'Staff shortages putting East Lancashire hospital patients at risk'

They spoke after further detailed information and analysis from the team behind the damning Keogh Report was publicly released.

Yesterday, the largest NHS union Unison and the Royal College of Nursing highlighted poor staffing as the key cause of problems at the Royal Blackburn and Burnley General hospitals.

Their criticism was last night backed by Russ McLean, chairman of East Lancashire Patients Voice group, who said the staffing situation was ‘critical’.

Blackburn MP Jack Straw will today raise their concerns about poor staffing levels, inadequate out-of-hours cover and over-use of agency nurses with East Lancashire Hospital Trust bosses in a summit at the Royal Blackburn.

Last week the trust was placed in ‘special measures’ and a outside team of experts parachuted in by health secretary Jeremy Hunt to help bosses tackle high mortality rates and ‘severe failings’ in care identified by NHS Medical Director Sir Bruce Keogh.

Concerns about staffing were spelt out in much greater detail in a second tier of information on the Department of Health website.

The specific new concerns highlighted by Sir Bruce and his team in the newly-published extensive supporting documents include a ‘significant shortage of junior doctors’ at the East Lancashire trust; a shortage of nursing staff on key units at the Royal Blackburn; inadequate overnight consultant cover; and failure to act over known staffing ‘hotspots’ at Blackburn and Burnley.

The latest documents claim the shortages outlined by senior ward staff had not been recognised or dealt with by the then deputy chief executive Lynn Wissett, who announced she was stepping down for personal reasons from her trust post after the initial Keogh report release.

Mr McLean said his group, along with Unison and the Royal College of Nursing, had been warning managers about the shortages and excessive use of agency staff for years.

Trust human resources director Ian Brandwood said after a staffing review identified areas of shortage, prior to the Keogh Report, there had been 40 job offers to nurses with recruitment started for another 60 nursing and six midwifery posts.

Sir Bruce’s main report said ‘insufficient leadership’ resulted in a shortage of nurses with an ‘inadequate skill mix’ leading to a ‘poor standard of care’.

The Lancashire Telegraph revealed in May the trust spent £13million on temporary staff in 2012/2013, £1.3 million in April alone, including agency nurses who cost three times more than permanent ones.

After studying the Keogh team’s newly-released analysis of staffing at all 11 trusts put into ‘special measures’ last week, Unison’s national head of health Christina McAnea said all faced a common issue.

She said: “We have been campaigning for safe staffing levels and the right skills mix on wards for many years.

“This includes in the evenings and at weekends. There is clear evidence that out of hours cover isn’t safe.

“It is time for the government to start listening and committing to minimum staffing levels.

“Spending pressures mean that health workers are losing their jobs.”

Sean Gibson, Lancashire regional manager for Unison, said the issue of under-staffing had been raised at the trust.

He said: “We have said all along that staffing levels aren’t at the level required to give the type of service the public deserve.

“I agree with Christina’s concern about out-of-hours cover safety for all trusts, not just specifically East Lancashire.

“The East Lancashire trust has assured Unison they are in the process of recruiting these staff.

“NHS Trusts have seemed to slip into using bank or agency as a short term fix. Recruiting permanent and properly qualified staff is a better option for the East Lancashire and other trusts.”

A spokesman for the Royal College of Nursing said: “It is absolutely vital that we now have mandatory minimum staffing levels introduced, supported by strong clinical leadership.”

Mr McLean said: “I would say that the staff shortages, which the trust admits, are very alarming, very alarming indeed. The staffing situation there is critical. I would agree with the unions. The shortage of staff and over-use of bank and agency nurses is something we have been warning the trust about for two-and-half-years.

“Shortages of permanent qualified staff are a real cause of some of the East Lancashire Hospital Trust’s problems as the Keogh report supporting documents make clear.

“There is too much use of agency staff.

“Hopefully after Keogh, the trust will spend some of the money used for agency and bank nurses on permanent, qualified staff to improve patient care.”

Mr Brandwood said: “A nursing staffing review had already been undertaken prior to the Keogh Review.

“This identified the need to increase the number of nurses and as a result, 40 job offers had already been made to nurses, in addition we are seeking to recruit 30 registered and 30 un-registered nurses.

“Six additional midwives are being recruited. The board had been in discussion with the Royal College of Midwives concerning the appropriate number of staff required.

“The shortage of junior doctors, particularly in emergency medicine, is a national issue. However, we have undertaken a review of medical staffing and are implementing recommendations to ensure appropriate levels of cover at all times. This would include more use of allied health professionals and senior nurses.

“The medical staffing review also considers medical rotas to ensure an appropriate level of medical cover, day or night.”

Blackburn MP Jack Straw, who is visiting the Royal Blackburn today (TUES), said: “Staffing has been a major cause of problems but there has also been a question of leadership. I shall be discussing all these issues with trust management. Turning the trust round is my number one priority.”

Patients’ group Healthwatch Lancashire says it expects East Lancashire Hospitals Trust to act upon the recommendations contained within the review and will be holding discussions with them concerning their actions.

INADEQUACIES HIGHLIGHTED BY HOSPITAL STAFF

The report found ‘insufficient leadership’ resulted in a shortage of nurses and an ‘inadequate skill mix’ contributing to patients receiving a ‘poor standard of care’.

The section of staffing highlighted:

• A significant shortage of junior doctors (seven out of 21 specialist registrar positions unfilled).
• Shortage of nursing staff, especially overnight, on the acute stroke unit [ward B2], and other medicine wards [B4, C10, C11,C18 and C22] at the Royal Blackburn Hospital.
• Inadequate consultant cover overnight.
• The emergency department at Blackburn and post-natal ward in Burnley were known hotspot’ areas for staffing problems which were not addressed.
• Shortages outlined to the inspectors by senior ward staff had not been recognised by the deputy chief executive Lynn Wissett.