Hospital in bullying claims did not monitor at-risk patientsMegan Orito
Hospital in bullying claims did not monitor at-risk patients.
West Suffolk NHS trust failed to heed warning over patients with aneurysms, raising questions about management.
The health secretary, Matt Hancock, at West Suffolk NHS foundation trust, which is his local hospital and is accused of bullying staff to identify a whistleblower. Photograph: Twitter @SteveDunnCEO
A hospital accused of bullying its staff is facing new claims that it failed to act on a leading doctor’s warning about a potentially fatal failure to monitor vulnerable patients, the Guardian can reveal.
Dr Jonathan Boyle, the UK’s top vascular surgeon, had warned West Suffolk NHS trust, the health secretary Matt Hancock’s local hospital, that patients at risk of dying from burst aneurysms were not being safely monitored. An IT glitch meant that patients were not followed up to see how soon they would need potentially life-saving surgery.
A doctor at the trust, however, says it initially repeatedly refused to take any action, raising further questions about its management.
The trust initially suggested the problem was the result of senior doctors not keeping up with emails, but later accepted its IT systems were at fault. The hospital was forced to recognise that patients were potentially put at risk and took action only after a whistleblower alerted the NHS regulator.
The Bury St Edmunds hospital is already at the centre of claims of bullying and intimidation after it demanded medical staff take fingerprint tests in an effort to identify a whistleblower who raised the alarm about potentially botched surgery with the family of a patient who died under its care.
It has offered a partial apology to staff and agreed to reflect on its tactics after the Guardian revealed its extraordinary response to an anonymous letter a member of staff sent to the patient’s widow.
Responding to the new claims, the hospital acknowledged problems had occurred with its vascular surgery services and confirmed that an investigation was underway, but insisted that no patients had been harmed.
The issue involves the handling of scans for patients with aneurysms which are conducted to detect signs of growth in case surgery is required to prevent a life-threatening rupture. Under the hospital’s eCare system those scans were automatically deleted after 90 days. The hospital’s email system failed to alert doctors that they needed to check the scans before they disappeared from the system.
Regular monitoring of these patients is vital because consultants need to know whether an aneurysm has reached 5cm in diameter, at which point they require an operation before the swollen blood vessels bursts.
Boyle, who is based at Addenbrooke’s hospital in Cambridge, but also works at West Suffolk, was so concerned about patients not being followed up that he made entries on Datix, the NHS-wide system for flagging up patient safety incidents.
Boyle, the associate editor of the European Journal of Vascular and Endovascular Surgery, did not respond to the Guardian after calls for comment. But a colleague and someone familiar with the issues both said Boyle made several Datix incidents reports about the problem.
His reports were dismissed, however, with a note saying that “no further action” was needed by the hospital’s head of eCare system, Dr Dermot O’Riordan, who previously served as the trust’s medical director and its interim chief executive.
Boyle was so alarmed by this failure to follow up his concerns that he reported the problem to the Care Quality Commission (CQC), which inspects and rates hospitals, including on the safety of their care.
O’Riordan has not responded to a request to comment.
The unnamed doctor told the Guardian that the problem typified how the trust sought to bury any signs of failure. “The trust knew what happened and didn’t act,” he said. The trust’s chief executive, Stephen Dunn, was awarded a CBE last year for services to health and patient safety.
Following Boyle’s intervention, the CQC asked the trust to explain its action both before and during its inspection visits in September and October. The trust is expected to lose its “outstanding” rating when the commission reports this month. The regulator has already said its maternity services need significant improvement.
“The reporting system used by the NHS is an important protection for patients, but only if it works properly and is acted upon. Delays in monitoring patients with aneurysms is a serious matter, potentially a life and death matter,” said Peter Walsh, the chief executive of Action Against Medical Accidents, a patient safety charity.
“It is very surprising that this was not acted upon and even more so if the doctor reporting concerns is senior. If patient safety is given the priority it deserves in a trust it should not need the CQC to intervene, but on behalf of the patients I am glad they did.”
A CQC spokeswoman said: “We were made aware of concerns regarding the handling of information submitted via the trusts’ Datix incident reporting system. These concerns were followed up directly with the trust prior to and during CQC’s latest inspection.”
A spokeswoman for West Suffolk NHS foundation trust said: “Regrettably, we identified an issue with our vascular surgery services and an investigation is underway. All affected patients have been identified, are receiving the appropriate treatment and there is currently no evidence that patients have been harmed.”
It pointed out that when it realised the problem might affect patients it recorded the potential problem on its risk register. It also introduced a new policy to ensure that doctors act on patients’ results, including scans, within 28 days.
After the Guardian revealed the unprecedented lengths to which the hospital had gone to identify whistleblowers last month, it appeared to acknowledge that it may have gone too far.
In a statement on its website after the story was published, it said: “We asked staff who were involved in the investigation to provide handwriting and fingerprint examples in order to immediately rule themselves out of the investigation. Staff were asked to provide these and were not threatened with disciplinary action if they chose not to do so.
“However, we know that for some colleagues involved that it did not necessarily feel that way and that this was a very difficult and stressful situation for them, for which we are sorry.”
It stopped short of acknowledging that the tactics were wrong, but added: “Knowing the impact it has had on staff involved, we will continue to reflect on as an organisation on our approach.”
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