NHS review at scandal-hit hospital condemned by watchdog

A health watchdog has condemned a scandal-hit hospital for failing to cooperate with safety reviews following “avoidable” patient deaths.

Parliamentary Health Service Ombudsman Robert Behrens, who investigates patient complaints, said University Hospitals Birmingham Foundation Trust had been “defensive” about investigations into patient complaints and had shown no willingness to learn from past failures.

In a letter to NHS chief nurse Dame Ruth May, Mr Behrens also warned that an NHS review of the trust’s leadership would lack “transparency” and “completeness” after he was excluded from the deposition.

Mr Beherens has received 521 complaints against the trust since 2021. So far, two investigations have shown that patient deaths could have been avoided, while another 60 active cases are under review.

The leadership review was one of three introduced at the trust following reports of a “toxic” culture within the organisation.

The outcome of the first, which investigated patient safety risks, is due to be published this month and is expected to find “significant” cultural and behavioral issues at the trust, according to a report to the local council last week. The second review will look at whether it has good leadership and the third will look at its culture.

In the letter to Dame Ruth on March 7, Mr Berhens raised concerns about the NHS excluding him from taking part in its leadership review.

He said: “As a partner with valuable knowledge and input on the issues addressed in the three reviews, we are disappointed not to have the opportunity to make an active contribution. Excluding PHSO from the review process leaves me concerned about the completeness and transparency of the reviews…

“Through our interactions with the previous leadership team at UHB, we are very concerned about their dismissive attitude in response to allegations of serious patient safety incidents. We have seen no evidence of a culture of accountability, nor a willingness to learn from past failures. This information is directly related to well-guided criticism. Through the Emerging Concerns Protocol, it has become clear that other supervisors and regulators share similar concerns about the culture at UHB.”

In August, the watchdog issued an unprecedented warning to health regulators and NHS England about UHB, warning that the agency had “serious concerns” about the trust’s response to inquiries into its patient safety.

However, seven months later and the regulator was forced to write to the trust again about its ongoing concerns about its “defensive” attitude towards patient safety investigations.

In a letter sent on March 7 to its interim chief executive, Jonathan Brotherton, Mr Berhens said: “We are concerned the defense of some senior leaders at the trust in relation to recent and ongoing investigations is eroding confidence that there is a willingness to accept responsibility or learn from failures. We have recently seen some engagement with our research recommendations. However, there are a number of recommendations from PHSO investigations that UHB has not yet complied with. We have found that UHB is consistently slow to respond to requests for information with multiple reminders necessary before providing relevant information.”

An expected patient safety review due to be published last week has been delayed, however, according to a report to the local council, first reported by the Birmingham Mail, it found “significant issues around culture, behaviour, leadership and governance”.

A spokesman for NHS England in the Midlands said: “Reviews at University Hospitals Birmingham Trust were commissioned to rigorously examine the leadership and culture in the organization to ensure they are providing safe care to patients, as well as providing transparent information in any areas Support and challenge need in the trust.

“We welcome the offer of support from the Ombudsman’s office that we met with recently and continue to work with them to use their expertise where it can provide the most value as part of the planned cultural review.”

A spokesman for University Hospitals Birmingham said: “The Chief Executive has responded to PHSO’s letter to provide reassurance that their concerns have been taken seriously and we are working to arrange further meetings to agree how our organizations can work better together in the interests of our patients and staff.

“We are committed to working with the PHSO to ensure all families have a clear understanding of any issues relating to their loved one’s care.”

NHS England has been approached for comment.

The title of the article was modified on the day of publication. It initially reported that the hospital had been condemned for obstructing the ombudsman’s contribution to the investigation, but this was not accurate. The hospital did not block the guard.

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