THIS week, a team direct from the Government has been in Grimsby to find out why our hospital's death rates are so high.
Northern Lincolnshire and Goole Hospitals NHS Foundation Trust (NLAG) was singled out as one of just a handful needing urgent attention across the country, as reported, right.
A review team set up by the medical director of NHS England, Sir Bruce Keogh, is in the area this week to assess where improvements need to be made.
Between October 2011 and September 2012, a Summary Hospital-level Mortality Indicator (SHMI) – used to calculate the number of expected deaths during a financial year – showed only 1,938 people were expected to die, but 2,236 actually did.
Compared to figures between July 2011 and June 2012, latest results show a reduction in the number of deaths by 50 people.
But, overall, they are still higher than the national average, and although this was as expected by NHS bosses, the trust is one of 14 being visited by Sir Bruce's team of experienced doctors, nurses and patient representatives.
This week they held a "listening event" with 100 members of the public to hear your concerns.
Their visit coincided with a report released by the Care Quality Commission, which said the results of its own routine inspections revealed shortfalls that are a "real concern".
The CQC found that NLAG – which manages Grimsby, Scunthorpe and Goole hospitals – was failing to meet national standards relating to welfare, and in the training and supervision of staff.
Sir Bruce's team here in northern Lincolnshire is being led by Mike Bewick, the medical director for NHS England (North), and the Grimsby Telegraph was granted an interview with him:
Q What are the aims of the investigation?
A It is rather like a smoke alarm going off. We will be looking at the results over the past two years and we will look at their systems to make sure they can be made as safe and effective as possible.
Q How are you going to achieve those aims?
A We have a multi-disciplinary team here with us today. There are a lot of people who are going to be looking at the activities in the hospital based on the data that we routinely use to look at the performance of an acute hospital like this. We will be looking at all three sites (Grimsby, Scunthorpe and Goole) and talking to patients and staff and taking the views of the public, listening to patients' experiences and talking to the senior management and the senior clinicians in the trust to make sure they are doing the best for patients that they possibly can.
Q Will the Care Quality Commission's findings highlighting concerns over patient care be part of the inquiry?
A The Care Quality Commission is part of the review and they will be working with us. This is a very transparent situation. We are trying to publish as much of our findings as we can in as short a period of time so the public can be reassured by what action plans are being put in place where there are difficulties. There are parts of the system where there are not problems and some of my team have commented very positively in some of aspects of the care where there are not difficulties. For instance, the diagnostic department we visited – that was very enthusiastically received by the team as being highly effective which is what you want for such a necessary part of the system. The theatres were visited today and we got positive feedback on the effectiveness of the theatres. There are areas I can't comment on yet because we need to get other evidence. We are looking specifically at how, particularly, the vulnerable and the very sick patients are looked after because the mortality reflects that and we are trying to make sure that the pathways that are used here are the ones that we would choose in all of our trusts to make sure patients are well looked after.
Q What reassurances can you give to patients treated at Diana, Princess of Wales Hospital that they will get good quality care?
A It would be unacceptable to leave here without making sure that the Trust was making the best use of its resources and making inroads into any difficulties that we found. If there wasn't a review, the CQC would be giving them and sharing with them an action plan about how they were putting their services right. We will build on that on a wider system-wide format. There are three hospitals here and we are looking across all of them. Our aim is to put anything that we find that isn't so good as right as possible in as short a period of time as possible.
Q What action could take place if failings are found?
A The NHS is not a regulatory body but it has powers such as helping the management of a trust. Monitor, an independent financial watchdog on hospital trusts, has given this trust a green light for its use of resources. We will be investigating staffing levels and NHS England can insist on specific levels of staffing.
Q Is the inquiry partly identifying areas not performing well in order for them to be privatised?
A That is not part of the review.
QCould there be mergers or takeovers by other trusts?
A This area is already a merger, so it is no stranger to mergers, but there are no immediate plans for mergers.
Q What kind of reception have you had visiting Grimsby?
A We have been welcomed. Everyone has been very open. The senior management has been very helpful and honest.
Q Are the areas where performance is not as good as they should be just a question of more money needed?
A I prefer to talk in terms of human resources. We shall see if small changes can be made with the best outcomes. It is all about patient safety and care.
Q How soon will the public know of the outcomes of the inquiry.
A In about two to three weeks' time.
You can share your views with the team by e-mailing brucekeogh.review@nhs.net or calling the Care Quality Commission on 03000 616161, selecting option two. You can also write to: Bruce Keogh Review, NHS England, Quarry House, Quarry Hill, Leeds, LS2 7UE.
To read the CQC in full, click here.
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