting. Such a review would gather hard evidence and would sample views from a wide range of sources, including employers, employees, trade unions, employment tribunal judges, the legal profession, MPs, whistleblowers etc.

A system that respects proportionality could involve staff losing one, two or three months’ salary for offences categorised in a reformed framework as serious at graduated levels, but not classed as dismissible

It would take into account published research related to key issues such as unconscious bias. It would explore why BME staff are over-represented in disciplinary hearings.

It would gather information on financial expenditure and financial controls in relation to staff disputes, and related issues of transparency and accountability. It would look at healthcare models outside the UK for dealing with disciplinary matters.

Such a review would ideally be wide-ranging in its scope, would encompass undergraduate and post-graduate training of NHS staff, and would also seek the views of regulatory bodies such as the General Medical Council, Nursing and Midwifery Council and Health and Care Professions Council, as well as supportive bodies such as the National Clinical Assessment Service, Advisory, Conciliation and Arbitration Service and the Social Partnership Forum. The review could consider proposals such as that for a Staff Support Commission.

One of the key aims of a review would be to put in place mechanisms and procedures to help prevent disputes in the NHS getting out of control to the point that they end up in threatening correspondence, in legal exchanges, in dismissal and appeal hearings, in employment tribunals, or in spurious referrals to regulatory bodies, all of which can prove extremely costly, badly damaging to reputations, and terribly distressing to individuals and their families.

Narinder Kapur is visiting professor of neuropsychology at University College London and Dean Royles is director of human resources and organizational development at Leeds Teaching Hospitals Trust

Report condemns hospital in baby death cover-up: Parents speak of ‘vindication’ as senior staff who plotted to delete evidence of medical blunders in care of their son are blasted by health chiefs

Mail on Line  By STEPHEN ADAMS and CHARLES YATES FOR THE MAIL ON SUNDAY    18 June 2016 | UPDATED: 17:16, 21 June 2016
  • Benjamin Condon died at just eight-weeks-old in April last year
  • Parents originally told that he had died of a cold-like infection
  • But doctors later admitted he could have been given antibiotics
  • New report vindicates Mail on Sunday investigation into Ben’s death 

 

A hospital where senior staff plotted to delete a tape recording in which they admitted appalling errors were made over a baby’s death has been heavily criticised in a damning report.

Bosses at the Bristol Royal Children’s Hospital ‘failed to get a grip of the real issues’ after a consultant and senior manager were caught trying to wipe the recording, said investigators.

The Mail on Sunday exposed the scandal last December, after being alerted to it by the parents of tragic baby Benjamin Condon.

Tragic: Ben Condon died at just eight-weeks-old last April and hospital bosses have been accused of a string of errors in his death

Tragic: Ben Condon died at just eight-weeks-old last April and hospital bosses have been accused of a string of errors in his death

His grieving parents Allyn and Jenny Condon were determined to understand what factors led to their beloved baby son's death

His grieving parents Allyn and Jenny Condon were determined to understand what factors led to their beloved baby son’s death

 

Now, an independent report, commissioned by hospital bosses, has concluded ‘there was a failure’ by management ‘to recognise one of the most serious allegations being made by the parents – why a clinician would want a conversation deleted and why a senior manager would agree to do it’.

It found University Hospitals Bristol NHS Foundation Trust ‘failed to provide Ben’s family with clear answers to a number of questions’ and ‘appeared to lose sight of the fact that this was a grieving family’.

Consultancy firm Verita said it had ‘not seen conclusive evidence to prove or disprove the charge of a conspiracy to cover up what happened to Ben’. But it commented that ‘little the trust did was well directed at disproving’ the existence of a conspiracy.

Manager Julie VassDr Paul MannixManager Julie Vass (left) and Dr Paul Mannix (right) met with Ben’s parents following his death to discuss what happened

Audio conversation between Ben’s parents and staff

 
NEW SON BRINGS JOY TO BEN’S TRAGIC PARENTS

Jenny and Allyn Condon with their baby son Raffi

Nothing can replace a lost child, but Jenny and Allyn Condon were finally able to celebrate again earlier this year with the birth of a boy, Raffi.

Jenny, who has suffered many miscarriages, gave birth to him ten weeks early at Southmead Hospital in Bristol after intensive monitoring by doctors. Their son is now four-and-a-half months old and doing well.

‘Raffi is a lovely, laughy baby – all smiles,’ said Allyn. Jenny said his birth, which came almost exactly a year after Ben was born, had brought back painful memories. She added: ‘I found myself reliving every moment, watching everything constantly, and expecting something to go wrong.’

Last night, Ben’s father Allyn, 41, said: ‘This report vindicates what my wife Jenny and I have been saying all along. We would like to thank the MoS, because without its coverage, it is unlikely this external investigation would have taken place.’

After Ben died last April, at eight weeks old, the couple were first told he had succumbed to a cold-like viral infection. But two months later, doctors revealed he had also contracted a more virulent bacterial infection, which could have been prevented with timely antibiotics. They incorrectly told them this infection, pseudomonas, was only identified after Ben died.

Unhappy with the care Ben received, the couple scoured his medical notes. At a meeting last July, they put it to doctors that staff had missed chances to spot the infection and treat him.

The meeting was openly recorded by both sides. During a break, the Condons left the room and the NHS representatives forgot they were being recorded. Neonatologist Dr Paul Mannix candidly told intensive care consultant Dr Margrid Schindler: ‘Margrid, they are absolutely right… these are not misinformed bolshy parents.’ Dr Schindler responded: ‘They’ve got a point.’

She then realised their own recorder was still taping and asked manager Julie Vass if there was ‘any possibility of taking off’ the last section ‘because that could get us into difficulty’. Mrs Vass agreed.

But moments later, Dr Mannix spotted the Condons’ own iPhone was recording too, so they left both machines running. Covering the microphone, Dr Mannix then said he ‘struggled to see’ why Ben did not get antibiotics three days before he died.

Dr Schindler was heading Ben’s child death review at the time while Dr Mannix, who works elsewhere, had been acting as the Condons’ representative. When the couple returned he alerted them to ‘extra stuff’ on their tape.

Trust chief executive Robert Woolley said: ‘We accept the report’s findings in full. We are saddened we missed too many opportunities to proactively engage with Ben’s parents. We apologise to them unreservedly.’

 

For further information:

http://thebristolreview.co.uk/news.html

Former South Devon NHS boss denies £20k fraud

BBC NEWS     24 June 201   From the section Devon
Dr Paula Vasco-Knight
Mrs Vasco-Knight was at one time NHS England’s national lead on equality and diversity matters

The former chief executive of an NHS Trust has denied defrauding it by siphoning off more than £20k to a company run by her husband.

Paula Vasco-Knight, 52, is alleged to have carried out the frauds in 2012 and 2013 while she was in charge of the South Devon NHS Foundation Trust.

Her husband Stephen has also denied receiving money fraudulently.

Businessman Habib Naqvi has denied enabling the offence to happen.

The allegations concern a payment of £9,000 made between October 2012 and April 2013 to a company run by Mr Vasco-Knight.

 

Mrs Vasco-Knight, who lives in Runcorn in Cheshire, is also alleged to have sent details of rival bids for a contract to produce leaflets to her husband via Mr Naqvi in August 2013.

Exeter Crown Court
Mrs Vasco-Knight is alleged to have ‘committed fraud by abusing her position as chief executive’ of the NHS Trust in Torbay

The third charge alleges she authorised a payment of £11,072 to her husband for work that was not done.

Mrs Vasco-Knight denied all three fraud charges when she appeared at Exeter Crown Court.

She is alleged to have “committed fraud by abusing her position as chief executive officer of the NHS Trust by ignoring normal procurement procedures”.

Torbay Hospital sign
South Devon NHS Foundation Trust runs Torbay Hospital

Mr Vasco-Knight, aged 45, denied one count of fraudulently receiving £11,072 in November 2013.

Mr Naqvi, aged 28, from Bristol, denied three counts of encouraging the commission of offences. He is alleged to have liaised with Mr or Mrs Vasco-Knight to process payments or pass on details of bidders.

Judge Graham Cottle adjourned all the cases for a two week trial in January 2017 and released all three defendants on bail.

Former Torbay Hospital boss denies £20,000 NHS fraud

2 Comments
Herald Express  By HEPaulGreaves  |  Posted: June 24, 2016

Paula Vasco Knight

THE former boss of Torbay Hospital is to stand trial accused of committing a £20,000 fraud which allegedly benefitted her husband’s business.

Paula-Vasco-Knight is charged with dishonestly abusing her position as chief executive of the South Devon NHS Foundation Trust between October 2012 and April 2013.

She appeared from Liverpool via video link at Exeter Crown Court on Friday alongside her husband Stephen Vasco-Knight.

The offences relate to Mrs Vasco-Knight, 52, and a tendering process involving her husband’s graphic design business and two payments of £9,000 and £11,072.

 

The first fraud alleges she abused her position as chief executive of trust and did not follow the normal procurement process; the second that she forwarded details of quotes of rival bidders to her husband enabling him to succeed with a tender for contract; the third that she authorised payment of £11,072 from the trust to her husband’s business for work that was not done.

To the three charges she pleaded not guilty.

 

Mr Vasco-Knight, 45, pleaded not guilty to a single count of fraud by false representation which alleges he submitted an invoice for £11,072.

A third defendant appeared in the dock at Exeter.

Habib Naqvi, 38, denied three fraud offences alleging he assisted his co-defendants and facilitated the payments.

Judge Graham Cottle set a trial date of January 23, 2017.

Mr and Mrs Vasco-Knight, of Runcorn in Cheshire, and Naqvi, from Bristol, were granted bail until the trial.

£177k forked out by NHS on New Cross whistleblower bill

Express and Star 19 June 2016

An independent report on New Cross Hospital’s botched investigation into a whistleblower’s claims cost the NHS nearly £180,000, it can be revealed.


A report on New Cross Hospital’s handling of a whistlebower’s claims cost the NHS nearly £180,000.

Investigative consultants Verita were called in to look at New Cross bosses’ handling of Sandra Haynes-Kirkbright’s allegations relating to an alleged cover up over mortality rates.

A Freedom of Information request by the Express & Star reveals the firm was paid £134,879 for producing the report, with a further £42,688 spent on legal fees.

The total figure of £177,567 has been branded a ‘scandalous waste of taxpayers’ money’ by a prominent city councillor, while Walsall Manor Hospital whistleblower Dr David Drew said he was appalled that such vast sums had been ‘squandered’ rather than being spent on patient care.

Verita’s inquiry led to calls for the trust’s chief executive David Loughton to stand down over his treatment of Mrs Haynes-Kirkbright.

It found that the Royal Wolverhampton NHS Trust’s investigation into claims of malpractice was ‘significantly flawed’ and criticised Mr Loughton for being ‘dismissive’ of the allegations.

Sandra Haynes-Kirkbright

The report was completed in March 2015 but publication was delayed for more than a year while the NHS Trust Development Authority engaged legal advice on issues regarding publication.

Councillor Milkinder Jaspal, chair of Wolverhampton council’s health and scrutiny panel, said: “This is a report that should never have been required in the first place.

“If the trust had done its job and investigated these claims properly we wouldn’t be left with this scandalous waste of taxpayers money. This is money the NHS can ill afford in the current climate.”

Mrs Haynes-Kirkbright claimed she had been head-hunted to ‘fix’ mortality rates and alleged she was suspended after she refused to take part in a cover-up.

She has been suspended on full pay from her £54,000-a-year role since 2012 and still has an internal disciplinary charge hanging over her.

Dr David Drew said: “This is just the latest example of David Loughton being involved in a situation that leads to the NHS squandering huge sums of money.”

NHS Improvement spokeswoman Rebecca Salari, said: “Due to its complex nature, the review process took longer than anticipated. However, it has produced a number of important findings and identified some additional governance issues that require dedicated and focused consideration.”

 

New twist in long-running legal battle of whistleblower doctor ‘wrongly sacked’ by Croydon’s NHS trust

 

Croydon Guardian 16 June 2016

An employment tribunal ruled Dr Kevin Beatt was wrongly sacked by Croydon Health Services NHS Trust

An employment tribunal ruled Dr Kevin Beatt was wrongly sacked by Croydon Health Services NHS Trust

The legal saga of a whisteblower doctor sacked by Croydon’s NHS trust after voicing fears about patient safety has taken a fresh twist.

Kevin Beatt, former consultant cardiologist at Croydon University Hospital, has been granted leave to appeal a High Court ruling that he must face a fresh employment tribunal.

A 2014 tribunal ruled he had been unfairly dismissed from his job in 2012 after raising concerns about patient safety and staff bullying in the hospital’s cardiac catheter unit, which he ran, following the death of a patient.

RELATED: ‘Landmark legal win’ for cardiologist sacked by Croydon hospital for whistleblowing on patient safety

Croydon Health Services NHS Trust, which runs the hospital, hired a £5,000-a-day QC to fight the ruling.

It insists it fired Dr Beatt for making “unsubstantiated and unproven allegations of an unsafe service” and successfully appealed to the Employment Appeals Tribunal, which in January ruled the original tribunal decision had not been “properly reasoned”.

But Dr Beatt’s legal team have now won permission to take the fight to the Court of Appeal.

He said: “With all the expense involved, it’s just about the most ridiculous decision that can be made when actually what could have happened and what’s happened in other cases is the court has just sought clarification of the judgment, which would have been a very reasonable way to do it, or for them to go back and contest one issue.

“We decided that in order to avoid that process we would appeal to the Court of Appeal, where three judges will hear it.”

RELATED: Whistleblower doctor facing second tribunal after Croydon’s NHS trust wins appeal against wrongful dismissal ruling

The hearing is not expected to be heard until April, meaning the legal battle is likely to enter into a fifth year.

The trust has spent hundreds of thousands of pounds on legal fees contesting the case and will be forced to pay Dr Beatt a large compensation package if it loses.

Dr Beatt, a respected specialist who led the hospital’s well-regarded department for interventional heart procedures from 2007, argued he should have been afforded protected whistleblower status when he made a catalogue of complaints about staffing shortages, “appalling” equipment and workplace bullying, including at the inquest into the death of a patient during a routine operation.

But instead he lost his job in a case he claimed provided a damning demonstration of the trust’s attempts to cover up failings.

The trust argues Dr Beatt’s allegations amounted to gross misconduct, but 2014 employment tribunal ruled there was “no consistent evidence” of wrongdoing by the cardiologist and concluded the trust had “failed to carry out a fair process”.

Dr Beatt, who is effectively unable to work in the NHS while the legal fight is ongoing, said: “Because [the trust] maintains [it] was right it makes it very difficult for me to get a job.

“What they should be doing is saying they were wrong and the service was unsafe and they should just admit it, but they won’t do that.”

A spokeswoman for Croydon Health Services said: “We are aware of the appeal. We will not comment further at this stage.”

Watchdog criticises A&E unit which told patients to go home if they weren’t dying

 

The Mirror
12 JUN 2016 
BY MARTYN HALLE , DAN WARBURTON

The Care Quality Commission says there not enough medical staff at the North Middlesex Hospital unit and ordered urgent improvements

North Middlesex Hospital
North Middlesex Hospital A&E struggled to cope with patients

An A&E unit exposed by the Sunday People for ordering patients to go home unless they were dying has been criticised by watchdogs.

Staff at the North Middlesex Hospital faced criticism after stricken patients were turned away despite waiting up to seven hours on hospital trolleys .

In February a shocking message was broadcast over the loudspeaker system in an ­alarming new low for the ­over-stretched NHS .

Patients were told: “We would ask anyone who doesn’t have a life-threatening illness to go home and come back in the morning.”

Our revelations in February sparked an urgent probe by the Care Quality Commission (CQC).

The watchdog found the hospital is struggling to provide a safe and effective service on a daily basis and ordered the trust’s embattled chief executive Julie Lowe to make improvements by August 26.

Inspectors found there were delays in the initial assessment of patients, in their assessment by a doctor and in moving them to specialist wards.

It also emerged there were “insufficient middle grade doctors and consultants”.

 

A&E units must see 95% of patients within four hours

 

The CQC’s deputy chief inspector of hospitals, Prof Edward Baker, said: “People going to the emergency department at the North Middlesex University Hospital NHS Trust are entitled to a service that is safe, effective and responsive.

“When we inspected we found that patients were not receiving the quality of care that they should have been.

“We have strongly encouraged the trust to engage with other organisations across the local health and social care system to resolve this challenging issue.

“We will continue to monitor the trust closely, and will be returning for further inspections of the hospital to check that the service has improved.”

Read more: Ambulance trust pays private firm to cover for crews after £50m cuts

In February the Sunday People reported how the department struggled to cope with more than 150 patients.

One eyewitness said he saw more than 100 people in the waiting room in addition to dozens in the treatment areas and cubicles.

At one point there were a dozen patients on trolleys lining the wall along the department because all cubicles were full. Many had been on trolleys for hours.

At 11pm a message went on the tannoy saying that the wait to see a doctor was eight hours for adults and six hours in children’s A&E.

The North Middlesex has one of the worst records in the country for meeting national four-hour treatment targets.

 

The NHS logoLack of resources in the NHS is hitting A&E departments
It has struggled to meet demand since the Coalition Government allowed the closure of the A&E at Chase Farm Hospital, six miles away, in December 2013.

Earlier this year we revealed paramedics at North Middlesex were forced to wait for hours in A&E with patients because of a trolley shortage.

The hospital saw 68% of A&E patients within four hours in March, the worst performance in London. It rose to 72% last month, but the NHS target is 95%.

Ms Lowe said: “We appreciate the CQC’s acknowledgement of our difficulties and the impact of the shortage of middle-grade and consultant emergency department doctors, which has led them to issue the warning notice.”

Critics see the failure at North Middlesex as a reflection of a national A&E crisis which many blame on a lack of resources from the Government.

Last November we reported how patients at Northumbria Specialist Emergency Care Hospital, in Cramlington, were waiting for hours in corridors.

And in a separate fiasco, so many ambulances were queuing at nearby Barnet Hospital that they had to park on a roundabout in the hospital grounds.

Cliff Mann, President of the Royal College of Emergency Medicine, said: “More and more A&E units are being failed due to a lack of resources.”

Whistleblower surgeon wins battle to clear name

The Times 11 June 2016 Katie Gibbons | Martyn Halle

The liver specialist was subjected to abuse from colleagues and sacked after raising concerns about a failing NHS trust  JACK HOLLINGSWORTH/CORBIS

 

A surgeon who was subjected to abuse from colleagues and sacked after raising concerns about a failing NHS trust has won a five-year battle that has cost more than £1 million of public money.

Aditya Agrawal, a liver specialist, was persecuted for speaking up while working at East Lancashire NHS Trust, which had one of the highest death rates in the country.

An employment tribunal has ruled that the consultant, 44, was unfairly dismissed after enduring a campaign of abuse from fellow staff. There have been £300,000 legal costs and a further £700,000 in locum costs to cover his suspension.

One colleague said that he would not allow Mr Agrawal to operate on his dog. Another declared that he wouldn’t p*** on him if he was on fire.

Peter Bottomley, the Conservative MP for Worthing West, has called for an independent investigation into the trust, which was put into special measures in 2013 for the number of patient deaths in its care. “In my experience it’s the worst case I’ve dealt with,” said Mr Bottomley, whose wife, Virginia, is a former health secretary. “They accused Mr Agrawal of being responsible for nearly killing a patient when the opposite was the truth. The patient had been written off by another consultant as someone who couldn’t be saved.”

The consultant became a victim of a hate campaign at Blackburn Hospital in Lancashire for raising his concerns. Mr Agrawal was suspended in 2011 and sacked in 2015. Mr Agrawal reviewed the patient he was accused of “nearly killing” and concluded he could save the patient. Two days later that patient walked out of hospital.

Another of the allegations was that he had put a patient at risk by inappropriately discharging them. However, the patient in question was discharged two days after Mr Agrawal had been suspended, the tribunal heard.

The trust’s case against him was so discredited that its attempt to get him struck off by the GMC was itself struck out by the High Court through lack of evidence. “This man has his career ruined for four years and is unlikely to rebuild it after such devastating treatment. He hasn’t had paid work since the trust sacked him,” Mr Bottomley said.

“There needs to be an investigation because the trust’s case was against this consultant was non-existent and a vast amount of money has been wasted.”

Compensation and a decision on whether the trust will be ordered to re-employ the consultant will be made at a remedy hearing later this year.

Mr Agrawal, who is still out of work, did not want to comment on his victory. A friend of the surgeon said: “If the tribunal refuse to allow him to go back to his old job, who knows how long he will be unemployed.”

A spokesman for East Lancashire NHS Trust said: “The unfair dismissal succeeded due to procedural issues and the trust will learn lessons from this going forward.”

 

 

 

""

 

Former Torbay Hospital boss Paula Vasco-Knight appears in court on fraud charges

1 Comment
Herald Express

By HERomPEllis  |  Posted: June 03, 2016

THE former chief executive of Torbay Hospital has appeared in court charged with fraud.

Paula Vasco-Knight, 52, is charged with three counts of fraud by abuse of position.

The charges relate to her role as chief executive officer at South Devon NHS Foundation Trust between October 2012 and April 2013.

It is alleged Vasco-Knight dishonestly abused that position intending to make a gains of £9,000 and £11,000. The allegations are contrary to the Fraud Act 2006.

Vasco-Knight, of The Seasons, Runcorn, Cheshire, appeared via video link at Torquay Magistrates’ Court.

She was no required to enter a plea during the short hearing. She will next appear at Exeter Crown Court on June 24 on unconditional bail.

Stephen Vasco-Knight, 45, of the same address also appeared in court. He faces one charge of fraud by false representation according to the Fraud Act 2006. He will appear at Exeter Crown Court on June 24.

A third defendent, Habib Naqvi, 38, of Wells Road, Bristol, entered a not guilty plea to three charges in breach of the Serious Crime Act 2007 when he appeared at Torbay Magistrates’ Court last week.

Naqvi was granted unconditional bail by District Judge Diane Baker and will next appear at Exeter Crown Court on June 24.

 

Head of trust under investigation was awarded CBE

2 Comments
John Simpson, Crime Correspondent | Katie Gibbons

May 21 2016, 12:01am, The Times

Lisa Rodrigues is made a CBE by the Prince of Wales at Buckingham Palace. She has faced severe criticism for her time at an NHS trustDOMINIC LIPINSKI/PRESS ASSOCIATION ARCHIVE

This article was amended on May 23 to include a statement from Ms Rodrigues, and to clarify that the health trust is currently under investigation.

A former NHS executive was appointed CBE for her work in mental health provision at the height of a series of murders, manslaughters and suicides involving patients in her care.

Lisa Rodrigues, former head of a trust that is under investigation for failures relating to up to ten deaths, received the honour despite later being accused of having fostered a culture of “blame, fear and bullying” during her tenure.

Ms Rodrigues, who has herself suffered from clinical depression, was chief executive at the Sussex Partnership NHS Foundation Trust for 13 years, including the decade covering eight of the ten deaths referred to NHS England for review this week.

Families in four of the cases warned staff that the killer was a risk days before the deaths, while Sussex coroners have raised concerns over how so many patients have been able to take their own lives.

The review was announced after Matthew Daley, a misdiagnosed patient, was last week convicted of manslaughter on the ground of diminished responsibility for murdering a retired solicitor. Don Lock, 79, was stabbed 39 times at the side of a road in the village of Findon, near Worthing, last July. Daley’s family had for years pleaded in vain for him to be sectioned.

Ms Rodrigues apologised shortly before she retired from the £220,000-a-year role in 2014.

An investigation by The Times has uncovered myriad failures at the trust beyond the remit of the review.

•One care home in Hove has experienced nine deaths and preventable suicides of inpatients in six years alone.

•A corporate manslaughter investigation by Sussex police was dropped after three deaths at a second hospital in St Leonards and a fourth in Worthing.

• The trust has repeatedly refused to publish details of internal reviews and reports in controversial cases.

•A woman who suffered life-changing injuries at the hands of a trust patient, and families of the murder victims, are still waiting to receive compensation.

Last year, serious concerns were raised by the Care Quality Commission about the prevalence of ligatures on wards and the number of suicides. Since 2010 eight patients have killed themselves at Mill View hospital in Hove.

Despite a 2011 report with 30 recommendations, the teacher Jessica Philpott was able to hang herself on the Caburn Ward, and Danuta Corbett jumped from the Brighton Metropole hotel in 2013 while on suicide watch.

Marjorie Wallace, of the charity SANE, praised the trust for its progress towards addressing problems.

The trust said: “Providing mental health care is complex. Most of the time we get things right. When we don’t, we need to reflect.”

Ms Rodrigues said: “I welcome the decision of my successor to review the recommendations of past investigations to see if there is more to do in the light of the recent incidents. He and all the staff at the trust have my continued support. They do an extremely difficult and important job providing care to many thousands of people.”

Clarification: In a report on the Sussex Partnership NHS Foundation Trust we referred to an apology issued by Lisa Rodrigues as chief executive (News, May 21). We have been asked to clarify that this was in response to a staff survey which criticised the trust’s leadership and identified a culture of blame, fear and bullying; it was not connected to the manslaughter of Don Lock by a misdiagnosed patient, which occurred after Ms Rodrigues had left the trust.

Illness prevents former Torbay Hospital boss Paula Vasco-Knight attending court on fraud charges

1 Comment
He

By HEDanielClark  |  Posted: May 26, 2016

Paula Vasco-Knight

 

A MAN has appeared in court charged with encouraging and assisting the former chief executive of Torbay Hospital of committing fraud.

Habib Naqvi, 38, of Wells Road, Bristol, entered a not guilty plea to three charges in breach of the Serious Crime Act 2007 when he appeared at Torbay Magistrates’ Court on Thursday morning.

Naqvi was granted unconditional bail by District Judge Diane Baker and will next appear at Exeter Crown Court on June 24.

Paula Vasco-Knight, 52, the former chief executive officer at South Devon NHS Foundation Trust, and Stephen Vasco-Knight, 45, both of The Seasons, Runcorn, Cheshire, were due to appear at court as well.

However, the court was told that both were unwell and unable to travel to court because of a stress-related illness.

Paula Vasco-Knight faces three charges with dishonestly abusing her position as the former chief executive officer at South Devon NHS Foundation Trust, intending to make gains of £9,000 and £11,000.

Stephen Vasco-Knight, 45, faces one charge of fraud by false representation according to the Fraud Act 2006.

District Judge Diane Baker adjourned the case against them to a yet to be determined date when they will appear at Torbay Magistrates’ Court via videolink from Liverpool and Knowsley Magistrates’ Court.

A spokesman for Torbay and South Devon Healthcare Trust said: “We have now seen the charges against Ms Vasco-Knight. Whilst they reference South Devon Healthcare, as far as we are aware they do not relate to trust business. We understand that they relate to the national role held by Ms Vasco-Knight whilst she was chief executive with us. We are unable to comment further as legal proceedings are now underway, but will be able to do so once sub judice restrictions are lifted.”

 

Former Torbay Hospital boss Paula Vasco-Knight due in court charged with NHS fraud

Leave a comment
Herald Express  By HEPaulGreaves  |  Posted: May 26, 2016

 Paula Vasco Knight

THE former chief executive of Torbay Hospital is due to appear in court this morning charged with fraud.

Paula Vasco-Knight, 52, is charged with three counts of fraud by abuse of position.

The charges relate to her role as chief executive officer at South Devon NHS Foundation Trust between October 2012 and April 2013.

It is alleged Vasco-Knight dishonestly abused that position intending to make a gains of £9,000 and £11,000. The allegations are contrary to the Fraud Act 2006.

Vasco-Knight, of The Seasons, Runcorn, Cheshire, is due to appear before magistrates in Torquay on Thursday morning.

 

Also due to appear is Stephen Vasco-Knight, 45, of the same address. He faces one charge of fraud by false representation according to the Fraud Act 2006.

A third defendant, Habib Naqvi is also due to appear at the same court.

Naqvi, 38, of Wells Road, Bristol, has been charged with three offences of encouraging/ assisting in the commission of an offence in breach of the Serious Crime Act 2007.

A spokesman for Torbay and South Devon Healthcare Trust said: “We have now seen the charges against Ms Vasco-Knight. Whilst they reference South Devon Healthcare, as far as we are aware they do not relate to trust business. We understand that they relate to the national role held by Ms Vasco-Knight whilst she was chief executive with us. We are unable to comment further as legal proceedings are now underway, but will be able to do so once sub judice restrictions are lifted.”

 

New Cross Hospital whistleblower report: I won’t quit, says chief executive David Loughton

Express and Star   May 24, 2016
New Cross Hospital boss David Loughton will not quit over a damning report into how he treated a whistleblower – and insists there is no truth in her allegations about death rates and fraud.
                                                                                                                                                          New Cross Hospital's David LoughtonNew Cross Hospital’s David Loughton 

An independent inquiry found Mr Loughton was ‘dismissive’ of the claims made by staff member Sandra Haynes-Kirkbright and tried to ‘kick them into the long grass’ ahead of a key visit by a health watchdog.

Details of her treatment emerged in the report published earlier this month and prompted other whistleblowers to demand his resignation.

Speaking on the report for the first time, the £200,000-a-year boss was adamant there was “no truth whatsoever” in Mrs Haynes-Kirkbright’s allegations.

He said the Royal Wolverhampton NHS Trust was better off without certain individuals.

And asked if he had considered stepping down, Mr Loughton replied: “never.”

He added: “Three people who do not work for the trust have called for my head.

“How many letters do we think we have had from staff members at the hospital? We’ve had none. None at all. That says it all.

“Without doubt this organisation is better off without certain individuals.”

(21128115)New Cross Hospital 

Mrs Haynes-Kirkbright, who has been suspended from her £55,000 role as a coder since 2012, alleged the trust had fraudulently made money by charging for treatments it had not performed. The 52-year-old from Stafford also raised concerns that death rates were being made to look better than they were because they were wrongly registered.

But Mr Loughton told investigators that ‘no-one cares’ about allegations of fraud and that some people would say ‘good on you’ for ‘fiddling’ figures to get more money for the Trust.

Dr David Drew, a whistleblower sacked from Walsall Manor Hospital, said the Chief Executive “has to be finished”. Whistleblowers Professor David Ferry and Dr Raj Mattu were similarly critical of Mr Loughton.

The New Cross boss was speaking following a meeting of the trust’s Board of Directors, during which Chairman Jeremy Vanes spoke briefly on the report.

He said: “We support all staff that were named and involved, past and former staff, in the report.

“Secondly, we welcome the government review, which was one of the conclusions. We were planning to do one ourselves but that was delayed to wait for this report.

“Thirdly there are several active workstreams in terms of the outcomes and conclusions of the report which are not concluded, so it is very difficult for us to say anything more.

“We will be able to answer any questions in due course when all aspects have been resolved.”

Mr Loughton has been a NHS chief executive for 27 years. In 2010 he was appointed CBE for services to healthcare.

 

The untouchables

1 Comment
Dentistry.co.uk   23 FEBRUARY 2016962 VIEWS

Ninian Peckitt

By Ninian Peckitt

CourtroomNinian Peckitt shares his story of being erased from the dental register by the GDC (read the GDC’s response to this article here).

The recent damning report from the Professional Standards Authority about the General Dental Council (GDC) and the declaration that it is unfit for purpose, along with the savaging of the GDC council members by Lord Hunt, paints a masterpiece of dysfunctional regulation that would even put Pablo Picasso into perspective.

Clinical regulation is unaccountable with QUANGOS (quasi-autonomous non-governmental organisation) having made their departure from peer review, and yet still profess to be the guardians of patient safety. Evidence confirms that nothing could be further from the truth. And so the time has come to tell my story…

Clinician of the year

I left the NHS in 2001 after a long battle to introduce engineering-assisted surgery (www.maxfac.com) into clinical practice, 3D printing in particular.

I was appointed locum consultant in oral and maxillofacial surgery in Ipswich (2012), during which time I was honoured as a shortlisted finalist for an Ipswich Hospital Trust award as ‘Clinician of the year’.

What the trust failed to state, was that in the same week of the shortlisting, it also referred me to the General Medical Council (GMC) on a fitness to practise (FtP) issue. I learned about this much to my surprise roughly one year later.

A series of unfortunate events

The case started to get really interesting following my reporting a critical incident when a critically injured trauma patient fell out of bed – allegedly in relation to low nurse staffing levels.

My reporting this as a critical incident appears to be the trigger for ‘a series of unfortunate events’ culminating in the notes relating to this fall mysteriously being ‘lost’ by the trust, a not uncommon complication in NHS trusts.

Evidence was fabricated, altered, withheld and destroyed. The nature of the FtP case was withheld from the patient and family by the trust and GMC, despite my protests.

Contradictory statements were made; allegations were made without patient identification and without my right to see evidence and defend my actions. My conduct was severely criticised and how the shortlisting of the Trust Award could be made with this conduct was never explained – or to be more precise it was ignored, in a regulatory omertà.

So it became quite clear that if the truth was to be revealed, and more importantly, if an investigation into the injured patient was to be secured, a different plan of action was required.

Perverting the course of justice

GDC reform red_4I asked the police to examine the evidence and conduct of the case. And it was no surprise to learn that they recorded a crime of perverting the course of justice against the trust and against the GMC. This is historic.

The GMC had referred the case to the GDC prior to making its own ruling. This confirms premeditated malice and when I reported that the GDC was critical of the GMC’s referral prior to its own ruling, by ruling in my favour, under rule 10,  it enraged the GMC, securing yet another charge on the charge sheet. The GMC concealed the GDC ruling and the details of the recorded crime from its FtP process. If this is subsequently judged to be a breach of duty of candour, this is a criminal offence.

The outcome was a foregone conclusion and I was of course erased from the GMC register. The lay controlled GDC reopened the case with immediate suspension. Mirroring the GMC standard of conduct, a case was made by the GDC, without any reference to the recorded crime, and my name was erased from the dental register, a body that had previously found in my favour and criticised the GMC in its initial ruling.

This was justified by virtue of the GMC erasure, my statements that the GDC criticised the GMC in its previous ruling in my favour, and that I had no respect for authority.

I have to plead guilty on the last issue, and join the ranks of the entire dental profession, the PSA, Lord Hunt and others, responsible for the crucifixion of the GDC and its loss of authority to regulate.

A twist in the tale

A new twist in this tale was exposed when my MP approached the Health Secretary, requesting an investigation into GMC probity. The response, from Dr Dan Poulter MP, confirmed the usual politically correct statements in line with omertà.

The Department of Health supported whistleblowers, but could not become involved in an ‘employment dispute’. How a recorded crime of perverting the course of justice was an employment dispute was never explained.

However, Dr Dan just happens to be a local MP for Ipswich, where the hospital is subject to a recorded crime. So my complaint, for now, must sleep with the fishes.

A breach in the duty of candour

It is very difficult to prove a criminal act against a statutory body. The CPS Test Model has to ensure >50% chance of conviction for prosecution of a case and therefore some thought needs to be employed. Negligence and error are not necessarily crimes but are good defence arguments.

The key to the burden of proof was the demonstration of concealment of key evidence by the regulator, such as the recorded crime. If such a record is absent in the public hearing and ruling, there could be no doubt of a breach of duty of candour or even an attempt to pervert the course of justice.

So if one does not attend a FtP hearing and give a verbal defence, nor appoint a lawyer, then the onus is on the regulator to reveal such evidence at the hearing.

The CPS may be forced into action by the determination of a lack of disclosure by the regulator, and if such an absence of candour is demonstrable, the chances of conviction approach 100%.

Meanwhile, the GDC omertà remains with reference to the damning PSA report and the noble views for resignation of the entire council.

The GDC is unfit for purpose, and has breached a duty of candour, and this matter must now be referred to the police/CPS as a matter of public interest and safety.

The sting in the tail is that all rulings of the current GDC format are now potentially unsafe and should be reassessed and revised. We need to set up a crowd funding facility for this purpose.

So who are the real guardians of patient safety? Clinicians.

Read the GDC’s response to this article here.

‘He has to go’: Whistleblowers demand resignation of New Cross Hospital boss

1 Comment
Express and Star 14.5.16

Whistleblowers today demanded the boss of New Cross Hospital resign after a damning report into the way he treated a staff member who made allegations over death rates and fraud.

David LoughtonDavid Loughton

David Loughton, who runs the Royal Wolverhampton NHS Trust, was found to be ‘dismissive’ of the allegations by Staffordshire whistleblower Sandra Haynes-Kirkbright and had tried to ‘kick them into the long grass’ ahead of a key visit by a health watchdog.

The £200,000-a-year boss told the author of the investigation report that ‘no-one cares’ about allegations of fraud and that some people would say ‘good on you’ for ‘fiddling’ figures to get more money for the Trust. Today three senior doctors said Mr Loughton’s position had become untenable.

Sandra Haynes-Kirkbright, who raised concerns about the trust that runs New Cross Hospital, rightSandra Haynes-Kirkbright, who raised concerns about the trust that runs New Cross Hospital, right

Dr David Drew, a whistleblower sacked from Walsall Manor Hospital, said the report demonstrated how those who raise concerns in the NHS are treated.

He said: “David Loughton has to be finished. He has to go. I cannot see how his position is remotely tenable after what has been revealed.”

Background to this story

crop-5703b67d160aa-imgID19510635.original

   

Professor David Ferry, who revealed that at least 55 cancer patients at New Cross were given extra chemotherapy treatment they did not need between 2005 and 2010, and was subsequently outed by New Cross after wanting to remain anonymous, said: “His behaviour cannot be tolerated. He has a track record of burying his head in the sand when it comes to serious concerns being raised. Despite what happened at Mid Staffs he is not learning his lessons. He cares more about reputational management than anything else. He has to resign or be sacked.”

And Dr Raj Mattu, a leading heart surgeon who was suspended by Mr Loughton while chief executive at Coventry Walsgrave Hospital after he exposed how two patients died in overcrowded bays, said: “It is time for Mr Loughton to be held to account and investigated fully. This man is not fit to hold senior public office.”

Dr Mattu was awarded £1.2 million in damages after being wrongly accused of fraud, sexual impropriety and assault in a case that is believed to have cost the NHS more than £10m.

Mrs Haynes-Kirkbright, who has been suspended from her £55,000 role as a coder since 2012, alleged the trust had fraudulently made money by charging for treatments it had not performed. The 52-year-old from Stafford also raised concerns that death rates were being made to look better than they were because they were wrongly registered.

Mr Loughton told investigators: “No one cares. If I’m fiddling money and stuff like that, it wouldn’t even get printed. Some people would probably give me a pat on the back and say: ‘If you are fiddling to try and get more money for the hospital, good on you’.”

 

‘Now sack £200,000 boss who hounded NHS whistleblower’: Calls come after damning report into treatment of whistleblower who accused his hospital of fixing death rates

By PAUL BENTLEY FOR THE DAILY MAIL   13 May 2016

  • David Loughton has spent more than £10million of taxpayers’ money over the past two decades fighting whistleblowers
  • Manager Sandra Haynes Kirkbright was suspended after raising concerns that his hospital trust had mis-recorded deaths
  • An independent review into her case condemned the trust’s management for its ‘significantly flawed’ and ‘unfair’ treatment

A £200,000-a-year NHS boss is facing calls to be sacked following a damning report into the treatment of a female employee who accused his hospital trust of ‘fixing’ death rates.

David Loughton, who runs The Royal Wolverhampton NHS Trust, has spent more than £10million of taxpayers’ money over the past two decades fighting whistleblowers.

Manager Sandra Haynes Kirkbright was suspended after raising concerns that his hospital trust had mis-recorded deaths, making it look like fewer patients had died needlessly.

David Loughton, who runs The Royal Wolverhampton NHS Trust, has spent more than £10million of taxpayers' money over the past two decades fighting whistleblowers

David Loughton, who runs The Royal Wolverhampton NHS Trust, has spent more than £10million of taxpayers’ money over the past two decades fighting whistleblowers

In claims first made to the Daily Mail three years ago, the 52-year-old grandmother also said the trust had fraudulently made money by charging for treatments it had not performed. She was suspended and threatened with disciplinary action for speaking to the Mail.

Yesterday, an independent review into her case ordered by Health Secretary Jeremy Hunt condemned the trust’s management for its ‘significantly flawed’ and ‘unfair’ treatment. In particular, it detailed the extraordinary behaviour of Mr Loughton, who was accused of making sure Mrs Haynes Kirkbright was ‘out of the way’ before a visit by hospital inspectors, telling staff to ‘kick this into the long grass’.

Mr Loughton told the report’s authors: ‘No one cares. If I’m fiddling money and stuff like that, it wouldn’t even get printed. Some people would probably give me a pat on the back and say: ‘If you are fiddling to try and get more money for the hospital, good on you’.’

Yesterday, regulator the NHS Trust Development Authority ordered a full review into the management of Mr Loughton’s hospital trust. But NHS whistleblowers called for him to be sacked or suspended.

Mr Loughton, 62, earns just over £210,000 per year as chief executive of Royal Wolverhampton. In 2013, the Mail revealed how Mrs Haynes Kirkbright faced ruin after being suspended by him. The hospital administrator blew the whistle after she was hired to oversee record keeping at the trust in 2011.

She said that when she arrived, others at the trust were ‘breaking every rule in the book’. Deaths had mistakenly been recorded in a way that made it look like fewer people were dying needlessly.

She also accused bosses of ‘fraud’ – which they strenuously deny. She said the trust had been charging the local primary care trust for more expensive procedures or treatments than the ones they had actually provided. The grandmother was suspended on allegations of bullying. After she spoke to the Mail, she was sent a threatening letter by Royal Wolverhampton saying she had breached her contract and faced disciplinary action.

Mr Hunt subsequently intervened, demanding an investigation and that all action against Mrs Haynes Kirkbright be frozen.

The independent investigation was overseen by top lawyer Lucy Scott-Moncrieff. The report, published yesterday, detailed how Mr Loughton allegedly ordered the removal of Mrs Haynes Kirkbright from the trust after she made her claims because it was due to be inspected by watchdog Monitor.

Manager Sandra Haynes Kirkbright was suspended after raising concerns that his hospital trust had mis-recorded deaths, making it look like fewer patients had died needlessly

Manager Sandra Haynes Kirkbright was suspended after raising concerns that his hospital trust had mis-recorded deaths, making it look like fewer patients had died needlessly

The report was particularly critical that allegations of fraud did not appear to have been investigated thoroughly. Mrs Haynes Kirkbright told the authors that after she used the word ‘fraud’ in an email, she was told ‘you can never put anything like that in an email because the Press can get hold of it through the Freedom of Information Act’.

The report found the trust’s whistleblowing policy ‘is not up to date and does not appear fit for purpose’.

Mr Loughton has worked as an NHS chief executive for 27 years and was appointed CBE in 2010 for services to healthcare.

When he ran Coventry’s Walsgrave Hospital for 17 years, it was named the worst in the country.

During this time, Mr Loughton suspended leading heart surgeon Dr Raj Mattu after he exposed that two patients had died in dangerously overcrowded bays.

Dr Mattu was wrongly accused of fraud, sexual impropriety and assault. He was cleared at a tribunal and in February was awarded £1.2million damages. Last year, Mr Loughton outed Professor David Ferry who had wished to remain anonymous while revealing 55 cancer patients were needlessly put through the agony of chemotherapy.

Mrs Haynes Kirkbright last night told the Mail: ‘I want the allegations I whistleblew about to actually be investigated properly. And I want my reputation back.’

Dr Mattu said: ‘It is time for Mr Loughton to be held to account and investigated fully. This man is not fit to hold senior public office.’

Professor Ferry said: ‘Loughton represents a generation of dinosaurs in the NHS. Central to his modus operandi is persecution of whistleblowers.’

The Royal Wolverhampton NHS Trust said it takes whistleblowing extremely seriously and encourages staff and patients to come forward if they have concerns.