Medway; NHS Trust Put In Special Measures

The Health Secretary says 11 of the 14 NHS trusts in England - investigated over high mortality rates - have been placed under special measures. Jeremy Hunt's told the Commons that since 2005, thousands more people may have died than expected and the Care Quality Commission has failed in its role as watchdog.

This is the report into Medway NHS Foundation Trust

The capacity of the Board and Clinical Executive Group has been diminished by changing personnel and the work associated with the possible merger with Darent Valley Hospital in Dartford and Gravesham NHS Trust. This has led to a lack of clear focus and pace at Board and Executive level for improving the overall safety and experience of patients.

Issues that were escalated immediately
No specific issues were escalated to the Trust or regulators.

Other urgent actions
The urgent actions identified included:
* Greater pace and clarity of focus at Board level for improving the overall safety and experience of patients.
* Reviewing staffing and skill mix to ensure safe care and improve patient experience.
*Improving consistency of early senior clinical review of patients in some areas, particularly the Emergency Department.
* Implementing a universal escalation protocol to rapidly identify patients at risk of deteriorating.

The Trust urgently needs a single, coherent quality strategy and action plan, supplemented by systematic staff training and roll out.
The panel identified a number of areas of good practice which need to be better disseminated throughout the Trust, as do lessons learnt from complaints and incidents.

Follow up
The Trust accepted the findings and welcomed the support to improve its action plans. A detailed response to the review was reviewed by risk summit attendees in early June and it was agreed a further risk summit will be held in August 2013 to review progress on these actions.

Statement from Dr Peter Green, Chief Clinical Officer, NHS Medway Clinical Commissioning Group (CCG) in response to the publication of the Keogh report.

What we have heard today in relation to mortality is not new. What is new is the spotlight that the NHS has shone on the problem, the review by a national team and the production of plans to address the areas of concern relating to quality of care the review team has identified.

What this demonstrates is that the existing systems of regulation have not produced the changes that are now clearly seen as necessary. In respect of mortality comparisons this was not a lack of knowledge, but a lack of action.

Since NHS Medway CCG began to take over commissioning responsibilities we have had our own concerns about the mortality rate at Medway NHS Foundation Trust (Medway Hospital) and have had meetings with its senior team and board.

We are very pleased that the review has been carried out and that the views of so many people including staff and patients have been heard.

NHS Medway CCG commissions healthcare on behalf of the population of Medway. We believe that what we and the public want is high quality and safe local care.

Medway Hospital is part of Medway. Most of the staff at the hospital will live in Medway. Most of the staff will have friends and family in Medway. Most of them will rely on Medway to provide hospital care if they become acutely unwell or require an operation. I don?t believe the staff at Medway Hospital are uncaring or want to do anything other than provide the best care they possibly can.

Healthcare is complicated and we should always strive to make it better. It can be a hard job. You see people born and you see people die, you share the emotion, the happiness and the sadness.

Whilst the report has a number of recommendations, some of which can be read as critical, it also recognises the need to galvanise the good work that is already going on in wards and to adopt and spread good practice.

It is the responsibility of the Board of the hospital to see that this plan is implemented and effective. The Department of Health and NHS England have outlined how Medway Hospital will be supported to deliver the necessary improvements at pace.

As commissioners we are determined to ensure the quality of hospital care for the people of Medway is as good as it can possibly be ? we owe it to our communities to do all we can to monitor the trust?s performance, the outcomes for patients, and the experience that patients report.

We fully support Medway NHS Foundation Trust?s action plan and note that as part of the special measures announced today that they will receive external support and be partnered with a high performing trust in order to ensure improvements are made as quickly as possible.

The politicians and the media will dissect the reasons why we?ve arrived at this point. Our role as a CCG and community is to be clear what we expect and want and to be supportive of Medway NHS Foundation Trust in delivering what we all want. We must use this opportunity for good and not be part of a bandwagon of blame.

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