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11 hospitals placed under ‘special measures’ after mortality review



The health secretary has instigated special measures in 11 hospitals in England, after an NHS report uncovered ‘fundamental breaches of care’ such as poor governance, inadequate staffing levels and high mortality rates at weekends.

Health secretary Jeremy Hunt, speaking in the House of Commons today, said that he was determined to ‘root out’ bad care in the NHS and told MPs that problems identified in the report in out-of-hours care would be remedied with his proposed changes to the GP contract.

Sir Bruce Keogh, the NHS medical director, conducted a series of ‘deep-dive’ reviews into 14 hospitals with mortality rates which have been consistently high for two years or more.

The report listed several key failings, such as hospitals’ professional and geographic isolation, failure to act on data or information that showed cause for concern, the absence of a culture of openness, a lack of willingness to learn from mistakes and ineffectual governance and assurance processes. The review team instigated special measures in 11 of the 14 hospitals.

But it found that overall mortality in all NHS hospitals had fallen by about 30% over the past 10 years, and despite higher mortality rates in the 14 hospitals studied, their rate of improvement was similar to other NHS hospitals.

The report concluded: ‘Understanding the causes of high mortality is not usually about finding a rogue surgeon or problems in a single surgical speciality. It is more likely to be found in the combination of problems that to a differing extent are experienced by all hospitals in the NHS: busy A&E departments and wards, the treatment of the elderly in and out of hospital, and the need to recruit and retain excellent staff.

‘Such issues are complex and require a “whole system” approach to deal with them. This is why it has been so important that this review has involved all the key players the NHS system to decide what to do to address problems, and agree who is responsible for implementing agreed improvements.’

Pulse revealed last year that one GP in seven regarded a local hospital department as ‘dangerously substandard’, with evidence that in a significant minority of hospitals patients are dying because of failings in care.

Health secretary Jeremy Hunt, speaking in the House of Commons today, said he was determined to tackle bad care in the NHS ‘head on’ and that the 11 hospitals in special measures would have to improve within a year.

He said: ‘We owe it to the three million people who use the NHS every week to tackle and confront abuse, incompetence and weak leadership head on.’

He also told MPs that problems identified in the report in out-of-hours care would be remedied with his proposed changes to the GP contract.

In response to Cheryl Gillen, Conservative MP for Chesham and Amersham, who highlighted the report’s findings of delays accessing medical advice out of hours, Mr Hunt said: ‘In Buckinghamshire, there were some serious problems identified with out-of-hours care and also dementia patients.

‘These are often people who need help and support out of hours, which is why I raised the difficult issue of the GP contract because there have been some issues of out-of-hours care.

‘We need to have more joined-up care in the community. It’s also why the chancellor announced a further £2.8bn going into joint commissioning arrangements between local authorities and health care. Put those two together what I hope we will get is vastly improved out-of-hours care for her constituents.’

Mr Hunt has previously said he will look to make changes to the GP contract to give practitioners greater responsibility for the out-of-hours care for their patients. His most recent pronouncement suggested GPs will be ‘named clinicians’ for vulnerable patients, and will coordinate their out-of-hours care plans.