The “rapid review” into West Suffolk hospital, which Hancock had to recuse himself from because of his friendship with the boss at the trust, was ordered in January and had been due for completion in April. Its publication was put back to this month because of the coronavirus pandemic. But it is now not expected until spring.

The Doctors’ Association UK suspects the conclusions are being sat on because they make embarrassing reading for the trust’s chief executive, Steve Dunn, described by Hanock as a “brilliant leader”.

A consultant who chairs the hospital’s medical staff committee wrote to the NHS’s regional director for the east of England, Ann Radmore, last week warning that senior medics felt the hospital could not move on until the review was published.

The NHS East insists the review will be published as soon as possible, but a source confirmed this is likely to be “spring next year”.

Dunn was urged by the Royal College of Anaesthetists to end the “toxic management culture” after the Guardian revealed an unprecedented hunt for a whistleblower who had tipped off a family about a potentially botched operation.

John Warby, whose wife, Susan, died after an operation in August 2018, was sent an anonymous letter highlighting errors in her procedure. A coroner concluded this year that errors in her care had contributed to her death.

After the anonymous tipoff, staff complained of bullying by hospital managers, who demanded they provide fingerprints to identify which of them had written to Warby.

The incident, and other failings in patient safety, contributed to the hospital becoming the first ever to be relegated by Care Quality Commission (CQC) inspectors from “outstanding” to “requires improvement” in January.

Weeks before Warby’s operation, Patricia Mills, a consultant anaesthetist at the trust, had, along with a number of other colleagues, formally raised the alarm internally about patient safety over a doctor who had been seen injecting himself with drugs.

Dozens of staff had accessed Warby’s hospital records, but it was those who had expressed concern about the drug-taking doctor who were asked to provide fingerprint and handwriting samples, insiders claim.

As the same doctor was involved in Warby’s care, Mills, along with other colleagues who had complained, was immediately suspected by those investigating the leak of alerting her family to the errors.

Mills has consistently denied this. But managers demanded that she and other senior staff provide fingerprint and handwriting samples in an attempt to identify the writer of the letter.

They were told by email in August that any refusal to comply could be relevant to the investigation and “could be considered as evidence which implicates you as being involved in the writing of the letter”.

Despite this apparent warning, Dunn insisted in a letter to Hanock in January that staff had not been “threatened with disciplinary action if they chose not to” provide handwriting and fingerprint samples. He accepted that the manner in which things had been done “deeply affected” some of the staff involved and that “this could have been handled differently”. He said staff involved had received a personal written apology.

Dr Rinesh Parmar, the chair of the Doctors’ Association UK, said: “Staff fear that the publication of the report is being further delayed as it may make difficult reading for the trust’s chief executive who the health secretary has previously championed.”

He added: “The delay makes a mockery of the process which was started to investigate concerns of a witch-hunt by senior managers to identify a whistleblower. Patient safety is undoubtedly improved when staff feel able to raise concerns, a culture which promotes this is required.”

A spokeswoman for the BMA said: “Investigations need to be thorough and that can take time, but ongoing delays can have very serious effects on those under investigation and they mean that an organisation cannot move ahead and implement recommendations that may arise from the inquiry itself.”

A West Suffolk hospital spokesman said: “Of course there are discussions in the trust about the review, as you’d expect, but decisions about timing are for NHS Improvement and the Department of Health and Social Care and not something we can comment on.”

It has said it cannot discuss issues about individual members of staff and that it would be premature to comment on matters covered by the review.

A spokesperson for NHS England said: “The independent review into whistleblowing at West Suffolk NHS foundation trust is ongoing, and the findings and recommendations will be published at the earliest possible opportunity.”

Article available here: https://www.theguardian.com/society/2020/dec/09/nhs-urged-to-publish-delayed-report-on-west-suffolk-hospital-witch-hunt-matt-hancock

In calling for protections to be strengthened Dr Parmar cited the countless emails and messages that the Doctors’ Association UK have received from frontline doctors with concerns. The meeting had a keytone address from whistleblower and Consultant Cardiologist Dr Raj Mattu. Speaking at the meeting, Dr Rinesh Parmar Chair of the Doctors’ Association UK said:

“COVID-19 has exposed and really shone a light on the current void in whistleblowing protection for healthcare workers.

Colleagues have raised concerns about the availability of PPE and testing and have faced detriment and disciplinary action.

A true freedom to speak up is vital for patient and staff safety, there is still a long way to go to achieve a just culture in the NHS.”

He spoke about how the Doctors’ Association UK during the first wave of the pandemic became the voice of frontline doctors, providing a platform for them to share their concerns safely. The creation of the NHSPPE App facilitated the raising of concerns anonymously.

“There is a perverse system at play which targets the whistleblower and their credibility, shifting focus away from the serious patient safety concern that has been raised. The reality is that patients are not safer and the issue is just brushed under the carpet.”

He spoke of the work being done by DAUK on the Learn Not Blame campaign as well as our support for the reforms to the Public Interest Disclosure Act (PIDA) and the calls for an independent Office for the Whistleblower.

Dr Jenny Vaughan spoke about her role with Learn Not Blame as well as some of the work being done by the Royal College of Physicians. Dr David Nicholl spoke about his own personal experiences of being a whistleblower about concerns over drug shortages and operation yellowhammer.

‘Ministers appear to have been sitting on their hands and not learning the lessons from the first wave.

You tend to have more patients that are not intubated and ventilated than are using other therapies. From a staffing point of view, it would also make sense to have it as a step down facility so you’re not then required to staff it with intensive care doctors and nurses who are already in short supply.”

Ministers have been accused of “sitting on their hands” over warnings that the country’s largest Covid-19 field hospital is ill-prepared to help the capital cope with a second wave of infections.

Last week, Matt Hancock, the Health Secretary, confirmed that the Nightingale hospitals set up earlier this year would be ready to receive patients once again as conventional hospitals in some parts of the country faced becoming overwhelmed.

However, despite warnings in the spring that the London Nightingale needed to undergo a transformation to play a significant role over the winter, NHS England has admitted that no changes have been made to the facilities since the field hospital was put on “standby” in May. 

The hospital, which has the potential to accommodate up to 4,000 patients, was constructed at east London’s ExCeL exhibition centre in April.

It was initially set up to provide up to 500 intensive care beds, but only cared for 51 patients, and senior critical care medics had suggested that it should instead adopt the ‘step down’ model used for the temporary hospitals in Manchester and Birmingham.

Research has shown that far fewer patients require ventilators than was previously thought, but the London Nightingale is designed for patients who have already been put on ventilators and require ongoing critical care.

Dr Rinesh Parmar, a specialist registrar in anaesthetics who chairs the Doctors’ Association, said: “Ministers appear to have been sitting on their hands and not learning the lessons from the first wave.

“You tend to have more patients that are not intubated and ventilated than are using other therapies. From a staffing point of view, it would also make sense to have it as a step down facility so you’re not then required to staff it with intensive care doctors and nurses who are already in short supply.”

Read the full article in The Daily Telegraph here.

The warning comes after a research study highlighted that nearly 70% of the 1700 doctors surveyed “were likely to quit the NHS” frustrated with the government’s handling of the pandemic. This warning from the Doctor’s Association of UK (DAUK) should be a red flag for the Health Secretary especially after 600 healthcare workers, a majority of them from BAME backgrounds, lost their lives during the first wave of coronavirus.

Concerned about some BAME doctors who are still working in high-risk environments, Dr. Rinesh Parmar, Chair of DAUK has disclosed that “it is still an on-going problem.” Speaking exclusively to Asian Voice, he said, “Institutions have previously failed to complete risk assessments and take actions based on those risk assessments to safeguard our BAME colleagues. Some individuals who are deemed high-risk have not been removed from high-risk environments. Although the government has assured that the published BAME review has been forwarded to the Equalities Minister’s workstream, we have not heard anything from them in terms of how the work would be taken forward. We are heading towards a potential second Covid-19 wave and this is not something that can be put on the back burner. It needs to be addressed now.”

The news, reported in the Independent, angered doctors’ leaders, who called for the medical examiner investigations to be made public.

The local examiners are to conduct reviews of the deaths of more than 620 NHS staff during the pandemic. They will be reporting their findings to the national medical examiner Dr Alan Fletcher.

The examiners may also refer cases to local coroners or to the Health and Safety Executive – and will consult families of the deceased. But the families may not receive the findings.

The Department for Health and Social Care said the process aimed to “support local learning.” The paper quotes it as saying the findings would not be made public – although it has not yet decided finally what to do with them.

A spokesperson said: “A summary of every case is received by the national medical examiner, who reviews findings and ensures employers are contacted if deemed necessary. We are monitoring progress of the medical examiners’ scrutiny, and consideration will be given to whether further steps should be taken in due course.”

Doctors’ Association chair Dr Rinesh Parmar said: “Following a petition with over 120,000 signatures we launched a legal challenge with the Good Law Project to urge the government to launch a rapid public inquiry into healthcare worker deaths and guarantee that investigations are opened in every case. Following that pressure the government has sanctioned medical examiner investigations, but we are learning that their findings may be hidden or swept under a rug.

“The families of our colleagues who have died deserve to know what happened, the circumstances surrounding the death and whether a lack of adequate PPE led to the deaths of loved ones.”

He added: “Learning needs to be widely shared in an NHS where we learn not blame, where we improve and prevent future tragedies and safeguard staff and patients alike. This is simply not possible if the findings are buried rather than published openly.”

The Independent revealed on Tuesday that medical examiners across England and Wales have been asked by ministers to investigate more than 620 deaths of frontline staff that occurred during the pandemic.

The senior doctors will review the circumstances and medical cause of death in each case and attempt to determine whether the worker may have caught the virus during the course of their duties.

But now the Department of Health and Social Care (DHSC) said the results will be kept secret with the aim of helping local hospitals to learn and improve protection for staff.

It has sparked criticism from across the political spectrum with both Labour and the Liberal Democrats calling for more transparency and warning against a “cover up” of any findings.

Dr Rinesh Parmar, chair of the Doctors’ Association UK, said: “The families of our colleagues who have died deserve to know what happened, the circumstances surrounding the death and whether a lack of adequate PPE led to the deaths of loved ones. Learning needs to be widely shared in an NHS where we learn not blame, where we improve and prevent future tragedies and safeguard staff and patients alike. This is simply not possible if the findings are buried rather than published openly.”

Read the full article in The Independent here

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The Independent has reported that an investigation began last month, covering around 620 deaths of nurses, doctors and care home staff since the beginning of March.

The review could trigger a number of investigations by hospitals, the Health and Safety Executive and coroners into whether staff received sufficient protective equipment. Early into the pandemic there were numerous reports of hospitals running out of protective masks and clothing.

In April, health secretary Matt Hancock announced that families of health and care workers who died from the virus as a result of their duties would receive a death in service benefit of £60,000.

Medical examiners will independently review all relevant deaths to verify the correct cause and identify any concerns around treatment. They will be asked to indicate whether the worker was tested for Covid-19 and the result was recorded, and whether there is reason to believe the infection was acquired in the course employment.

If so, hospitals have a duty to report this to the Health and Safety Executive (according to Riddor (reporting of injuries, diseases and dangerous occurrences regulations)). The HSE could then investigate. Certain cases may be passed on to a coroner.

Medical examiners are employed by local trusts and are accountable to a national medical examiner. They were introduced after the public inquiry into serial killer GP Harold Shipman.

An NHS England spokesperson told The Independent: “NHS and other care staff have gone to extraordinary lengths to treat people during the Covid-19 pandemic, it’s absolutely right that we seek to understand the circumstances of every death, which is why all NHS employers will work with the Health and Safety Executive, as well as local and regional medical examiners, to ensure any lessons are learned to protect frontline staff.”

Doctors’ Association UK, which represents doctors, has campaigned for a public inquiry into the deaths of NHS workers during the coronavirus pandemic. It welcomed the reviews into the deaths but said they could go further.

Dr Rinesh Parmar, its chair, said: “It’s a positive step that the government is recognising these deaths need investigation, but we would ask that they take the next step with a full coroner’s investigation into all health worker deaths.

“Coroners are best placed to carry out independent investigations. They have the experience and they are not directly employed by hospital trusts so there is less of a chance of them being persuaded to make certain decisions or recommendations.”

The Doctors’ Association (DAUK) with support from the Good Law Project and charity Hourglass are calling for a judicial review into the decision by the government not to hold a public inquiry into the planning, procurement, and provision of personal protective equipment (PPE) for health and social care staff.

With healthcare being left “wearing visors made by teenagers on 3D printers” and “care workers being told to share the same mask”, the group has raised concerns that the inadequacy of PPE may have contributed wholly or in part to the tragic deaths of health and social care workers.

At least 245 health and social care workers are known to have died from COVID-19 – with some figures suggesting this is dramatically more.

Despite a petition receiving over 120,000 signatures supporting a public inquiry, there has been no formal response from the government.

Dr Rinesh Parmar, Chair of the DAUK said: “With over 300 healthcare worker deaths due to Covid-19, the UK is an international outlier – only Italy has similar death rates amongst its healthcare staff. Yet the government have told us that looking into the issue now will distract officials, thus risk causing further deaths. This is a nonsense. It is our members and colleagues who are working non-stop to save lives – indeed, the only ones who have stopped are those who are shielding, sick or have died.

“There is simply no excuse for the government to bury its head in the sand and pretend that learning in the form of a public inquiry is not required. Now is precisely the time to hold a rapid, focused inquiry into the provision of PPE to healthcare workers. There may be a second wave, and it may be soon.

Before adding; “We know there has been an inadequate PPE supply of out of date and perishing stock; we know our standards have fallen short of WHO and European CDC guidance. It would be unconscionable to ask our NHS and care sector to face that second wave without learning lessons from the first. The pride of politicians and officials cannot take precedence over the lives and safety of our healthcare workers.”

Read the full article.

On 8 June, the Doctors’ Association UK (DAUK), in conjunction with the Good Law Project, a not-for-profit membership organisation, and elder abuse charity Hourglass, instructed solicitors to start the legal challenge.

They believe that, under the Human Rights Act 1998 and article 2 of the European Convention on Human Rights, the government has a legal obligation to launch an independent public inquiry into whether failures to provide adequate PPE may have caused or contributed to the deaths or serious illness of patients and health and social care workers.

A pre-action letter, sent by the group’s lawyers to the government legal department on 9 May, set out the rationale behind calling for an independent review. It asked ministers to appoint an independent investigator, and take steps to preserve evidence, identify witnesses, and commit to involving relatives of health and care workers who have died.

In response to the letter, however, the government declined to conduct such a review at this time.

DAUK chair Rinesh Parmar said that this decision was nonsense. “Now is precisely the time to hold a rapid, focused inquiry into the provision of PPE to healthcare workers. There may be a second wave, and it may be soon.” He added, “It’s our members and colleagues who are working non-stop to save lives—indeed, the only ones who have stopped are those who are shielding, sick, or have died.”

Jolyon Maugham, director of the Good Law Project, said it was important that a review was held soon “because we need to learn lessons before a second or third wave.”

Richard Robinson, chief executive of Hourglass, echoed this sentiment, saying, “As lockdown restrictions ease, it’s vital that lessons are learnt from our response to the pandemic before we encounter a second wave.

“There can be no excuse for a repeat of the carnage we’ve seen in our care homes over the past few months,” Robinson added. “The government must act now and commit to an urgent public inquiry before more lives are lost.”

A Department of Health and Social Care spokesperson said that they were unable to comment on ongoing legal proceedings.

• The DAUK and the Good Law Project are crowdfunding their legal actions through Crowdjustice. You find out more about their campaign here: www.crowdjustice.com/case/too-many-nhs-deaths

Read the full article here.