Spotlight on hospital inspections

People in a hospital corridor

The hard-hitting report demanding that 14 hospitals improve their care made headlines. Patients played an important role, as Sarah Brealey discovers.

Fourteen hospital trusts have been told to make improvements and 11 of them placed in special measures following the Keogh Mortality Review.

The hospitals were investigated because they had higher-than-expected mortality rates – and the review found that none were providing a consistently high quality of care.

For the first time, patients played a crucial role in the investigations, including three heart patients nominated by the BHF.

The hospitals visited were:

  • Basildon and Thurrock University Hospitals NHS Foundation Trust
  • Blackpool Teaching Hospitals NHS Foundation Trust
  • Buckinghamshire Healthcare NHS Trust
  • Burton Hospitals NHS Foundation Trust
  • Colchester Hospital University NHS Foundation Trust
  • The Dudley Group NHS Foundation Trust
  • East Lancashire Hospitals NHS Trust
  • George Eliot Hospital NHS Trust
  • Medway NHS Foundation Trust
  • North Cumbria University Hospitals NHS Trust
  • Northern Lincolnshire and Goole Hospitals NHS Foundation Trust
  • Sherwood Forest Hospitals NHS Foundation Trust
  • Tameside Hospital NHS Foundation Trust
  • United Lincolnshire Hospitals NHS Trust

Each hospital trust was assigned a dedicated team of 15–20 people, including about four patient and public representatives. One of them, Trevor Fernandes from Essex, who has heart failure and atrial fibrillation, said: “We patients made a real difference. We took part in discussions and our views were listened to. We all had an input into the final report.”

Often we were able to shift the focus back onto patients

The teams studied detailed facts and figures, visited the hospitals, held listening events with patients, staff and the public, and drafted a report. They then held a ‘risk summit’ meeting with the hospital and other relevant bodies to discuss the findings and how to make improvements.

Trevor, 59, said: “Often we were able to shift the focus back onto patients. People in the NHS can become blinkered and sometimes it takes someone from outside to point that out. The career NHS professionals on our teams were very good on assessing risk and governance but, to our eyes, they didn’t always think about the patient perspective.”

Equal partners

The review came about as a result of the Francis Report into failures at Mid-Staffordshire Hospital, which highlighted that higher-than expected hospital death rates should trigger further investigation. Sir Bruce Keogh, the NHS Medical Director, emphasised the important role that patients played in the review, and the need for hospitals to engage them.

This level of patient involvement will change how the NHS is assessed in a way we cannot go back from

He told Heart Matters: “Everybody involved in the reviews was overwhelmed by the quality of the contributions from the public and patients. This level of patient involvement will change how the NHS is assessed in a way we cannot go back from.”

He added that all the hospitals need to do more to learn from patients. One of the main ambitions in the final report is that patients, carers and the public should feel like equal partners in the design and assessment of their local NHS, and that their feedback should be listened to.

Sir Mike Richards, England’s Chief Inspector of Hospitals, said patients, relatives and carers had “an incredibly important and powerful role” in the Keogh Review. He said: “They can ask the questions others wouldn’t think of asking.”

Trevor said: “The BHF has been calling for this for a long time. The way patients and public have been involved should be a blueprint for other reviews. Patients should be involved in the decision making process and at the design stage of services.  Their involvement should not just be a box-ticking exercise.”

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