Children failed by inadequate service at Kettering General Hospital
It is both incredibly worrying and sad to hear of yet another hospital scandal last week, this time surrounding paediatric and neonatal care at Kettering General Hospital. The care regulator has rated the service inadequate, flagging issues about sepsis treatment, staff numbers, cleanliness and the lack of an “open culture” where concerns can be raised without fear. Shockingly, some 50 families have come forward after their children tragically died or succumbed to serious illness and harm after receiving treatment at the hospital.
Depressingly, this scandal is not the first and comes in the wake of several other hospital scandals…
So why is this continuing to happen, and to one of the most vulnerable groups in our society? Why are our babies, children and their families continuing to be failed and then having to deal with the devastating and life changing fall-out that results?
There is now no doubt that the NHS is experiencing a staffing crisis, with understaffing contributing to difficult and highly stressful working conditions. These conditions are not conducive to attracting new talent, so as more and more people leave, the more stretched existing staff become. Not only does this mean they lack the time to provide proper and safe care, but also, they become vulnerable to burn-out. Put simply, when people are too overstretched, stressed, exhausted and do not feel valued, the standard of care and the level of compassion they bring to their roles will inevitably be negatively impacted. Whatever one’s view on the current round of strikes, these are points that are being made time and time again by people working on the front line, including nurses, junior doctors and paramedics when pushing for improved pay and conditions. If conditions don’t improve, then more people will leave, compounding an already difficult situation and plunging the NHS into an even deeper crisis.
Clearly, the other critical issue affecting Kettering is the lack of an “open culture” where concerns can be raised without fear of recrimination. Time and time again, one has to wonder whether some NHS Trusts have ever truly embraced the principles and approach recommended by Sir Robert Francis KC in his report, prepared back in 2013 in the aftermath of serious and shocking failings in patient care at the Mid Staffordshire NHS Foundation Trust between 2005 and 2009.
One of key recommendations in that report was the need to address a “culture of fear” that presented a threat to improving patient safety and quality of care. Indeed, promoting a culture where healthcare professionals at all levels can speak openly and honestly about concerns in patient care, including the conditions in which patients are looked after, is vital to improving healthcare standards. Such information should, in theory, highlight where improvements are needed and enable training to be delivered and positive changes to be made to improve standards. Healthcare professionals working directly with patients are clearly the people best placed to flag any problems, as they are working on the ground and so are seeing any difficulties as they arise first hand.
However, there has always been a deep-rooted fear associated with ‘whistleblowing’ in the NHS. This is largely because of the unacceptable way in which healthcare professionals who have spoken out openly about concerns in patient care have historically been treated, including being ignored, sacked or subjected to bullying or intimidation. This is an entrenched and cultural problem.
In the case of Kettering, the CQC said, in the context of their concerns about paediatric life support training levels and over governance:
“Leaders did not have a robust oversight of the service at the time of our inspection to ensure the service was being effectively managed… We found limited progress had been made to improve the quality and safety of the service”.
It follows then that had there been an open culture in which healthcare professionals on the ground could have raised their concerns honestly and openly and without fear of recrimination, those concerns would have reached leaders who could then have taken steps to improve the quality of care and levels of cleanliness. And the deaths and serious injury experienced by some 50 families could potentially have been avoided.
A shift in the attitude towards “whistleblowing” in the NHS is now mission critical. It is vital that healthcare professionals on the front line are empowered and encouraged by the NHS Trusts who employ them to speak out without fear of recrimination about concerns they may have relating to patient care and conditions to managers who will actively listen to them. Indeed, it is a matter of common sense that it is only by being open and honest about such problems that they can be addressed and resolved and ultimately standards of patient care and conditions improved. If they continue to be swept under the carpet, then regrettably, it is inevitable that more scandals will follow, putting more vulnerable people at risk.
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