Cash crisis in NHS leaves patients lying on operating tables
A cash crisis in the NHS has left patients lying on the operating table before doctors realised vital equipment had not been ordered, according to a leaked report
Women in labour have been forced to wait while epidural equipment was borrowed from other hospitals, while other patients have been denied chest drains and radiology supplies, according to doctors at South London Healthcare Trust.
Minutes of a meeting between medical staff and the trust’s chief executive say “cash flow” problems at the trust which has a £50 million deficit, mean vital equipment is regularly not ordered.
A separate letter sent to managers of the trust, one of the largest in the country, says consultants have been misled into carrying out operations when it was not safe to go ahead because of bed shortages.
NHS watchdog the Care Quality Commission (CQC) has been asked to investigate the concerns, after eight doctors contacted their local MP.
Staff at the NHS trust, which last year merged trusts running three hospitals in South London and Kent, are being asked to make major savings to tackle a worsening financial situation.
Minutes of a meeting of the medical staff committee of Princess Royal University Hospital in Bromley say managers acknowledged that “crude measures” introduced to cut spending had affected clinical supplies, meaning that stocks had run out when they were needed.
The document records: “The trust in different areas had run out of under water sealed chest drains, epidural packs, gynaecological disposables, radiological disposables, and the response to this was 'this was a cash flow issue’”.
Doctors told managers “again and again” that consultants were unable to know that equipment was missing until the last item had been used, when their patient was already lying on the table, according to the minutes of June 16 meeting.
The document states that Chris Streather, the trust’s chief executive said the situation had improved to the extent that the trust could now pay some of its bills, but that he could not promise that the problem would not recur.
It describes “significant risks” to patient safety because of shortages of beds, and “chaotic” failures dealing with such crises at the trust, which also runs Queen Mary’s Hospital in Sidcup, in Kent, and Queen Elizabeth Hospital in Woolwich, London, and NHS units in Orpington and Beckenham, in Kent. Patients affected include a woman who had undergone major cancer surgery who could not be found a bed.
A separate letter sent from a senior consultant to trust managers describes shortages of fracture equipment, ventilation masks and endoscopic cameras used to diagnose cancer.
It says doctors fear that the trust’s hospitals will be left “in the same situation as Mid Staffs” where hundreds of patients died amid failings in basic care.
James Brokenshire, Conservative MP for Old Bexley and Sidcup, contacted the CQC after eight clinicians told him they feared patients were being put at risk, but were afraid of the repercussions if they were named.
The junior home office minister met the trust’s chief executive last month, who said the issues were being addressed, but Mr Brokenshire remained so concerned that he asked regulators to investigate the concerns.
Mr Brokenshire said: “It is not often that you get a group of clinicians making a representation like this, and the issues were sufficiently concerning that while there was no reason to question what the trust said, I felt it was appropriate to make a formal reference to the CQC, to highlight the concerns and give some external assurance.
"I don’t want to cause unnecessary alarm, but I think it is important that an external body examines this.”
The CQC said the trust was already one of several under “close scrutiny” meaning it underwent more regular unannounced inspections.
In April it was told to improve its reporting of serious untoward incidents, supervision of its maternity services and increase the number of staff working on patient safety.
The trust is not currently under investigation, but a CQC spokesman said the concerns passed on by the MP were being examined.
Peter Walsh, chief executive of charity Action against Medical Accidents expressed concern at the risks to which patients had been exposed.
He said: “The sorts of circumstances being described here are deeply concerning; what worries me is that we will see more and more of this in the current economic crisis, when the NHS is trying to make cuts. We have to find a way to ensure that the safety of patients always trumps attempts at efficiency”.
A trust spokesman said the organisation was making progress since the hospitals had merged but faced many challenges, and that some staff were “uncomfortable” with the scale of changes being made.
He said: “Some consultants at the trust have raised concerns recently about the ordering and shortage of some medical supplies. We accept this concern and following a recent meeting, our medical director took up the specific issues about procurement and found that there were some technical problems with the ordering of equipment which were identified and have now been resolved.
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