The Stafford Hospital scandal concerns poor care and high mortality rates amongst patients at the Stafford Hospital, Stafford, England, during the first decade of the 21st century. The hospital was run by the Mid Staffordshire NHS Foundation Trust, and supervised by the West Midlands Strategic Health Authority. It has been renamed County Hospital. The scandal also resulted in the resignation of NHS Chief Sir David Nicholson in 2013.
Julie Bailey, whose mother died in Stafford Hospital in 2007, started a campaign called Cure the NHS to demand changes to the hospital. She was supported by the Staffordshire Newsletter, but the Public and Patient Involvement Forum and the Governors of the Trust were defensive. [1]
The scandal came to national attention because of an investigation by the Healthcare Commission in 2008 into the operation of Stafford Hospital in Stafford, England. The commission was first alerted by the "apparently high mortality rates in patients admitted as emergencies". [2] When the Mid Staffordshire NHS Foundation Trust, which was responsible for running the hospital, failed to provide what the commission considered an adequate explanation, a full-scale investigation was carried out between March and October 2008. [2] Released in March 2009, the commission's report severely criticised the Foundation Trust's management and detailed the conditions and inadequacies at the hospital. Press reports suggested that because of the substandard care between 400 and 1,200 more patients died between 2005 and 2008 than would have been expected for the type of hospital, [3] [4] based on figures from a mortality model, but the final Healthcare Commission report concluded that it would be misleading to link the inadequate care to a specific number or range of numbers of deaths. [5] [6]
The Healthcare Commission criticised the foundation trust board, which was led by chief executive Mr Yeates and chairman Ms Brisby, for holding in camera board meetings and "for making cutbacks to staffing and services in order to make millions of pounds' worth of surplus at the end of each year," because "bosses focused on the Trust achieving millions of pounds surpluses over a three year period, in order to gain Foundation status", [7] a goal which had been fostered by successive governments setting target dates by which all NHS trusts were supposed to have reached NHS foundation trust status. For example, in 2009, the Department of Health was announcing "A new type of NHS hospital". [8]
The trust's chief executive, Martin Yeates, was suspended (with full pay) and its chairwoman, Toni Brisby, resigned. [4] [9] [10] On 15 May 2009, Yeates resigned. [7] Prime Minister Gordon Brown and Health Secretary Alan Johnson apologised to those who suffered at the hospital. [4] [11] In response to the scandal, the mortality rates of all National Health Service hospitals have been made accessible on a website. [12]
Cynthia Bower, who was from 2006 chief executive of NHS West Midlands, was recruited to run the Care Quality Commission quango in March 2009, a move which was criticised. [13]
On 21 July 2009, the Secretary of State for Health, Andy Burnham, announced a further independent inquiry into care provided by Mid Staffordshire Foundation Trust. [14] The generally critical inquiry report was published on 24 February 2010. The report made 18 local and national recommendations, including that the regulator, Monitor, de-authorise the foundation trust. [15] [16]
In February 2010, Burnham agreed to a further independent inquiry of the commissioning, supervisory and regulatory bodies for foundation trusts. [15]
As early as October 2010, compensation payments averaging £11,000 were paid to some of the families involved. [17]
The revelations of the neglect to patients at Stafford hospital were widely considered to be deeply shocking by all sections of the mainstream UK press; for example, patients were left in their own urine by nurses. [18] In June 2010, the Cameron–Clegg coalition announced that a full public inquiry would be held. [19]
The inquiry began on 8 November 2010, chaired by Robert Francis QC, who had chaired the fourth inquiry which he had criticised for its narrow remit. The inquiry considered more than a million pages of previous evidence as well as hearing from witnesses. [20] Former chief executive Martin Yeates, who "resigned with a pay-off of more than £400,000 and a £1 million pension pot", escaped cross-examination at the inquiry due to self-reported ill-health "with post-traumatic stress disorder, a condition often associated with soldiers returning from war zones" but did participate with a written statement. [18]
Helene Donnelly, a nurse at the hospital, complained that the two Sisters running the department had told staff to lie about waiting times. The Sisters were suspended and Helene was harassed. She subsequently gave evidence to the Francis inquiry and was later appointed [21] ambassador for cultural change at Staffordshire and Stoke-on-Trent Partnership NHS Trust.
The final report of the Francis inquiry was published on 6 February 2013, making 290 recommendations. [22] [23]
Academics at the University of Oxford and King's College London have criticised the recommendations of the Francis inquiry to legally enforce a new duty of openness, transparency and candour amongst NHS staff, arguing that increasing 'micro-regulation' may produce serious unintended consequences. [24]
Medical lawyers offered their assistance to distraught and angry families who waited for proof that lessons had been learned. Many families of the victims felt that crucial questions have been left unanswered. [25]
The Nursing and Midwifery Council (NMC), the UK's regulator of nurses and midwives, held hearings about nurses working in the trust following allegations that they were not fit to practise. Acting to protect the public, the NMC has struck off from their register or suspended several nurses as a result of these hearings. This includes two who falsified accident and emergency discharge times, [26] two involved in the death of a diabetic patient [27] and a nurse who physically and verbally abused a dementia patient. [28]
Yeates was appointed to be Chief Executive of Impact (Alcohol and Addiction Services Shropshire and Telford) in November 2012. [29] It later emerged in November 2013 that a "compromise agreement" had been agreed with him, whereby he had left the NHS with a gagging agreement in place. [30]
In April 2013, the Stafford Hospital was placed into administration by Monitor. This action "was taken after a review team concluded that its services were clinically and financially unsustainable... [and also] concluded that the Trust was unlikely to be able to repay its debts." [31]
In April 2013, Yeates and Brisby were referred to the Crown Prosecution Service by the Stafford Borough Council "over allegations of misconduct in public office by knowingly giving false and misleading evidence relating to death rates to the council's statutory overview and scrutiny committee". [31]
Sir David Nicholson, who was in charge of the NHS which was responsible for the hospital at the height of the failings between 2005 and 2006, resigned in May 2013 in connection with this scandal. [32]
An independent 2008 study into hospital standardised mortality ratios found that the mortality measure developed by the Foster Unit at Imperial College is prone to methodological bias, and that it was not credible to claim that variation in mortality ratios reflects differences in quality of care. [33] In 2015, The Guardian amended an article from 2013:
...subsequent investigations into the poor care at Stafford hospital, including the two reports by Sir Robert Francis QC, said that this disputed estimate, which appeared only in a draft report from 2009 by the Healthcare commission and was based on mortality statistics, was an unreliable measure of avoidable deaths. The Francis report of February 2013 concluded that it would be unsafe to infer from these statistics that there was any particular number of avoidable or unnecessary deaths at the trust. [34]
According to Jeremy Hunt the enquiry described a systematic failure by both the NHS and the Department of Health to deal with such problems. Protecting the reputation of the NHS had become more important. Concentrating on national targets led to managers deprioritising the safety and well-being of patients. [35]
On 30 January 2019, Channel 4 announced that they had commissioned a drama of the Stafford Hospital scandal from the perspective of Julie Bailey. [36]
An NHS foundation trust is a semi-autonomous organisational unit within the National Health Service in England. They have a degree of independence from the Department of Health and Social Care. As of March 2019 there were 151 foundation trusts.
Monitor was an executive non-departmental public body of the Department of Health, responsible between 2004 and 2016 for ensuring healthcare provision in NHS England was financially effective. It was the sector regulator for health services in England. Its chief executive was Ian Dalton and it was chaired by Dido Harding. Monitor was merged with the NHS Trust Development Authority to form NHS Improvement on 1 April 2016.
Sir David Nicholson is a public policy analyst and NHS Manager who is the Chair of Sandwell and West Birmingham Hospitals NHS Trust and Chair of Worcestershire Acute Hospitals NHS Trust. He was previously the Chief Executive of the National Health Service in England. He was appointed in October 2011 following the NHS reforms, having been seventh Chief executive of the NHS within the Department of Health since September 2006. He issued what has become known as the "Nicholson challenge" regarding the finances of the NHS. He retired from the role on 1 April 2014 in the wake of the Stafford Hospital scandal.
The West Midlands Ambulance Service University NHS Foundation Trust (WMAS) is responsible for providing NHS ambulance services within the West Midlands region of England. It is one of ten ambulance trusts providing England with emergency medical services, and is part of the National Health Service.
Criticism of the National Health Service (England) includes issues such as access, waiting lists, healthcare coverage, and various scandals. The National Health Service (NHS) is the publicly funded health care system of England, created under the National Health Service Act 1946 by the post-war Labour government of Clement Attlee. It has come under much criticism, especially during the early 2000s, due to outbreaks of antibiotic resistant infections such as MRSA and Clostridium difficile infection, waiting lists, and medical scandals such as the Alder Hey organs scandal. However, the involvement of the NHS in scandals extends back many years, including over the provision of mental health care in the 1970s and 1980s (ultimately part of the reason for the Mental Health Act 1983), and overspends on hospital newbuilds, including Guy's Hospital Phase III in London in 1985, the cost of which shot up from £29 million to £152 million.
The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR).
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The Royal Free London NHS Foundation Trust is an NHS foundation trust based in London, United Kingdom. It comprises Royal Free Hospital, Barnet Hospital, Chase Farm Hospital, as well as clinics run by the trust at Edgware Community Hospital, Finchley Memorial Hospital, and North Middlesex University Hospital. On 1 July 2014, the Barnet and Chase Farm Hospitals NHS Trust was acquired by Royal Free London NHS Foundation Trust, making it one of the largest trusts in the country.
The Royal Wolverhampton NHS Trust runs New Cross Hospital and West Park Rehabilitation Hospital in Wolverhampton and Cannock Chase Hospital in Cannock.
The Mid Staffordshire NHS Foundation Trust was a NHS foundation trust which managed two hospitals in Staffordshire, England:
County Hospital is an acute hospital with less than 200 inpatient beds, opened in 1983. It is the main hospital in Stafford, England. The hospital is managed by University Hospitals of North Midlands NHS Trust. County Hospital's Accident and Emergency unit is the only such facility in Stafford. Wards at County Hospital are numbered, with the exception of specialist units. The hospital changed its name on 1 November 2014 from Stafford Hospital to County Hospital as part of the dissolution of the Mid Staffordshire NHS Trust.
The Bristol heart scandal occurred in England during the 1990s. At the Bristol Royal Infirmary, babies died at high rates after cardiac surgery. An inquiry found "staff shortages, a lack of leadership, [a] ... unit ... 'simply not up to the task' ... 'an old boy's culture' among doctors, a lax approach to safety, secrecy about doctors' performance and a lack of monitoring by management". The scandal resulted in cardiac surgeons leading efforts to publish more data on the performance of doctors and hospitals.
The Furness General Hospital scandal involves an investigation by Cumbria Constabulary and other government and public bodies into the deaths of several mothers and newborn babies, during the 2000s at Furness General Hospital (FGH) in Barrow-in-Furness, Cumbria, England. Cases date back to 2004, with a number of major incidents occurring in 2008. The death of Joshua Titcombe and a suppressed report by the Morecambe Bay NHS Trust brought the spotlight onto FGH in 2011 when investigations began. Claims of medical records being intentionally destroyed alongside the discovery of major wrongdoing on behalf of midwives led to threats of closure to the maternity ward.
The Keogh Review into patient safety was carried out by Professor Sir Bruce Keogh in July 2013.
Sir Hugh Henderson Taylor, is a British former Permanent Secretary at the Department of Health and current Chair of Guy's and St Thomas' NHS Foundation Trust.
Julie Dawn Bailey CBE is a cafe owner who was a central figure in the Stafford Hospital scandal.
The University Hospitals of North Midlands NHS Trust was created on 1 November 2014. It runs Royal Stoke University Hospital, formerly run by the University Hospital of North Staffordshire NHS Trust and the County Hospital. It was formed after the dissolution of Mid Staffordshire NHS Foundation Trust. The trust is currently under the leadership of chair David Wakefield and chief executive Tracy Bullock.
Sir Robert Anthony Francis, KC is a British barrister. He specialises in medical law, including medical and mental health treatment and capacity issues, clinical negligence and professional discipline. He has appeared as a barrister for and chaired several high-profile inquiries into medical controversies/scandals.
Healthcare in Staffordshire was the responsibility of six clinical commissioning groups until July 2022, covering Stafford & Surrounds, North Staffordshire, South East Staffordshire and Seisdon Peninsula, East Staffordshire, Cannock Chase, and Stoke-on-Trent.
Institutional corruption is a phenomenon in public bodies that has been defined by the UK Independent Inquiry into the Murder of Daniel Morgan as placing the protection of reputation above fidelity to the truth, especially in the context of an independent or public inquiry.
{{cite news}}: |author= has generic name (help)it has been concluded that it would be unsafe to infer from the figures that there was any particular number or range of numbers of avoidable or unnecessary deaths at the Trust.
1.10 The Government's aim is that by 2008, all NHS Trusts will have reached a standard which would enable them to apply for NHS Foundation Trust status. This will ensure that throughout the country there are high performing organisations which are empowered to deliver high quality services to local people, so that no part of the NHS is left behind.