26 Feb 2014

Jeremy Hunt breaks up Mid Staffs Foundation Trust

When the special administrators were sent in to run Mid-Staffordshire NHS Foundation Trust – or Mid-Staffs as everyone calls it – they found it “both clinically and financially unsustainable”. It was, to put it mildly, in a bit of a mess.

So they recommended to Health Secretary Jeremy Hunt a plan that means the first-ever break up of a foundation trust.

In the inimitable world of the NHS, this did not mean the wholesale closure of the trust, which is based on two sites in Stafford and Cannock.

Pre News refresh player – this is the default player for the C4 news site – please do not delete. Ziad

Instead, the proposal by the administrators was a downgrading of maternity services.

A midwife-led unit would stay at Stafford and the more complicated births would happen at University Hospital of North Staffordshire NHS Trust (UHNS), 17 miles away.

Today Health Secretary Jeremy Hunt said there would be a review by NHS England to determine whether Stafford could retain consultant-led services capable of handling more difficult births.

There will be a paediatric assessment unit run in conjunction with the 14-hour a day A&E unit. Sicker children, needing overnight stays will be sent to the UHNS.

The critical care unit would allow patients to be treated at Stafford but only if necessary staff were in place.

And Stafford Hospital will be run by UHNS while Cannock will be operated by Royal Wolverhampton NHS Trust.

Read more on Mid Staffs from Channel 4 News

Legal challenge

All of this is expected to start happening by next autumn, if there is no legal challenge. But that may well happen. Not for the hospital to remain as it currently stands – not even its supporters think that is a viable option – but if they believe that the plans will leave the town and, more importantly, patients, without a safe health service, then they will take legal action.

Although Mid-Staffs has now become a byword for neglectful, inhumane care, its failure goes back well beyond the scandal which led to the Francis inquiries.

It had struggled financially for years, with management under constant pressure to balance the books. Even now there are questions over why it was ever allowed to become a foundation trust.

But then came the stories over the sheer scale of this neglect, this appalling treatment of patients. The first Francis inquiry heard from relatives describing how their loved ones were left unfed, without water, lying in their own faeces.

There is absolutely no basis for the claims that 1,200 more patients died than would have been expected.

That was a figure made up by a newspaper extrapolating from a figure in the Healthcare Commission report. It does not appear in either of the Francis inquiry reports.

Appalling care

Nevertheless, patients did die – possibly hundreds – sooner than they might have. And their care was appalling. Julie Bailey, who spearheaded the campaign after her mother died, has spoken and written eloquently about the conditions on some of the wards, about the uncaring attitude of some of the staff and of the management and trust boards refusal to deal with it.

All the evidence presented to the Francis inquiries in 2010 and then the second report published last year, shows that the trust was desperately understaffed. It was struggling on a whole number of levels.

Even now we are waiting to hear how large the fine will be after the trust pleaded guilty to failing to ensure the safety of 66-year-old Gillian Astbury, who died after lapsing into a diabetic coma. The criminal prosecution was brought by the health and safety executive, three years after an inquest had ruled low staffing levels and a systemic failure to provide adequate nursing facilities contributed to her death.

And so to the present day. The administrators said that the quality of care had improved significantly from this low point between 2005 and 2009. But it was still experiencing difficulty in hiring and retaining staff and was too small to keep up with all the clinical changes and guidelines expected of a modern-day foundation trust.

It is hardly a surprise.

Its reputation was so comprehensively trashed it was always going to find it difficult to lure new staff to work there. It is also still running an £11m operating deficit. Turning it around and making it work, is no longer an option.

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