The Care Quality Commission (CQC) is the body responsible for inspecting England’s health and social care services. Inspectors usually arrive unannounced to observe care, talking to patients and staff, and gathering information from a wide range of sources to build a picture of how well the hospital is performing.
In November 2013 Barts Health, the largest NHS Trust in the country serving 2.5 million people was inspected following concerns raised by hospital performance information and patient and staff surveys. The cancer patient experience survey gave particular cause for alarm, in 50 of 64 questions patients at Barts rated their experience as being in the bottom 20% of all Trusts.
Perhaps in part, those cancer patients poor experiences resulted from the low staff morale highlighted in the report. In the 2013 staff survey 32% of staff reported being bullied (compared to the average score of 24% for English NHS Trusts). Many of the staff that the CQC spoke to only agreed to speak openly if their anonymity was protected. The real impact on staff, but most importantly on patients, of this culture can only be guessed at.
The report identifies that between October 2012 and September 2013 the trust had 10 “never ever” incidents. Never ever events are defined by the CQC as “serious, largely preventable patient safety incidents” which are not acceptable in any circumstances. This is three more incidents than the Trust which is most comparable with Barts.
Our experience of acting for claimants in clinical negligence claims leaves us in no doubt that a bullying culture and low staff morale makes never ever type incidents more likely, whether because junior staff are scared to seek advice and support from more senior colleagues or because staff are despondent and lack attention to detail.
Interestingly, the CQC commented that the people they spoke with were consistently unhappy with the way their complaints had been dealt with. Again, the link between a bullying staff fearing the consequences of owning up to mistakes creates fuels difficulties in investigating complaints in an open an open and accountable fashion.
The report highlights many areas of concern, which need to be addressed urgently. At the heart of this must be reforming a bullying culture that unacceptably endangers patients.