A criminal investigation could be launched into allegations that staff at a general hospital were bullied and pressured into falsifying information about patients’ cancer care, potentially putting lives at risk, it emerged on Tuesday.
Sir Mike Richards, the Care Quality Commission(CQC) chief inspector of hospitals, is so worried by findings from his investigation into Colchester General hospital in Essex that he has referred the matter to police. Nurses’ leaders said they had already warned of bullying by senior managers at the trust that runs the hospital.
In what threatens to emerge as another major scandal for the NHS, already bruised by failings such as those at Stafford hospital and Furness General hospital, Essex police said they were reviewing the information from Richards to see whether a criminal investigation was necessary.
Richards has recommended the government puts Colchester in special measures, a system that imposes stricter supervision by regulators and pairs hospitals with a neighbouring high-performing trust.
The Colchester hospital has written to 30 patients or their next of kin offering to review their treatment after the highly critical CQC report. About 6,000 people a year are treated for cancer at Colchester general and the town’s Essex County hospital.
CQC inspectors said they looked at just a “small sample” of patients who had been referred to cancer services in the town and found discrepancies between the hospital’s cancer waiting time records and the information contained in patients’ individual medical records.
There is strict national guidance on appointments, diagnoses and timeframes for treatments for cancer, and improving care for the disease is a key NHS priority.
Of 61 care records examined, 22 showed people had been put “at risk of receiving care that was unsafe or not effective, due to delays in receiving appointments or treatment”, the CQC said.
Patients had been receiving treatment for urological cancers, cancers of the lower and upper gastrointestinal systems, and those of the head, neck, breast and skin. In some cases, people did not get treatment within the required 62 days and, in three cases, delays went beyond 100 days. The Colchester Hospital University NHS Foundation Trust is separately examining another three cases of waits of more than 100 days.
An internal investigation last year identified some concerns, but the trust failed to investigate the allegations thoroughly or follow up the concerns with affected patients, according to the CQC. Staff told inspectors they had been pressured or bullied to change data.
Inspectors spent six days at the hospital talking to patients and staff in August and September following “information of concern” about patients’ treatments dating back to 2011.
Richards, an oncologist who was previously the government’s cancer tsar, said: “If you are diagnosed with cancer, you are entitled to think that your hospital will do all they can to ensure you get the treatment you need as soon as possible. It is shocking to think that people’s lives may have been put at risk for the sake of the waiting time figures. It is essential that people in north Essex can have confidence in their hospital.”
The CQC report raised questions at the highest level, said Richards. “We have found that the concerns raised by staff in relation to changes made to people’s cancer pathways were not appropriately managed or investigated by senior staff of the trust, which is why I am now recommending that this trust should be placed in special measures.”
He praised staff who raised concerns: “It’s thanks to them that we can ensure that the service is better in future.”
The government said the action in Colchester vindicated a new regime that gave whistleblowers better protection and made it compulsory for staff to raise concerns. Referrals to the police are rare, although checks on standards, especially where raised by whistleblowers, are now comparatively rapid and tough following the Stafford case.
The Royal College of Nursing (RCN) said it had not raised specific issues about cancer care with the hospital, but the CQC findings chimed with other concerns it had raised over staffing and safety at the trust.
Claiming senior managers had called the RCN “fantasists”, the organisation’s regional director, Karen Webb, said there was “a very defensive culture among senior managers … a real lack of openness, and we have had serious concerns about a bullying culture”.
The CQC inspection was arranged after a whistleblower tipped off a team carrying out other inspections as part of a review of NHS trusts by the health service’s medical director, Sir Bruce Keogh.
The Department of Health said: “For too long, patients have had to put up with poor care and cover-ups because it was too inconvenient to expose and take action … what’s happened at Colchester shows the new system working; the spotlight shone on failings and extra support being given to quickly improve standards.”
The trust’s medical director, Sean MacDonnell, said: “We are very sorry for the worry, distress and concerns that have been raised by the publication of the CQC report into our cancer services… we urge all patients currently using our cancer services to keep their appointments. The issues are primarily about delays to treatment and it is vitally important that patients continue with their treatment.
“Patients and the public can be reassured that we are taking the findings extremely seriously and are determined to get to the bottom of the issues and sort them out … it is essential that patients and staff can trust all of our employees to do the right thing. It seems that this has not always been the case.”
The trust would take “the strongest possible action” if any staff were found to have inappropriately adjusted cancer figures, he said.
Source: theguardian.com