Report: Not enough staff and poor care

Blackpool Victoria Hospital

Blackpool Victoria Hospital

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When a team of experienced clinicians, patients, and health managers visited the Vic as part of the overall review, they found low staff levels were being blamed for poor quality of care.

Although the subsequent report highlighted there was a high level of ‘commitment and compassion’ displayed by frontline staff during the visit, indeed praising some areas of the hospital and its effective board structure”, the review team also came across worrying examples of poor quality of care.

These included:

• Patients’ families having to help feed other patients and some patients left in soiled conditions due to lack of staff.

• Concerns over out-of-hours cover were raised, with one example describing a locum doctor – who has since been removed from on-call duties – being unable to manage a cardiac arrest in the high dependency unit.

The nurse in charge of the intensive care unit (who also covered HDU) refused to attend the cardiac arrest and sent another staff nurse.

• It was also found some nurse shift leaders in ICU were not trained in advanced life support and had shown resistance to training.

In the Escalation, or temporary, ward set up to deal with high numbers of patients, the visiting panel found “inadequate” staffing levels for a ward with a great many “acutely unwell” patients.

The report stated: “Staff are pulled from other wards within their divisions to work on the escalation ward and also on other wards.

“One nurse described being moved three times in the course of one night shift to different areas and that movement of nursing staff from area to area is an everyday occurrence.”

• The review team also discovered nursing staff spending too much time on paper-work.

• The stroke ward was highlighted because its layout makes it difficult to observe patients with the current level of staff and there is no dedicated stroke consultant over the weekend.

• In orthopaedics, one junior doctor reported seeing patients for four days in a week without advice from a senior colleague.

• And in the geriatric medicine ward staffing levels were deemed to be inappropriate. On 11 out of 17 days in May at least one member of staff was absent through illness.

The review team said the trust needed to ensure that while recruitment of more staff is underway the current staffing levels on the wards and departments listed are safe, particularly out of hours.

The report said: “During focus groups and ward observations the panel learned of insufficient staffing levels and staffing mix on a number of wards.

“The trust should improve capacity through the implementation of a robust retention and recruitment policy.”

In response, the trust said it has already increased out of hours agency support for unscheduled care and will increase staff levels elsewhere in by October.

There are plans in place, the reports adds, to recruit 35 new consultants with 10 already having been appointed.

The use of locum, or temporary consultants, had caused “resentment” among some of the full-time staff due to the fact they are brought in and paid higher rates.

This, the report added “presents long-term recruitment/retention” risk.

The hospital trust is also recruiting from universities and from other countries such as Portugal and Ireland in a bid to plug the gaps.

Patients need to be listened to

Blackpool’s MPs are united in saying lessons will be learned from the Keogh Report.

Gordon Marsden, for Blackpool South, and Paul Maynard, for Blackpool North and Cleveleys, today welcomed the report, and news Blackpool Vic had been saved from ‘special measures’.

And both agree there are issues which need to be addressed as a priority by Blackpool Teaching Hospitals NHS Foundation Trust.

Mr Marsden said: “There is a new team at Blackpool Teaching Hospitals, and it is important they learn the lesson of the Keogh Review.

“I have consistently raised issues about the mortality levels at the hospital and staffing over the weekends. I have had two meetings already this year, pressing on the management to keep a laser-like focus on this.

“But there have been significant cuts in nursing staff since 2010, which has earlier been identified as a risk to care.

“As well as the responsibility of the hospital trust, this must be a warning for the Government.”

Mr Maynard said he was confident the hospital managers were clamping down on the issues raised in the report.

He added: “We do not want members of staff to feel in any way that their vocation is being questioned, or any patient to feel worried or concerned about going into The Vic.

“What we do need to ensure is that when staff and patients have concerns they feel they are being listened to, and I’m not sure that has always happened in the past.

“Problems should not be hidden, but confronted.

“When you are running such a large organisation, it is impossible for everything to run right, but the making of a good organisation is how it deals with things when they are found to be wrong.”

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