TAMESIDE HOSPITAL BOSSES ACCUSED OF LACKING CAPABILITY AND LEADERSHIP!

A leaked report into Tameside Hospital which has been seen by Northern Voices and which has been sent to the Secretary of State for Public Health, Andrew Lansley, has condemned Tameside Hospital management for lacking capability and for failing to provide leadership and integrated governance.

The report written by Milton Pena, a consultant orthopaedic surgeon at the hospital since 1997 and Chairman of the Senior Medical Staff Committee (SMSC) also accuses hospital management of putting finance and performance before the safety and care of its patients.

Between 2002-2009 Tameside Hospital was one of the worst 10-20 performing NHS Trusts in England for mortality, out of 153 NHS Trusts. In 2003, Mr. Pena reported the hospital to the Commission for Health Improvement and in 2005, he reported the hospital to the Health Commission. In 2005, Tameside Hospital management took disciplinary action against him for speaking out publicly about his concerns for patient safety. The author of the report says that the reasons for contacting these external organisations was mainly because of unsafe care to patients due to poor nursing staffing levels in the orthopaedic wards. As Chairman of the SMSC, he also reported the hospital to the Care Quality Commission (CQC) in August 2009.

Although the hospital has been keen to publicise the fact that they have reduced the Hospital Standard Mortality Rate (HSMR) i.e the death rate as compared with the average hospital, the report points out that it is reasonable to conclude that this improvement in the figure may be due to changing the coding process rather than any improvements in clinical and nursing care. The report says that while the Trust Board reported on 30th September 2010 that:

"It is clear that clinical documentation and coding have played the largest part in the reduction seen", the hospital`s Medical Director, had nevertheless stated that the recent improvement in the HSMR was due to improvements in care. To add to this confusion, the report says that after the Board meeting on 30th September, 'Team Brief' reported that: "It is clear that documentation and coding have played the largest part in the reduction seen".

In his report Mr. Pena, says that: "This ambiguity shows lack of clarity in the collective thinking of the Board...at Tameside Hospital Foundation Trust (THFT), the Medical Director, has failed to show what steps were undertaken by the Trust Board to improve the HSMR for acute myocardial infarction, stroke and broken hips".

The report says that a review of contemporary adult deaths at the hospital was carried out by a consultant paediatrician and adds: "This is worrying because he is outside his area of expertise".

According to the report there has been a collapse of the bed management system at Tameside Hospital. There is a persistent failure to admit patients to the right bed and the right consultant with patients being distributed arbitrarily to the next available beds. The reports says that due to a lack of bed capacity some patients have to wait many hours or sometimes the whole night waiting for a bed while sitting on chairs or lying on trolleys with drips etc. Some patients find that while in theatre having operations, their bed has been taken by another patient. Patients with infections are admitted onto medical and surgical wards exposing other patients to the risk of infections. Patients admitted to hospital for operations often find that no bed is available and have to wait until a hot bed is vacated. The report says that the lack of bed capacity may be a significant factor in spreading infections as patients move from ward to ward. Also, the lack of beds has led to the current practice of sending patients with fractures and needing admission to A&E to their homes to wait for an operation. The report says this can make subsequent operations more difficult as the bones begin to set in the wrong position.

The report accuses the Trust Board of failing to recognise the serious nature of complaints raised by patients over the years. The report says that since 2003, there has been a failure to provide safe levels of nursing care during many shifts in medical, geriatric, surgical, orthopaedic and A&E wards. It also says that the Trust Board: "has been oblivious to an embedded culture of bullying and intimidation that pervades the Trust". Apparently, hospital employees are not allowed to ask critical questions at the open forum and there is a tendency to hide facts from the public and media.The report says that there is low staff morale and a failure to retain skilled doctors and nurses. Consultants have left mainly due to dissatisfaction with working conditions.

The report also says that the Chairman of the Board, the Rev Tim Presswood, has failed to put important reports on the agenda for discussion such as a report by the Royal College of Physicians in 2009; a report by the Deanery in May 2010 and the Junior Doctors Charter. It points out that a report by the consultants Korn/Ferry/Whitehead Mann, said that the Board were not discussing urgent clinical matters in depth and not conducting rigorous debate on key issues. The Chairman and CEO of the hospital Christine Green, were also said to lack the leadership qualities required. Mr. Prestwood`s response (he receives £44,000 p.a, for a minimum three day week) was to tell the press that he was no Alan Sugar but would take note of what was said in the report.

We understand that a copy of Mr. Pena`s report has been forwarded by the Secretary of State for Public Health to the Regulator Monitor.