Two years ago, certain hospital trusts in the UK fell under suspicion of poor quality of care. Professor Sir Bruce Keogh, the Medical Director of NHS in England, picked out fourteen particular hospitals as outliers in terms of mortality rate.

Although mortality was the defining factor for inquiry, the actual review was based upon the quality of care and treatment in each hospital. This was evaluated in six key areas; patient experience, workforce, safety, leadership and governance, clinical and operational effectiveness, and of course mortality.

NHS blunders and medical negligence are more common that most people think and it’s important to know whether you may have been a victim of poor care at one of these hospitals – these are the eleven which were put under special measures.

UK Hospitals currently under the NHS ‘special measures scheme’ as at Feb 2015.

Tameside Hospital NHS Foundation Trust

Under the investigation, it was discovered that some patients had complained negligence at Tameside Hospital, particularly being left on trolleys, completely un-monitored for a significant period of time. It was also considered that there was a culture of overlooking sub-optimal care.

There was an insufficient amount of senior clinical cover, especially out of normal hours. The bed management was inadequate, and deteriorating patients were poorly managed.

In November of 2013 it was found that patient satisfaction had improved on the wards, although the casualty department had declined in standards.

BLD Hospital Special Measures Negligence V1

North Cumbria University Hospitals NHS Trust

North Cumbria’s negligence was in the form of poor maintenance in two of its operating theatres; these were closed immediately. There were also shortfalls when it came to learning from serious incidents, poor levels of staffing and a worrying weakness in the control of infections, and in prevention practices.

Burton Hospitals NHS Foundation Trust

The issues at this hospital were particularly urgent. Staff had been found to be working twelve days concurrently and the medical equipment hadn’t been consistently safety checked. What was also concerning was that death certificates didn’t appear to be in line with the procedures set out by the Trust.

On top of this, the report found that the Burton Hospital negligence included a poor level of communication between the patients and staff. Additionally the trust’s quality objectives were not being carried out, and there were signs of escalation, delegation and other issues within the clinical practice.

Northern Lincolnshire and Goole Hospitals NHS Foundation Trust

The report was very concerned with the negligence at the Diana, Princess of Wales Hospital, especially in terms of its stroke services.

Additionally, one patient had been exposed in an inappropriate way in front of both female and male patients. It seemed as though the emphasis was not on quality of care, but on meeting financial and superficial targets.

United Lincolnshire Hospitals NHS Trust

The Keogh review discovered that at this hospital there was a lack of awareness around the issues of caring for patients with mental health needs, patient experience wasn’t a focus and the escalation procedure wasn’t regularly followed.

As in other hospitals there were issues of out of hours negligence at the United Lincolnshire Hospitals, including poor planning of the workforce and inadequate staff levels. Perhaps more worrying, concerns were raised about how “do not attempt resuscitation” forms had been completed.

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Sherwood Forest Hospitals NHS Foundation Trust

Poor attention was paid to client care here, with patients being unaware of who was caring for them and not receiving care when they needed it. Hygiene was also of a poor level; these complaints had been going on for quite some time, yet the trust didn’t have a proper system to receive feedback from its patients.

King’s Mill and Newark Hospitals were particular concerns in terms of staffing levels.

East Lancashire Hospital NHS Trust

There were many worrying issues here. There were serious inadequacies in governance and staff levels, the process for complaints was uncompassionate and poorly managed, and there was a lack of quality management in A&E when there were high patient levels.

There were even greater issues at the weekends, where mortality rates were high due to the East Lancashire Hospital’s negligence, including the rate of still-born babies.

Basildon and Thurrock University Hospitals NHS Foundation Trust

Most of the issues here were around staff mismanagement at Basildon and Thurrock University Hospitals. Temporary staff were not being paid well and operational deployment was raising concerns.

The trust must now take its bed management under review in order to improve it, take consistent care with infection control procedures and reduce the pressures of the A&E department.

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George Eliot Hospital NHS Trust

There were again issues of clinical cover, most noticeably out-of-hours, and the resulting effects this had on patients including unnecessary movements between wards and increasing bed sores.

End of Life care outside of the George Eliot hospital was also deemed to be in need of improvement, as well as a lack of reporting on mortality and quality.

Medways NHS Foundation Trust

In an initial consultation with the public, the review heard of poor levels of communication between patients and staff, inappropriate medical interventions and referrals, delayed discharges, substandard management of deteriorating patients and exceedingly long A&E waiting times.

The hospital trust was urged to fix all of these issues, including reviews of the staffing to make sure safe care was always available, an overview of early senior clinical care, and a rapid identification system to highlight patients who are at risk of deteriorating.

Sign above the Emergency Department in NHS hospital. Zoom effect centered on sign.

Buckinghamshire Healthcare NHS Trust

There were many shortcomings in terms of the nursing care at Buckinghamshire Healthcare Trust in relation to patient medication, observations and nutrition. Complaints had also been made about the way that patients with dementia had been treated.

There was a significant lack of initiative to develop an appropriate safety culture, and concerning staffing levels of senior grade staff. The Keogh Review warned that it must provide assurance that there was a major change in services.

The three other trusts which were not put into special measures are the Colchester Hospital University NHS Foundation Trust, The Dudley Group NHS Foundation Trust, and Blackpool Teaching Hospitals NHS Foundation Trust.

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