NHS blunders claiming 11,000 lives every year amid 'blame game' culture
Eleven thousand patients a year may be dying as a result of NHS blunders amid a "blame game" culture between staff, health chiefs have warned. A new safety strategy say thousands of lives may be being lost - with older patients most likely to fall victim - because errors are being repeated as medics “close ranks”.
‘Devastating impact’ of NHS blunders revealed in ombudsman’s report
Cases revealed by the NHS ombudsman included a man who had a fatal heart attack and stroke after staff failed to say he was at risk. Photograph: David Sillitoe for the Guardian Press Association Wed 29 Oct 2014 10.20 GMT 124 The NHS has committed a catalogue of blunders that have had a “devastating impact” on every generation, a report has revealed.
New cases published by the parliamentary and health service ombudsman have exposed potentially avoidable deaths and patients suffering needless harm in England’s hospitals.
The 161 summaries of investigations carried out between April and June this year included complaints about incorrect discharges from hospitals and failings in diagnosis of cancer.
One complaint concerned Barking, Havering and Redbridge university hospitals NHS trust, where a man died after a liver biopsy. The investigation found he had an inadequate care plan, was incorrectly discharged from A&E and did not consent to the biopsy. He was not properly monitored after the procedure, was given the wrong medicine and the trust lost his clinical records.
In another case a man was inappropriately discharged from a Bedford hospital NHS trust A&E department complaining of nausea, vomiting and constipation lasting three days. The following day he was admitted to hospital where surgery revealed he had suffered a complete loss of blood supply to his small intestine.
One woman was told after surgery at Wirral University teaching hospital NHS foundation trust that she had stomach and bowel cancer, and would need treatment and tests. However, no tests were arranged and a surgical consultant told her she did not have cancer. Five weeks later, the same consultant told her she did in fact have the disease.
A man had a fatal heart attack and stroke while on holiday after doctors at Blackpool teaching hospitals NHS foundation trust, to whom he had complained of chest pain, failed to tell him he was at risk of a heart attack and early death if he flew.
In another case, a woman was forced to give birth at home with no medical support after a student midwife at Blackpool teaching hospitals NHS foundation trust turned her away from the maternity ward after wrongly believing she was not in established labour.
The ombudsman, Dame Julie Mellor, said these investigations showed the “devastating impact” failures in public services could have on the lives of individuals and their families.
She said: “A shocking case that stood out was that of a one-day-old baby who suffered permanent brain damage at Barts Health NHS trust in London because a nurse and two doctors made serious mistakes during a blood transfusion.
“We are increasingly concerned about patients being discharged unsafely from hospital. Unplanned admissions and re-admissions are a massive cost to the NHS.
“We are publishing these summaries so public services, MPs and members of the public can see the different types of complaints we look into, our findings and recommendations.
“I hope this will give people with concerns about the service they have received the confidence to come to us to complain. We also want to provide valuable lessons for public services, and show how complaining makes a positive difference to them.”
The ombudsman is the final step for people who want to complain about being treated unfairly or receiving poor service from the NHS in England, or a UK government department or agency.
The ombudsman service investigated 2,199 cases in 2013-14 compared with 384 in the previous financial year.
The shadow health minister Jamie Reed said: “This catalogue of poor care shows an NHS heading in the wrong direction. Hospitals are full to bursting – struggling to admit or discharge patients – and these reports make clear there isn’t enough staff to cope.
“Under David Cameron, half of nurses say their ward is dangerously understaffed. Labour will invest an extra £2.5bn to recruit 20,000 more nurses and help hospitals to provide safer care.
“By wasting £3bn on a reorganisation, David Cameron is making care problems more likely, not less. It is proof you can’t trust him with the NHS.”
Cost legacy of decades-old NHS blunders begins to rise
You might also be interested in: Lapses lead to mistake every five births Litigation 'threatening NHS finances' Birth problems twice as common in some trusts
So why are you bringing up these reports then? Have you got a problem why the NHS? Do you think a Labour government is going to instantly solve the problem?
NHS errors: Tools left in patients and amputation errors make list of blunders Errors such as patients receiving the wrong blood, overdoses of insulin and botched hysterectomies made the "never events" list.
More than 600 patients have suffered due to serious NHS errors, including botched hysterectomies and surgeons operating on the wrong patient.
A total of 629 "never events" - meaning they are so serious they should never happen - occurred between April 2018 and July 2019 in NHS hospitals - the equivalent of nine patients every week.
The mistakes include doctors operating on the wrong body parts and leaving surgical tools such as gloves and drill bits inside patients.
Two men were mistakenly circumcised, while a woman had a lump removed from the wrong breast.
The wrong toe was amputated from one patient and two women had biopsies taken from their cervix, rather than their colon.
Six women had their ovaries removed during botched hysterectomies, putting them into early menopause.
Figures also show that some patients had procedures intended for someone else, including laser eye surgery, lumbar punctures and colonoscopies.
Potentially fatal mistakes included patients being given regular air rather than pure oxygen, and some being given overdoses of drugs such as insulin.
Some even had feeding tubes placed into airways instead of their digestive system.
Six patients received the wrong type of blood in a transfusion, while 52 people had the wrong teeth removed.
In total, there were 270 incidents linked to wrong site surgery (where an operation is performed on the wrong part of the body), with a 127 cases of "foreign objects" being left inside people following their surgery - including needles, specimen bags and swabs.
Almost 140 men have lost a 'healthy' testicle in six years due to NHS blunders - leading to £3 million being dished out in compensation Some £2.8 million in compensation was dished out to those who were affected The statistics were released by NHS Resolution - which is the litigation authority They revealed some of the most horrific cases that have occurred in England
What are the most famous hospital scandals in the UK? One by one the scandals have become etched on the public consciousness. The mass killings by Harold Shipman. The deaths of babies undergoing heart surgery at Bristol Royal Infirmary and born under the care of Morecambe Bay maternity services. The needless suffering of patients at Stafford Hospital. Shipman, Bristol, Stafford, Morecambe Bay - BBC News
www.bbc.co.uk/news/health-44550913 Search for: What are the most famous hospital scandals in the UK? How many women have been affected by the three NHS scandals? The inquiry found that the NHS did not know how many women had been affected by the three scandals. And it detailed “heart-wrenching stories” of how treatments provided on the NHS had “damaged lives” and highlighted how campaigners have fought for decades to get acknowledgement of their suffering. The NHS scandals which 'damaged so many lives' revealed in
www.lep.co.uk/health/the-nhs-scandals-which-damaged-s… Search for: How many women have been affected by the three NHS scandals? What can we learn from the NHS’s worst maternity scandal? The NHS’s worst maternity scandal raises fundamental questions about the culture and safety of our health service. The Independent has revealed that an inquiry into maternity care at Shrewsbury and Telford hospital NHS trust has uncovered dozens of avoidable deaths and more than 50 babies suffering permanent brain damage over the past 40 years. Latest NHS maternity scandal is product of toxic 'can't
Covering up NHS scandals should become a criminal … https://www.dailymail.co.uk/health/article-11335399 20/10/2022 · NHS staff who lie to cover-up poor care in the health service should face a criminal charge, the author of the damming probe into the East Kent maternity scandal has said. The …
Thousands had their lives 'ruined' in three avoidable … https://www.thesun.co.uk/.../thousands-lives-ruined-three-nhs-scandals 08/07/2020 · THOUSANDS of women and children had their lives damaged in three avoidable health scandals, a scathing report says. They were left in pain and suffering because the NHS …
Latest NHS maternity scandal is product of toxic 'can't …
https://www.theguardian.com/society/2019/nov/22/nhs-maternit… 22/11/2019 · The NHS’s worst maternity scandal raises fundamental questions about the culture and safety of our health service. The Independent has revealed that an inquiry into maternity care at Shrewsbury...
Well theres an alternative to the NHS, go private, I'm sure they'll do a better job for the same price.
So is that the best you have got to offer? Let the NHS carry on killing people, and if you dont like it, go private.
Shrewsbury maternity scandal: Repeated failures led to deaths
Catastrophic failures at an NHS trust may have led to the deaths of more than 200 babies, nine mothers and left other infants with life-changing injuries.
Senior midwife Donna Ockenden examined maternity practices at Shrewsbury and Telford NHS Trust (SaTH) over 20 years.
Her report found that babies' deaths were often not investigated and grieving parents were not listened to.
This meant, she said, "failures in care were repeated" and some mothers were even blamed for their own deaths.#
The review, which examined almost 1,600 cases, is thought to be largest of its kind in NHS history.
Severe brain injuries It revealed 201 babies could have survived had SaTH provided better care, related to 70 neonatal deaths and 131 cases where babies were stillborn.
There were also 29 cases where babies suffered severe brain injuries and 65 incidents of cerebral palsy.
Ms Ockenden said: "We now know that this is a trust that failed to investigate, failed to learn and failed to improve.
"This resulted in tragedies and life-changing incidents for so many of our families."
Post-it notes Speaking in the House of Commons on Wednesday, Health Secretary Sajid Javid told MPs in one case the hospital trust had kept important clinical information on post-it notes, which were then swept into the bin by cleaners.
Key findings: A culture where mistakes were not investigated and a failure of external scrutiny Parents were not listened to when they raised concerns about the care they received Where cases were examined, responses were described as lacking "transparency and honesty" The trust failed to learn from its mistakes, leading to repeated and almost identical failures A culture of bullying, anxiety and fear of speaking out among staff at the trust "that persisted to the current time" Caesarean sections were discouraged, often leading to poor outcomes
In all, Ms Ockenden identified 60 specific improvements that could be made at SaTH and said there could be "no excuses" going forward.
The review found a culture of not investigating mistakes, with hundreds of instances where SaTH failed to appropriately examine deaths or undertake serious incident investigations with mistakes being "inappropriately downgraded".
Between 2011 and 2019, 40% of stillbirths and 43% of neonatal deaths did not even have an investigation. Of those cases that were examined, the Ockenden team graded the reviews as poor in almost half of stillbirths and over a third of neonatal cases.
Analysis By Michael Buchanan, Social Affairs correspondent
The numbers are enormous, shocking even for those of us who long suspected there was something far wrong with the care at the trust. But the crucial thing to remember is that what the failings highlight are individual families who've grieved in private and at times been lied to by a trust that seemed uninterested in helping them to understand what happened or to learn any lessons.
Reading the report, there seems at times to have been an almost casual disregard for life - mothers have explicitly told me of being told, you'll be fine, you're young, you can have another child.
The central question now is how does the trust convince the women of Shropshire that it's currently providing a safe service - Donna Ockenden's remarks about care and culture in the trust in 2022 raise significant questions about the ability of the leadership team there to drive through the many changes that are clearly needed.
Blame mothers On those occasions where cases were investigated, the trust failed to identify areas for improvement and missed opportunities to learn.
Ms Ockenden added the trust had a tendency to blame mothers for poor outcomes, and even in some cases for their own babies' deaths.
The inquiry was first commissioned in 2017 following a campaign by two families who had lost their babies.
Comments
Parminder Singh Sidhu, 49, passed away in agony in March - within a year of the procedure - after doctors failed to spot a tumour.
https://www.dailymail.co.uk/news/article-11444745/Fit-healthy-dad-dies-given-cancerous-kidney-transplant-inquest-hears.html
Cases revealed by the NHS ombudsman included a man who had a fatal heart attack and stroke after staff failed to say he was at risk. Photograph: David Sillitoe for the Guardian
Press Association
Wed 29 Oct 2014 10.20 GMT
124
The NHS has committed a catalogue of blunders that have had a “devastating impact” on every generation, a report has revealed.
New cases published by the parliamentary and health service ombudsman have exposed potentially avoidable deaths and patients suffering needless harm in England’s hospitals.
The 161 summaries of investigations carried out between April and June this year included complaints about incorrect discharges from hospitals and failings in diagnosis of cancer.
One complaint concerned Barking, Havering and Redbridge university hospitals NHS trust, where a man died after a liver biopsy. The investigation found he had an inadequate care plan, was incorrectly discharged from A&E and did not consent to the biopsy. He was not properly monitored after the procedure, was given the wrong medicine and the trust lost his clinical records.
In another case a man was inappropriately discharged from a Bedford hospital NHS trust A&E department complaining of nausea, vomiting and constipation lasting three days. The following day he was admitted to hospital where surgery revealed he had suffered a complete loss of blood supply to his small intestine.
One woman was told after surgery at Wirral University teaching hospital NHS foundation trust that she had stomach and bowel cancer, and would need treatment and tests. However, no tests were arranged and a surgical consultant told her she did not have cancer. Five weeks later, the same consultant told her she did in fact have the disease.
A man had a fatal heart attack and stroke while on holiday after doctors at Blackpool teaching hospitals NHS foundation trust, to whom he had complained of chest pain, failed to tell him he was at risk of a heart attack and early death if he flew.
In another case, a woman was forced to give birth at home with no medical support after a student midwife at Blackpool teaching hospitals NHS foundation trust turned her away from the maternity ward after wrongly believing she was not in established labour.
The ombudsman, Dame Julie Mellor, said these investigations showed the “devastating impact” failures in public services could have on the lives of individuals and their families.
She said: “A shocking case that stood out was that of a one-day-old baby who suffered permanent brain damage at Barts Health NHS trust in London because a nurse and two doctors made serious mistakes during a blood transfusion.
“We are increasingly concerned about patients being discharged unsafely from hospital. Unplanned admissions and re-admissions are a massive cost to the NHS.
“We are publishing these summaries so public services, MPs and members of the public can see the different types of complaints we look into, our findings and recommendations.
“I hope this will give people with concerns about the service they have received the confidence to come to us to complain. We also want to provide valuable lessons for public services, and show how complaining makes a positive difference to them.”
The ombudsman is the final step for people who want to complain about being treated unfairly or receiving poor service from the NHS in England, or a UK government department or agency.
The ombudsman service investigated 2,199 cases in 2013-14 compared with 384 in the previous financial year.
The shadow health minister Jamie Reed said: “This catalogue of poor care shows an NHS heading in the wrong direction. Hospitals are full to bursting – struggling to admit or discharge patients – and these reports make clear there isn’t enough staff to cope.
“Under David Cameron, half of nurses say their ward is dangerously understaffed. Labour will invest an extra £2.5bn to recruit 20,000 more nurses and help hospitals to provide safer care.
“By wasting £3bn on a reorganisation, David Cameron is making care problems more likely, not less. It is proof you can’t trust him with the NHS.”
https://www.theguardian.com/society/2014/oct/29/nhs-blunders-revealed-ombudsman-report
You might also be interested in:
Lapses lead to mistake every five births
Litigation 'threatening NHS finances'
Birth problems twice as common in some trusts
https://www.bbc.co.uk/news/uk-england-42442343
https://www.england.nhs.uk/2018/12/avoidable-patient-harm-to-be-halved-in-key-areas-as-part-of-ambitious-strategy/
NHS errors: Tools left in patients and amputation errors make list of blunders
Errors such as patients receiving the wrong blood, overdoses of insulin and botched hysterectomies made the "never events" list.
More than 600 patients have suffered due to serious NHS errors, including botched hysterectomies and surgeons operating on the wrong patient.
A total of 629 "never events" - meaning they are so serious they should never happen - occurred between April 2018 and July 2019 in NHS hospitals - the equivalent of nine patients every week.
The mistakes include doctors operating on the wrong body parts and leaving surgical tools such as gloves and drill bits inside patients.
Two men were mistakenly circumcised, while a woman had a lump removed from the wrong breast.
The wrong toe was amputated from one patient and two women had biopsies taken from their cervix, rather than their colon.
Six women had their ovaries removed during botched hysterectomies, putting them into early menopause.
Figures also show that some patients had procedures intended for someone else, including laser eye surgery, lumbar punctures and colonoscopies.
Potentially fatal mistakes included patients being given regular air rather than pure oxygen, and some being given overdoses of drugs such as insulin.
Some even had feeding tubes placed into airways instead of their digestive system.
Six patients received the wrong type of blood in a transfusion, while 52 people had the wrong teeth removed.
In total, there were 270 incidents linked to wrong site surgery (where an operation is performed on the wrong part of the body), with a 127 cases of "foreign objects" being left inside people following their surgery - including needles, specimen bags and swabs.
https://news.sky.com/story/nhs-errors-tools-left-in-patients-and-amputation-errors-make-list-of-blunders-11811131
Some £2.8 million in compensation was dished out to those who were affected
The statistics were released by NHS Resolution - which is the litigation authority
They revealed some of the most horrific cases that have occurred in England
https://www.dailymail.co.uk/health/article-5316147/NHS-blunders-led-137-men-losing-testicle-six-years.html
https://www.bbc.co.uk/news/health-22366147
What are the most famous hospital scandals in the UK?
One by one the scandals have become etched on the public consciousness. The mass killings by Harold Shipman. The deaths of babies undergoing heart surgery at Bristol Royal Infirmary and born under the care of Morecambe Bay maternity services. The needless suffering of patients at Stafford Hospital.
Shipman, Bristol, Stafford, Morecambe Bay - BBC News
www.bbc.co.uk/news/health-44550913
Search for: What are the most famous hospital scandals in the UK?
How many women have been affected by the three NHS scandals?
The inquiry found that the NHS did not know how many women had been affected by the three scandals. And it detailed “heart-wrenching stories” of how treatments provided on the NHS had “damaged lives” and highlighted how campaigners have fought for decades to get acknowledgement of their suffering.
The NHS scandals which 'damaged so many lives' revealed in
www.lep.co.uk/health/the-nhs-scandals-which-damaged-s…
Search for: How many women have been affected by the three NHS scandals?
What can we learn from the NHS’s worst maternity scandal?
The NHS’s worst maternity scandal raises fundamental questions about the culture and safety of our health service. The Independent has revealed that an inquiry into maternity care at Shrewsbury and Telford hospital NHS trust has uncovered dozens of avoidable deaths and more than 50 babies suffering permanent brain damage over the past 40 years.
Latest NHS maternity scandal is product of toxic 'can't
www.theguardian.com/society/2019/nov/22/nhs-maternit…
Covering up NHS scandals should become a criminal …
https://www.dailymail.co.uk/health/article-11335399
20/10/2022 · NHS staff who lie to cover-up poor care in the health service should face a criminal charge, the author of the damming probe into the East Kent maternity scandal has said. The …
Thousands had their lives 'ruined' in three avoidable …
https://www.thesun.co.uk/.../thousands-lives-ruined-three-nhs-scandals
08/07/2020 · THOUSANDS of women and children had their lives damaged in three avoidable health scandals, a scathing report says. They were left in pain and suffering because the NHS …
Latest NHS maternity scandal is product of toxic 'can't …
https://www.theguardian.com/society/2019/nov/22/nhs-maternit…
22/11/2019 · The NHS’s worst maternity scandal raises fundamental questions about the culture and safety of our health service. The Independent has revealed that an inquiry into maternity care at Shrewsbury...
Let the NHS carry on killing people, and if you dont like it, go private.
Shrewsbury maternity scandal: Repeated failures led to deaths
Catastrophic failures at an NHS trust may have led to the deaths of more than 200 babies, nine mothers and left other infants with life-changing injuries.
Senior midwife Donna Ockenden examined maternity practices at Shrewsbury and Telford NHS Trust (SaTH) over 20 years.
Her report found that babies' deaths were often not investigated and grieving parents were not listened to.
This meant, she said, "failures in care were repeated" and some mothers were even blamed for their own deaths.#
The review, which examined almost 1,600 cases, is thought to be largest of its kind in NHS history.
Severe brain injuries
It revealed 201 babies could have survived had SaTH provided better care, related to 70 neonatal deaths and 131 cases where babies were stillborn.
There were also 29 cases where babies suffered severe brain injuries and 65 incidents of cerebral palsy.
Ms Ockenden said: "We now know that this is a trust that failed to investigate, failed to learn and failed to improve.
"This resulted in tragedies and life-changing incidents for so many of our families."
Post-it notes
Speaking in the House of Commons on Wednesday, Health Secretary Sajid Javid told MPs in one case the hospital trust had kept important clinical information on post-it notes, which were then swept into the bin by cleaners.
Key findings:
A culture where mistakes were not investigated and a failure of external scrutiny
Parents were not listened to when they raised concerns about the care they received
Where cases were examined, responses were described as lacking "transparency and honesty"
The trust failed to learn from its mistakes, leading to repeated and almost identical failures
A culture of bullying, anxiety and fear of speaking out among staff at the trust "that persisted to the current time"
Caesarean sections were discouraged, often leading to poor outcomes
In all, Ms Ockenden identified 60 specific improvements that could be made at SaTH and said there could be "no excuses" going forward.
The review found a culture of not investigating mistakes, with hundreds of instances where SaTH failed to appropriately examine deaths or undertake serious incident investigations with mistakes being "inappropriately downgraded".
Between 2011 and 2019, 40% of stillbirths and 43% of neonatal deaths did not even have an investigation. Of those cases that were examined, the Ockenden team graded the reviews as poor in almost half of stillbirths and over a third of neonatal cases.
Analysis
By Michael Buchanan, Social Affairs correspondent
The numbers are enormous, shocking even for those of us who long suspected there was something far wrong with the care at the trust. But the crucial thing to remember is that what the failings highlight are individual families who've grieved in private and at times been lied to by a trust that seemed uninterested in helping them to understand what happened or to learn any lessons.
Reading the report, there seems at times to have been an almost casual disregard for life - mothers have explicitly told me of being told, you'll be fine, you're young, you can have another child.
The central question now is how does the trust convince the women of Shropshire that it's currently providing a safe service - Donna Ockenden's remarks about care and culture in the trust in 2022 raise significant questions about the ability of the leadership team there to drive through the many changes that are clearly needed.
Blame mothers
On those occasions where cases were investigated, the trust failed to identify areas for improvement and missed opportunities to learn.
Ms Ockenden added the trust had a tendency to blame mothers for poor outcomes, and even in some cases for their own babies' deaths.
The inquiry was first commissioned in 2017 following a campaign by two families who had lost their babies.
https://www.bbc.co.uk/news/uk-england-shropshire-60925959
Police investigate 'worst maternity scandal in NHS history'
https://www.youtube.com/watch?v=NZCXYUPiBe0