Whistleblowers Often Give First Indication of Risks at NHS Trusts

Recently published statistics from the Care Quality Commission (CQC), have shown that almost 25% of Britain’s NHS hospitals are performing so poorly that they can be classed as high risk, and have practices which could endanger patient safety. The report also shows that members of staff working within the Trusts have blown the whistle on almost every serious failure found by the report. The Health Secretary, Jeremy Hunt, stated that the CQC report showed that the government were getting tough on hospital standards and had nothing to hide. The Minister also said that the CQC report showed just how important it was to try to change the culture within the NHS and ensure staff members were listened to.

These set of statistics covering all NHS trusts in England is the first since systems were changed in the wake of a number of hospital scandals. There are 161 individual Trusts in England, and these were split into six different categories depending on how well they performed on a number of factors such as waiting times, death rates, infection control and hygiene. 44 of the 161 Trusts fell into the two categories for highest risk, and of these 44, 41 were Trusts where employees were so worried about what they saw going on at work that they had previously contacted the CQC.

The scale of the problem

Out of the 44 Trusts in the two highest bands, 24 were in the highest risk ranking, and 16 of those Trusts had high death rates. Many of these Trusts are also under investigation by the medical director of the NHS after well-publicised scandals. 6 have already been put in special measures to improve.

Although in many cases the CQC had had previous concerns about hospital Trusts which were ranked highly for poor practice, two had passed all previous inspections. The poor rankings by the CQC on this occasion were flagged up by whistleblowers, and in several cases concerns were about infection control and long waiting times for cancer testing, infection in women after childbirth and long waiting times in A&E.

One of the worst performing Trusts overall was the now-defunct South London Healthcare NHS Trust, which had 17 areas of risk identified, a high number of which were directly related to patient care. CQC found that in the three hospitals run by the Trust patients felt they were unable to voice their concerns and were left without adequate pain relief. Surveys at the nearby Croydon Health Services Trust found that patients did not trust nurses and had no confidence in their ability.

NHS culture criticised

In total, over 400 whistleblowers working within the NHS contacted the CQC over serious concerns over practices at their place of work. The Chief Inspector of the CQC stated that evidence and reports from whistleblowers was critical in uncovering problems in hospitals, and urged anyone working in the NHS who sees something they feel is unsafe to come forward immediately.

The culture within the NHS was also heavily criticised by the CQC’s chairman, David Prior. He called the culture “chilling”, and said that even the highest level surgeons were afraid to step over the line and point out problems with patient care.

New ratings for hospitals planned

The NHS regulatory system is being completely overhauled and is changing from the previous system whereby Trusts could do their own assessments and be rated highly without having to disclose critical statistics such as death rates.

In the future, hospitals will be rated by experts in the same way as schools are, and will be given ratings. Inspections will be targeted in the first instance at the poorest performing Trusts in the CQC report.

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