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The Stafford Hospital scandal concerns poor care and high mortality rates amongst patients at the
Stafford Hospital __NOTOC__ County Hospital is an acute hospital with less than 200 inpatient beds, opened in 1983. It is the main hospital in Stafford, England. The hospital is managed by University Hospitals of North Midlands NHS Trust. County Hospital's Acciden ...
,
Stafford Stafford () is a market town and the county town of Staffordshire, in the West Midlands region of England. It lies about north of Wolverhampton, south of Stoke-on-Trent and northwest of Birmingham. The town had a population of 70,145 in t ...
, England, during the first decade of the 21st century. The hospital was run by the
Mid Staffordshire NHS Foundation Trust The Mid Staffordshire NHS Foundation Trust was a NHS foundation trust which managed two hospitals in Staffordshire, England: * Stafford Hospital - acute hospital with approximately 350 inpatient beds, opened in 1983, Now renamed County Hospita ...
, and supervised by the
West Midlands Strategic Health Authority NHS West Midlands was a strategic health authority (SHA) of the National Health Service in England. It operated in the West Midlands region, which is coterminous with the local government office region. It was abolished in April 2013. Gener ...
. It has been renamed County Hospital. The scandal also resulted in the resignation of NHS Chief
Sir David Nicholson Sir David Nicholson is a public policy analyst, forthcoming Chair of Sandwell and West Birmingham NHS Trust, current Chair of Worcestershire acute hospitals NHS trust and NHS manager who was Chief Executive of the National Health Service in En ...
in 2013.


History


Discovery of scandal

Julie Bailey, whose mother died in Stafford Hospital in 2007, started a campaign called Cure the NHS to demand changes to the hospital. She was supported by the Staffordshire Newsletter, but the
Public and Patient Involvement Forum The Commission for Patient and Public Involvement in Health (CPPIH) was an independent, non-departmental public body sponsored by the UK Department of Health. The Commission was established by and act of Parliament on 10 December 2002 with a remi ...
and the Governors of the Trust were defensive. The scandal came to national attention because of an investigation by the
Healthcare Commission The Healthcare Commission was a non-departmental public body sponsored by the Department of Health of the United Kingdom. It was set up to promote and drive improvement in the quality of health care and public health in England and Wales. It aimed ...
in 2008 into the operation of
Stafford Hospital __NOTOC__ County Hospital is an acute hospital with less than 200 inpatient beds, opened in 1983. It is the main hospital in Stafford, England. The hospital is managed by University Hospitals of North Midlands NHS Trust. County Hospital's Acciden ...
in
Stafford Stafford () is a market town and the county town of Staffordshire, in the West Midlands region of England. It lies about north of Wolverhampton, south of Stoke-on-Trent and northwest of Birmingham. The town had a population of 70,145 in t ...
, England. The commission was first alerted by the "apparently high mortality rates in patients admitted as emergencies". When the
Mid Staffordshire NHS Foundation Trust The Mid Staffordshire NHS Foundation Trust was a NHS foundation trust which managed two hospitals in Staffordshire, England: * Stafford Hospital - acute hospital with approximately 350 inpatient beds, opened in 1983, Now renamed County Hospita ...
, which was responsible for running the hospital, failed to provide what the commission considered an adequate explanation, a full-scale investigation was carried out between March and October 2008. Released in March 2009, the commission's report severely criticised the
Foundation Trust A foundation trust is a semi-autonomous organisational unit within the National Health Service in England. They have a degree of independence from the Department of Health and Social Care (and, until the abolition of SHAs in 2013, their local s ...
's management and detailed the conditions and inadequacies at the hospital. Press reports suggested that because of the substandard care between 400 and 1,200 more patients died between 2005 and 2008 than would have been expected for the type of hospital, based on figures from a mortality model, but the final Healthcare Commission report concluded that it would be misleading to link the inadequate care to a specific number or range of numbers of deaths. The Healthcare Commission criticised the foundation trust board, which was led by chief executive Mr Yeates and chairman Ms Brisby, for holding
in camera ''In camera'' (; Latin: "in a chamber"). is a legal term that means ''in private''. The same meaning is sometimes expressed in the English equivalent: ''in chambers''. Generally, ''in-camera'' describes court cases, parts of it, or process wh ...
board meetings and "for making cutbacks to staffing and services in order to make millions of pounds' worth of surplus at the end of each year," because "bosses focused on the Trust achieving millions of pounds surpluses over a three year period, in order to gain Foundation status", a goal which had been fostered by successive governments setting target dates by which all
NHS trusts An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...
were supposed to have reached
NHS foundation trust A foundation trust is a semi-autonomous organisational unit within the National Health Service in England. They have a degree of independence from the Department of Health and Social Care (and, until the abolition of SHAs in 2013, their local s ...
status. For example, in 2009, the Department of Health was announcing "A new type of NHS hospital". The trust's chief executive, Martin Yeates, was suspended (with full pay) and its chairwoman, Toni Brisby, resigned. On 15 May 2009, Yeates resigned. Prime Minister
Gordon Brown James Gordon Brown (born 20 February 1951) is a British former politician who served as Prime Minister of the United Kingdom and Leader of the Labour Party (UK), Leader of the Labour Party from 2007 to 2010. He previously served as Chance ...
and Health Secretary
Alan Johnson Alan Arthur Johnson (born 17 May 1950) is a British politician who served as Secretary of State for Education and Skills from 2006 to 2007, Secretary of State for Health from 2007 to 2009, Home Secretary from 2009 to 2010, and Shadow Chancel ...
apologised to those who suffered at the hospital. In response to the scandal, the mortality rates of all
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
hospitals have been made accessible on a website.
Cynthia Bower Cynthia Bower (born 6 July 1955) is a former manager in the National Health Service, and the first Chief Executive of the Care Quality Commission (CQC) in the United Kingdom, from which she was forced to resign after the Winterbourne View hospit ...
, who was from 2006 chief executive of
NHS West Midlands NHS West Midlands was a strategic health authority (SHA) of the National Health Service in England. It operated in the West Midlands region, which is coterminous with the local government office region. It was abolished in April 2013. Gener ...
, was recruited to run the
Care Quality Commission The Care Quality Commission (CQC) is an executive non-departmental public body of the Department of Health and Social Care of the United Kingdom. It was established in 2009 to regulate and inspect health and social care services in England. I ...
quango A quango or QUANGO (less often QuANGO or QANGO) is an organisation to which a government has devolved power, but which is still partly controlled and/or financed by government bodies. The term was originally a shortening of "quasi-NGO", where NG ...
in March 2009, a move which was criticised. On 21 July 2009, the
Secretary of State for Health The secretary of state for health and social care, also referred to as the health secretary, is a secretary of state in the Government of the United Kingdom, responsible for the work of the Department of Health and Social Care. The incumbent ...
,
Andy Burnham Andrew Murray Burnham (born 7 January 1970) is a British politician who has served as Mayor of Greater Manchester since 2017. He served in Gordon Brown's Cabinet as Chief Secretary to the Treasury from 2007 to 2008, Culture Secretary from 2008 ...
, announced a further independent inquiry into care provided by Mid Staffordshire Foundation Trust. The generally critical inquiry report was published on 24 February 2010. The report made 18 local and national recommendations, including that the regulator,
Monitor Monitor or monitor may refer to: Places * Monitor, Alberta * Monitor, Indiana, town in the United States * Monitor, Kentucky * Monitor, Oregon, unincorporated community in the United States * Monitor, Washington * Monitor, Logan County, West ...
, de-authorise the foundation trust. In February 2010, Burnham agreed to a further independent inquiry of the commissioning, supervisory and regulatory bodies for foundation trusts. As early as October 2010, compensation payments averaging £11,000 were paid to some of the families involved.


Public inquiry

The revelations of the neglect to patients at Stafford hospital were widely considered to be deeply shocking by all sections of the mainstream UK press; for example, patients were left in their own urine by nurses. In June 2010, the
Cameron–Clegg coalition The Cameron–Clegg coalition was formed by David Cameron and Nick Clegg when Cameron was invited by Queen Elizabeth II to form a new administration, following the resignation of Prime Minister Gordon Brown on 11 May 2010, after the gene ...
announced that a full
public inquiry A tribunal of inquiry is an official review of events or actions ordered by a government body. In many common law countries, such as the United Kingdom, Republic of Ireland, Ireland, Australia and Canada, such a public inquiry differs from a royal ...
would be held. The inquiry began on 8 November 2010, chaired by Robert Francis QC, who had chaired the fourth inquiry which he had criticised for its narrow remit. The inquiry considered more than a million pages of previous evidence as well as hearing from witnesses. Former chief executive Martin Yeates, who "resigned with a pay-off of more than £400,000 and a £1 million pension pot", escaped cross-examination at the inquiry due to self-reported ill-health "with
post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
, a condition often associated with soldiers returning from war zones" but did participate with a written statement. Helene Donnelly, a nurse at the hospital, complained that the two Sisters running the department had told staff to lie about waiting times. The Sisters were suspended and Helene was harassed. She subsequently gave evidence to the Francis inquiry and was later appointed ambassador for cultural change at Staffordshire and Stoke-on-Trent Partnership NHS Trust. The final report of the Francis inquiry was published on 6 February 2013, making 290 recommendations. Academics at the
University of Oxford , mottoeng = The Lord is my light , established = , endowment = £6.1 billion (including colleges) (2019) , budget = £2.145 billion (2019–20) , chancellor ...
and
King's College London King's College London (informally King's or KCL) is a public research university located in London, England. King's was established by royal charter in 1829 under the patronage of King George IV and the Duke of Wellington. In 1836, King's ...
have criticised the recommendations of the Francis inquiry to legally enforce a new duty of openness, transparency and candour amongst NHS staff, arguing that increasing 'micro-regulation' may produce serious unintended consequences. Medical lawyers offered their assistance to distraught and angry families who waited for proof that lessons had been learned. Many families of the victims felt that crucial questions have been left unanswered.


Actions against nurses

The
Nursing and Midwifery Council The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses and nursing associates eligible to prac ...
(NMC), the UK’s regulator of nurses and midwives, held hearings about nurses working in the trust following allegations that they were not fit to practise. Acting to protect the public, the NMC has struck off from their register or suspended several nurses as a result of these hearings. This includes two who falsified accident and emergency discharge times, two involved in the death of a diabetic patient and a nurse who physically and verbally abused a dementia patient.


Other sequels

Yeates was appointed to be Chief Executive of Impact (Alcohol and Addiction Services Shropshire and Telford) in November 2012. It later emerged in November 2013 that a "compromise agreement" had been agreed with him, whereby he had left the NHS with a gagging agreement in place. In April 2013, the Stafford Hospital was placed into administration by
Monitor Monitor or monitor may refer to: Places * Monitor, Alberta * Monitor, Indiana, town in the United States * Monitor, Kentucky * Monitor, Oregon, unincorporated community in the United States * Monitor, Washington * Monitor, Logan County, West ...
. This action "was taken after a review team concluded that its services were clinically and financially unsustainable... nd alsoconcluded that the Trust was unlikely to be able to repay its debts." In April 2013, Yeates and Brisby were referred to the
Crown Prosecution Service The Crown Prosecution Service (CPS) is the principal public agency for conducting criminal prosecutions in England and Wales. It is headed by the Director of Public Prosecutions. The main responsibilities of the CPS are to provide legal adv ...
by the Stafford Borough Council "over allegations of misconduct in public office by knowingly giving false and misleading evidence relating to death rates to the council's statutory overview and scrutiny committee". Sir David Nicholson, who was in charge of the NHS which was responsible for the hospital at the height of the failings between 2005 and 2006, resigned in May 2013 in connection with this scandal. An independent 2008 study into hospital standardised mortality ratios found that the mortality measure developed by the Foster Unit at
Imperial College Imperial College London (legally Imperial College of Science, Technology and Medicine) is a public research university in London, United Kingdom. Its history began with Prince Albert, consort of Queen Victoria, who developed his vision for a cu ...
is prone to methodological bias, and that it was not credible to claim that variation in mortality ratios reflects differences in quality of care. In 2015, ''
The Guardian ''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Gu ...
'' amended an article from 2013:
...subsequent investigations into the poor care at Stafford hospital, including the two reports by Sir Robert Francis QC, said that this disputed estimate, which appeared only in a draft report from 2009 by the Healthcare commission and was based on mortality statistics, was an unreliable measure of avoidable deaths. The Francis report of February 2013 concluded that it would be unsafe to infer from these statistics that there was any particular number of avoidable or unnecessary deaths at the trust.
According to
Jeremy Hunt Jeremy Richard Streynsham Hunt (born 1 November 1966) is a British politician who has served as Chancellor of the Exchequer since 14 October 2022. He previously served in the Cabinet as Secretary of State for Culture, Olympics, Media and Sport ...
the enquiry described a systematic failure by both the NHS and the
Department of Health A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their ow ...
to deal with such problems. Protecting the reputation of the NHS had become more important. Concentrating on national targets led to managers deprioritising the safety and well-being of patients.


Television

On 30 January 2019,
Channel 4 Channel 4 is a British free-to-air public broadcast television network operated by the state-owned enterprise, state-owned Channel Four Television Corporation. It began its transmission on 2 November 1982 and was established to provide a four ...
announced that they had commissioned a drama of the Stafford Hospital scandal from the perspective of Julie Bailey.Channel 4 commissions drama of Stafford Hospital scandal
Channel 4 press release


See also

*
Institutional abuse Institutional abuse is the maltreatment of a person (often children or older adults) from a system of power. This can range from acts similar to home-based child abuse, such as neglect, physical and sexual abuse, and hunger, to the effects of assist ...
*
Patient abuse :''This article incorporates "medical abuse", which has a similar meaning but relates more specifically to harmful medical treatment rather than care in general, and may include victims who did not choose to be patients.'' Patient abuse or neglect ...
*
Winterbourne View hospital abuse The Winterbourne View hospital inquiry occurred at Winterbourne View, a private hospital at Hambrook, South Gloucestershire, England, owned and operated by Castlebeck. A ''Panorama'' investigation, broadcast on television in 2011, exposed the phys ...


References


External links


The Mid Staffordshire NHS Foundation Trust Public Inquiry
*
The Mid Staffordshire NHS Foundation Trust Independent Inquiry website

Robert Francis Inquiry report into Mid-Staffordshire NHS Foundation Trust

Mid Staffordshire NHS Foundation Trust website
* * {{coord , 52, 48, 40, N, 2, 5, 52, W, type:event_region:GB-STS, display=title Medical scandals in the United Kingdom Stafford Institutional abuse 2000s in Staffordshire Hospital scandals Cover-ups