Hospital chief executive quits amid suggestions death rates were' fiddled to improve results'
Major investigation underway at Royal Bolton Hospital, ManchesterFour times as many deaths were recorded from septicaemia than expectedAround 800 deaths recorded as this rather than the expected 200
Jackie Bene, acting chief executive of Bolton NHS Foundation Trust, has quitRobert Francis renews call for a NHS culture change starting today
Wrong that hospital security and cab drivers face more regulations than worker 'cleaning the bottom of your grandmother', he added

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The new scandal comes just weeks
after a public inquiry into Mid Staffordshire NHS Trust found up to
1,200 patients died needlessly between 2005 and 2008 because bosses put
government targets ahead
of patient safety.

The NHS chief executive is already under pressure to quit after presiding over the scandal.

Sir David Nicholson was previously head of West Midlands Strategic Health Authority
between 2005 and 2006 – the body supervising Mid Staffordshire – but
failed to pick up on the horrific standards of care.

Campaigners have called for him to quit his 270,000 post, which
he has held for six years, following the public inquiry into the
failings.

There are now claims that Dr Bene was forced out of Bolton NHS Foundation Trust amid suggestions that she allowed death figures to be manipulated.

After six years as one of the worst performing trusts for death rates, Bolton recorded a significant improvement in 2011.

Dr Foster and Bolton's Clinical Commissioning Group (CCG) are currently investigating 200 of the septicaemia cases.

Their report, which is supported by NHS Commissioning Board and Professor Sir Bruce Keogh, the UK's national medical director, is expected to be completed on March 6.

It is too early to say why the Trust had so many cases of septicaemia, but the CCG said its interim findings for 50 of the cases show 'cause for concern'.

It is believed patients' records could have been coded incorrectly causing the 'discrepancies'.

In
December, Bolton NHS Foundation Trust's results were 'better than
expected'. This followed an award for 'most improved' trust in 2011.

But
for the six previous years, Bolton was one of the worst performing
trusts for death rates, with figures massively above the national
average.

In a statement, Bolton NHS Foundation Trust said: 'We do not believe that there are any clinical concerns regarding the care of patients, but rather there are questions that need answering about how the trust reports information about their care for administrative and financial purposes.

Investigation: Death rates at trusts all over the UK are being looked at after up to 1,200 patients died unnecessarily in Stafford Hospital between 2005 and 2008

Investigation: Death rates at trusts all over the UK are being looked at after up to 1,200 patients died unnecessarily in Stafford Hospital between 2005 and 2008

Pressue: Groups like 'Cure The NHS' have been created in the wake of the scandal, led by campaigner Julie Bailey, pictured in front of a memorial wall for the dead

Pressue: Groups like 'Cure The NHS' have been created in the wake of the scandal, led by campaigner Julie Bailey, pictured in front of a memorial wall for the dead

'The steps we have taken will provide
the Trust and our community with information about what has happened,
any steps that need to be taken and any lessons that may need to be
learned. The Trust will report back on this in public.'

The statement added that 'the issue
is the way in which some conditions and some causes of death were
recorded on the Trust’s administrative system. It does not change the
number of people who have died.

'And it does not change the facts or reliability of a patient’s death certificate.'

On Monday,
the Trust's interim chairman David Wakefield informed staff that Dr Bene
had 'stepped aside' to 'allow a fully independent view to be taken'.

Mr Wakefield, who was appointed by health watchdog Monitor after the Trust was put in the highest risk rating for governance and finance, said an independent team would be brought in to look at coding practices.

He said the Trust wanted to 'rule out any serious issues as soon as possible' and make sure the way they code patient outcomes meets 'highest quality standards'.

He stressed the 50 cases would be reviewed by clinical staff to rule out any serious issues, and if there were any concerns with care then families would be contacted.

But he added: 'We do not believe that there are any clinical concerns regarding the care of patients, but rather there are questions that need answering about how the trust reports information about their care for administrative and financial purposes.'

Dr Wirin Bhatiani, chairman of Bolton Clinical Commissioning Group, said it first became aware of the 'unusually high' number of septicaemia cases in October and commissioned Dr Foster to carry out an independent audit.

CCG chiefs discussed concerns with the Trust, Monitor, quality experts from the Strategic Health Authority in the North, NHS Greater Manchester and the Care Quality Commission on January 24.

Dr Bhatiani said: 'While we are keen to wait for the final report, we are sufficiently concerned by the interim findings to commence further investigations, and to inform the chair of the trust.

'When the final report is available on March 6, we will present the findings openly and transparently, reflecting the fact that the Bolton public are our main concern and priority.'

'NHS CULTURE CHANGE MUST HAPPEN NOW', SAYS STAFFORD REPORT QC

Robert Francis QC

Culture change in the NHS should happen immediately, the chair of the public inquiry into the 'disaster' at Stafford Hospital said.

Robert Francis QC (right) said that healthcare workers should not wait for Government recommendations to implement a change of attitudes towards care in the health service.

Mr Francis’s report into Mid Staffordshire NHS Foundation Trust highlighted the 'appalling and unnecessary suffering of hundreds of people' between 2005 and 2009.

He made a total of 290 sweeping recommendations for healthcare regulators, providers and the Government.

In his first public appearance since publishing the report, Mr Francis told healthcare professionals at The King’s Fund: 'We are of course waiting for the Government’s response to the recommendations.

'But why are we waiting There is much in this report that doesn’t require a change of law, it doesn’t require a policy guidance from the Care Quality Commission.

'It doesn’t require anything other than a change of attitude on the part of people.

'Everyone in this room who has a job in the health service can walk out and actually start doing something that makes a difference.'

Mr Francis said the 'first and foremost' thing that healthcare workers could do was to listen to those who have complaints because 'there is almost always something you can do about it'.

He also reiterated some of his recommendations, including his call for a registration database for healthcare support workers, saying: 'Isn’t it odd that the security guard at the door of the hospital, the driver of the minicab who takes you there, have more regulation attached to them and more sanction available to their supervision than does the support worker who is cleaning the bottom of your grandmother

'We have to have a system where those who are unfit for the job are excluded from doing so.'

He said that patients should be put first in a set of values which each healthcare worker should commit to.

He also said there should be “no tolerance” for breaches of fundamental standards in care.

Quoting Florence Nightingale, who said it was a strange principle to have to say that the very first requirement of a hospital is that it should do the sick no harm, Mr Francis said: “Also in 1860 there she was saying ‘what can’t be cured must be endured is the very worst and most dangerous maxim for a nurse’.

'Unfortunately we have now found that it was a maxim that was prevalent in the National Health Service at numerous levels even today.'

NHS Medical Director Professor Sir Bruce Keogh said: 'If we’re to have an open and accountable NHS, where patients and the public know how NHS hospitals are doing, those hospitals must behave openly and honestly about their performance.'

'There are clear national guidelines on how death rates should be recorded, and I expect all NHS hospitals to follow them.'