St Andrew’s Healthcare in Northamptonshire based on an inspection between 17th and 18th December 2019, reported today as inadequate, unsafe: https://www.cqc.org.uk/location/1-121538276
This is the latest in a long list of catastrophic failures across NHS England. They are described below but first:
I have friends and relatives across England. They deserve better. This Tory regime over more than ten years now has let them down badly. It’s not just about money, it’s about the political leadership and management of NHS Scotland. Nearly 3 years ago the Nuffield Trust identified the key role of the Scottish Government in enabling NHS Scotland to thrive and to improve, leaving the NHS in England and, for that matter, Wales, in its wake:
Scotland has a unique system of improving the quality of health care. It focuses on engaging the altruistic professional motivations of front-line staff to do better, and building their skills to improve. Success is defined based on specific measurements of safety and effectiveness that make sense to clinicians.
Scotland’s smaller size as a country supports a more personalised, less formal approach than in England. The Scottish NHS has also benefited from a continuous focus on quality improvement over many years. It uses a consistent, coherent method where better ways of working are tested on a small scale, quickly changed, and then rolled out. Unlike in the rest of the UK, this is overseen by a single organisation that both monitors the quality of care and also helps staff to improve it.
There is much for the other countries of the UK to learn from this. While comparing performance is very difficult, Scotland has had particular success in some priority areas like reducing the numbers of stillbirths. Scotland’s system provides possible alternatives for an English system with a tendency towards too many short-term, top-down initiatives that often fail to reach the front line. It also provides one possible model for a Northern Irish NHS yet to have a pervasive commitment to quality improvement, and a Welsh system described as needing better ways to hold health boards to account while supporting them in improving care.
Scotland has a longer history of drives towards making different parts of the health and social care system work together. It has used legislation to get these efforts underway while recognising that ultimately local relationships are the deciding factor. There is much for England and Wales to learn from this.
Research Report, July 2017, Learning from Scotland’s NHS at: https://www.nuffieldtrust.org.uk/files/2017-07/learning-from-scotland-s-nhs-final.pdf
The emergency services at King’s College Hospital in London were inspected in November 2019 and the report appeared last week. They were found to be unsafe. The inspectors found:
Click to access rjz01_location_king_s_college_hospital_newapproachfocused_20191219%20final%20.pdf
Orpington’s Princess Royal Hospital was inspected in November 2019 and reported last week as inadequate unsafe: http://downloads2.dodsmonitoring.com/downloads/Misc_Files/rjz30_location_princess_royal_university_hospital_newapproachfocused_20191219%20final.pdf
North Midlands Trust only looks better by contrast with the inadequacy above but, in Scotland this would lead to calls for heads to roll.
East Kent NHS Trust: An independent review will be held into maternity services at the East Kent NHS Trust after up to 15 babies died there in recent years. Nadine Dorries, minister for patient safety, pledged immediate action and said NHS England would investigate the two hospitals in Margate and Ashford.
https://www.bbc.co.uk/news/uk-england-sussex-51490841
Hospital mortality rate higher than expected in 8 NHS England trusts
#https://beta.isdscotland.org/find-publications-and-data/health-services/hospital-care/hospital-standardised-mortality-ratios/
Patient safety is frequently at risk in NHS hospital trusts in England, with 70% of them failing to meet national safety standards, according to an Observer analysis of inspection reports, with staff shortages the biggest problem.
Urgent enforcement powers’ used to protect patients in Worcester Royal Hospital: A review of data for each month in 2019 suggested limited overall improvement, suggesting staff had normalised the use of the corridor as compared to the use of the corridor only being reserved for times of significant surge.
Click to access Worcestershire%20Royal%20-%20CQC%20report%20-%20Feb%202020.pdf
The sheer injustice and cruelty meted out on Stafford Hospital’s wards: https://www.independent.co.uk/voices/nhs-mid-staffs-hospital-care-crisis-a9284856.html
Concerns 150 deaths were not properly investigated by Liverpool Community Health: https://www.bbc.co.uk/news/uk-england-merseyside-48537553
Neglect & serious failures by South London and Maudsley NHS Foundation Trust: https://www.inquest.org.uk/kenan-canalp-closes
I could go on but I’m tiring.
Talking-up Scotland / Scottish media fact checking is like shooting fish in a barrel 
With so many examples of NHS England’s failings highlighted over recent weeks on Talking Up Scotland, let us never forget this THREAT to Scotland and its NHS from PM Johnson in the HoC Chamber last October, as recorded for posterity in Hansard:
https://hansard.parliament.uk/Commons/2019-10-30/debates/EE676E39-9A59-47E9-B17A-E7D8FB1A2D11/Engagements#contribution-16088310-3187-4256-A374-4A7D93AF7D6E
“As I said earlier, that is why SNP Members rant, to use their own word, so incessantly about independence – because they wish to distract or to dead-cat, as the saying goes, from the lamentable failures of the SNP Government. He (John Lamont, Tory MP for Berwickshire, Roxburgh and Selkirk) is entirely right that, if this goes on, I think THE SNP WILL FORFEIT THE RIGHT TO MANAGE THE NHS IN SCOTLAND.” (my emphasis)
LikeLiked by 1 person
There is also another more insidious threat to the NHS because of what is happening in NHS England which is likely to affect each of the other NHS groups and NHS England itself and that is the demoralisation of staff at all levels and all disciplines such that they leave the NHS whether to work abroad or change careers.
Currently the 4-NHS groups to a greater or lesser extent can draw upon a common pool of staff but if people leave NHS England then that pool is diminished to the detriment of the other NHS groups. This is further exacerbated by the effect of Brexit on staff recruitment from the EU. There is also some evidence that people are being put off taking up a career in the NHS. As reported by some of the Royal Colleges there was some evidence that the doctors’ strike and the way they were treated over their contract seemed to put people off applying for Medicine as well as increasing the number of young doctors who moved abroad. The cost of Tuition Fees and lack of bursaries has had an effect on the numbers coming forward to train as nurses. Scotland has mitigated these effects to some extent but the situation in NHS England makes that harder.
LikeLiked by 1 person
I note that with the drugs conferences in Glasgow this week various media organisations are again reporting on the drug death statistics in Scotland. These are indeed very concerning; they do seem to have an explanation (but I’m no expert); and it is the subject of action by the SG, its agencies, third sector bodies etc.
Although the figures for Scotland on drugs deaths are appalling and worse that those in England (although calculated a bit differently,) it is notable that even within England alone the actual figures are strikingly different across the regions.
Below are some facts from the latest data published by the Office for National Statistics (ONS).
Source: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2018registrations
The ONS reports that in 2018 in North East England there were 96.2 deaths per million persons due to drug misuse – the highest in England. The lowest figure was 34.9 deaths per million persons in London – that’s a very big difference. There is a general pattern of the rate of deaths increasing the further one moves away from London and the South East (see ONS Figure 4: Drug misuse has a marked North-South divide).
Why is there such variability within one country, one system, and all under the management of a Tory government for the past 10 years? If current UK drug policy is sufficient and the Westminster government is actively using all the (adequate) powers at its disposal – as it may claim – why is this variability across England still in existence?
But the ONS also states: “The number of deaths registered arising from drug use in 2018 (in England and Wales) was the highest since our records began in 1993. We have also seen the biggest year-on-year percentage increase”.
So whatever is said in the media about the situation in Scotland – and it is right that the situation is seriously addressed – let’s try not to permit the coverage to airbrush out the very marked, unexplained regional variations in England.
LikeLiked by 1 person
St ANDREW’s Healthcare in Northampton?
St Andrew – patron saint of Scotland, Northamptonshire is where Corby is and Corby has thousands of Scots and Scots descended. I am amazed Reporting Scotland has not latched on to this because it is clear proof that Scots cannot manage things!
LikeLike