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    In October 2012, Monitor appointed a Contingency Planning Team (CPT) to assess the sustainability of Mid Staffordshire FT (MSFT) and develop a long-term plan. The CPT’s interim report concluded that, despite improving clinical performance, its small scale means it is both clinically and financially unsustainable in its current form. The CPT then went on to propose that Stafford Hospital should be downgraded, its services halved and without a 24/7 A&E.  With some minor changes to Cannock Chase Hospital this made a “two local hospitals” solution.  The hospitals will be transferred to other providers and an exercise has begun to invite […]
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    Robert Francis QC’s much-awaited report on the care provided under the auspices of the Mid-Staffordshire NHS Foundation Trust is published and laid before Parliament today.  But while most people will be aware, at least passingly, of the scandal at Stafford Hospital in which up to 500 patients are said to have died due to poor care.  But what are the specifics?   What Happened? It’s difficult to summarise such a massive scandal – but what can be said is that between 2005 and 2008, there were between 400 and 1,200 more deaths than might have been statistically expected.  Moreover, the […]
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    Whilst attention has been paid to issues around Hospital Standardised Mortality Ratio (HSMR[1]) at Mid. Staffs I have examined simple mortality rates.  The use of HSMR remains controversial as the ratio is influenced by issues around quality and depth of coding as well as interpretation and recording problems. I used figures which were not subject to coding or interpretation.  The mortality rate is just the number of deaths divided by the level of activity, easy to use and understand.  You could just look at the number of deaths but almost all hospitals are dealing with increasing levels of activity.  Crude […]
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    A five-point plan to prevent a repeat of the failings at Mid Staffordshire NHS Foundation Trust  A response by Unite The terrible events that engulfed Mid Staffordshire NHS Foundation Trust (Mid Staffs) should serve as a stark warning to politicians, care providers and commissioners of services, both within and without, the NHS. The reports by the Health Care Commission (HCC) and Robert Francis QC have highlighted the tragic scale and depth of management failure, bad practice and mistreatment that occurred. This briefing details the concerns of the Unite health sector, which represents more than 100,000 members in the health service, […]
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    Note: This analysis is not applicable to the NHS in Scotland, Wales and Northern Ireland where organisational principles and practice are different. On the basis of more than forty yearsʼ experience as an NHS manager, researcher , teacher and consultant adviser, I believe that there is evidence to suggest that the following combination of contextual factors in the wider NHS (in England) and the United Kingdom Government are likely to have contributed to the specific problems which occurred in Mid-Staffordshire: 1. The failure to make population health gain, quality of treatment and appropriate, evidence-based (management and clinical) practice the over-riding policy objectives (see first recommendation of first […]
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    Notes on an informal Socialist Health Association discussion 8/5/13 This is still work in progress.  We haven’t decided anything, and we would particularly welcome constructive comments on what we might say which would be helpful. We don’t think more regulation will avoid future problems.  In fact we are not very convinced about the Care Quality Commission or its predecessors.  Registering providers is worth doing, but is there good evidence that the inspecting and monitoring regimes delivers results?  Ofsted style ratings and Chief Inspectors are meaningless gimmicks. Local monitoring of standards based on more transparency is a more productive way forward.  […]
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    Speech to Reform Conference Tuesday 12th February 2013 by Liz Kendall MP, Shadow Minister for Care and Older People It’s a week since Sir Robert Francis published his report on the failings at Mid Staffordshire Hospital. And – let’s not forget – three months since the Government produced its final report into the scandal at Winterbourne View. Whilst the appalling events at these hospitals do not represent what is happening in the wider NHS or social care, there are serious lessons that must be learnt from the bottom to the top of the system: for providers, commissioners, regulators, Professional bodies – and yes, […]
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    Between 1997 and 2010 our NHS improved in terms of everything that could be properly measured, as independent studies have confirmed.  Plans to continue this improvement have been overtaken by the Coalition’s wasteful and unnecessary reorganisation. Labour invested in the service and in those who worked in it and dramatically improved access, hugely reducing waiting times to levels thought impossible.  Labour’s use of targets, such as those for waiting times, met with some reasoned criticism but on balance independent observers accepted that they contributed to the improvement in our NHS. In 2010 patient satisfaction with NHS was at its highest […]
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