Health ombudsman issues unprecedented warning over safety and culture at scandal-hit NHS trust

Exclusive: Health service ombudsman has never before taken action of this kind against a trust

The Queen Elizabeth Hospital, Birmingham (PA) (PA Archive)

A health watchdog has issued an unprecedented warning over patient safety, culture and leadership at a scandal-hit NHS trust,The Independent has learned.

The Parliamentary Health Service Ombudsman, the government body that investigates patients’ complaints, has used powers for the very first time to raise “serious concerns” about University Hospitals Birmingham Foundation Trust.

The body does not have its own powers to intervene but the warning has triggered an investigation by NHS England.

Ombudsman Rob Behrens said there needed to be “significant improvements” in culture and leadership at the trust. He also raised concerns that the trust had failed to “fully accept or acknowledge” the impact of findings from investigations on patient safety.

The decision to trigger the alert, known as the emerging concerns protocol, was “not taken lightly”, Mr Behrens said.

The trust is already facing three reviews into concerns over patient safety and its culture, which were launched after an inquest found a junior doctor who worked at the trust took her own life. In December, former consultants also spoke to BBC Newsnight, alleging that staff had been punished for raising safety concerns.

Local MP Preet Gill told The Independent that, since the BBC expose, she had had more than 50 staff from the trust come foward with concerns about poor patient care and the “toxic and Mafia-like culture.”

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Mr Behrens said in a statement: “On the basis of a number of recent PHSO investigations we have serious concerns about University Hospitals Birmingham.

“These include the culture of the trust, its failure to fully accept or acknowledge the impact of our findings from investigations on patient safety, and its approach to the duty of care to its staff.

“This is the first time we have triggered the Emerging Concerns Protocol, a decision we do not take lightly. There needs to be significant improvements in culture and leadership so that people living in the West Midlands can access high quality and safe hospital care with confidence.

“We are now considering our next steps to make sure our evidence is fully considered going forward.”

One independent review, led by a former NHS executive Mike Bewick and set to be published this month, was tasked with looking into patient safety issues.

The second review, looking at the leadership and governance at the trust, is being carried out by an internal NHS England team. A third review into the trust’s culture has been contracted to consultancy Korn Ferry.

The trust is one of the worst performing trusts in the country in terms of its waiting times for planned surgery, accounting for almost 10 per cent of waiting list. However the trust pointed out it has improved its performance in this area and is on track to hit NHS targets in march to eliminate the number of patients waiting more than 78 weeks.

Earlier this year in an exclusive interview, whistleblower and former consultant Tristen Reuser told The Independent that, when patient safety issues at the trust occur, “people are so afraid to speak up for fear of retribution that they don’t speak up”.

Mr Rueser launched an employment dispute with the trust in 2017 which eventually found he had been unfarily dismissed. The trust was later penalised by a judge for “unreasonable” behavior throughout the tribunal proceedings.

UHB’s former chief executive Dr David Rosser was also warned by the General Medical Council over misleading behavior during an employment tribunal against Mr Reuser.

The Independent also revealed the trust, which is a specialist transplant centre, has the worst five year survival rates for lung transplant patients in the country with rates 20 per cent lower than other centers. NHS commissioners had previously raised concerns to the trust about its survival rates, however it has since improved survival rates for 90 days and one year.

The Independent also revealed a review by training regulator Health Education England found obstetric and gynecology trainees at the trust were in “meltdown”. In a separate report the Royal College of Surgeons found “deep rooted” relationship problems between consultants within the neurosurgery department had put patients at risk.

In 2020 multiple whistleblowers came forward from the trust’s haemtology department, warning patients were coming to harm.

Last year the trust’s director repsonsible for internal whistblowing Julian Bion warned leaders staff who raise concerns “ feel that they have suffered detriment as a result, and would not be willing to speak up again.”

During an inquest into the death of young medic Vaish Kumar, who took her own life, her parents said she was “Belittled” while working at UHB. She is the second doctor to have taken their own lives after Dr Eduard Zigar was found in a hospital store room less than a week after he started working.

Preet Kaur Gill, MP for Birmingham Edgbaston told The Independent: “University Hospitals Birmingham Trust serves more than 2.2 million people. That’s why I was so concerned when more than 50 doctors, nurses and clinicians at the Trust contacted me raising their concerns about the poor patient care and ‘the toxic and Mafia-like culture’.

“Hospitals up and down the country are already facing tremendous pressures with unprecedented waiting lists. How can we expect our local NHS staff to tackle these burdens when they are working with a cloud of fear hanging over them?”

She wrote to the health secretary for support for an independent inquiry, and has set up a cross party group to scrutinse the upcoming reviews into the trust.

She added: “Staff should not be scared to raise genuine concerns about patient safety for the fear that they will be referred to the General Medical Council. Doctors and nurses must be allowed to work freely and in the best interest of the patient. It is the only way we will see improved patient care.”

A spokesperson for University Hospitals Birmingham said: “We are engaging with the Parliamentary Health Service Ombudsman to better understand the issues they have raised.

“The Trust does take these concerns seriously and is working to ensure a highly cooperative relationship by meeting regularly with PHSO representatives, so that we can put the best interests of our patients and staff first.”