Stepping Hill Hospital and Stockport NHS Foundation Trust has had a difficult period over the last couple of years in terms of both its reputation and public confidence in its safety standards.
In July 2011, a major investigation followed the finding that saline drips at the hospital had been deliberately contaminated with insulin, which was thought to be connected with the death of seven patients. In January 2012 an employee was arrested in connection with altered prescription charts. He was questioned on suspicion of tampering with medical records which may have led to patients being given additional doses of medication.
In April 2012, the hospital was the subject of a routine inquiry by experts from the Care Quality Commission (CQC). The purpose of their visit was to check on progress made since the first shocking incidents leading to the poisoning of 22 patients and the death of seven. Despite that shocking and appalling backdrop it would seem that the Trust has learned little about safety standards. The CQC report states that the Trust has arrangements for the safe administration and disposal of medicines, but staff are not always following them, so patient health is being placed at unnecessary risk.
Inspectors also suggested that they saw numerous prescription errors by doctors, not all of which were identified by the dispensing pharmacist; hence the systemic ‘failsafe’ appeared to be failing. In addition, the report sets out examples of serious prescribing mistakes. It highlights lack of staff training, the hospital’s inability to audit its own quality control and the lack of staff adherence to guidelines.
The hospital has responded stating that patient care is always “top priority”. However, the evidence would seem to suggest that the words are not being supported by action.
The CQC’s stated objective is to “check whether hospital, care homes and care services, are meeting government standards”. They do excellent work in identifying failure to adhere to good practice and good standards but the action plans to prevent further problems and to remedy existing problems are not always being implemented.
It’s not just Stepping Hill who are guilty of this. The Association Against Medical Accidents (AvMA) in their August 2011 report, suggested that almost 50 per cent of Trusts had not complied with all patient safety alerts and that some had been outstanding for over five years.
For many the NHS is a monopoly supplier of healthcare services. In light of these recent reports, entering the NHS system as a patient would seem akin, certainly in some Trusts, to be engaging in ‘Russian roulette’.
There’s no doubt the NHS is an under-funded resource but at what cost? Gambling with patient safety can surely never be acceptable.
If businesses provide sub-standard client service delivery, the clients simply go elsewhere. However the NHS, without effective competitors, does not enjoy a sufficient level of competition in its marketplace and for most of us the ability to choose is ineffective since we are not armed with the knowledge to make an informed selection choice.
If the patients can’t vote with their feet, is the answer more regulation and more rigorous penalties for repeat offenders like Stepping Hill? An over-regulated workplace is unlikely to make a happy one and quality staff will simply select quality trusts to work for.
Recent developments demonstrate that clear leadership is required at Stepping Hill to ensure that the decline in standards is arrested immediately. Strong safeguards need to be put in place which are followed up by rigorous monitoring – it should not need a CQC inquiry to uncover the fact that procedures are not being followed.