NHS trust admits safety failings over patient death

The trust pleaded guilty to failing to ensure the safety of 66-year-old Gillian Astbury, who lapsed into a fatal diabetic coma while being treated at Stafford Hospital in April 2007.

The case is being referred to Stafford crown court because of its seriousness, and the trust – which is in administration and running an annual operating deficit of around £11m – faces an unlimited fine.

It admitted to breaching the law by failing to properly manage and organise hospital services, including its systems for record-keeping, patient information and communication between staff members.

Systemic failure

The criminal prosecution at Stafford magistrates’ court was brought by the Health and Safety Executive (HSE) three years after an inquest jury ruled that Mrs Astbury’s death was contributed to by low staffing levels and a systemic failure to provide adequate nursing facilities.

The inquest also concluded that a failure to administer insulin amounted to a gross failure to provide basic care.

Mrs Astbury, from Hednesford, Staffordshire, pictured above, died while being treated for fractures to her arm and pelvis.

Public inquiry

Stafford hospital has previously been the subject of several highly critical reports, including a full public inquiry, which identified “routine” neglect of patients between 2005 and 2009.

The trust, which admitted one count of failing to discharge its duties under safety laws, wanted the case dealt with by magistrates, but the HSE said the “grave” matters should be considered by a crown court judge.

Bernard Thorogood, prosecuting, said Mrs Astbury’s carer, Ron Street, had clearly instructed medical staff that she had diabetes at the start of her ten-day hospital stay.

‘Highest level of gravity’

Arguing for the case should be sent to the crown court, Mr Thorogood told magistrates: “Mrs Astbury came into hospital for care and as a direct result of the defendant’s failings, she died.

“The harm caused is of the highest level of gravity – the loss of a life. This is the only criminal case to have been brought in connection with the problems which everybody nationally knows about at the trust.

“There is a public interest in such a sensitive and important matter being dealt with at the most senior level within the criminal jurisdiction.”

Ruling that the maximum fine of £20,000 that they could impose would be insufficient punishment for the offence, magistrates committed the case to the crown court.

In the final days of Mrs Astbury’s life, some hospital staff failed to make adequate records and conduct hand-overs properly, and she was not given insulin.

David Lewis, representing the trust, said the organisation wished to place on record that it was “very sorry” for the loss, pain and distress caused by its actions.