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The Healthcare Commission today (Thursday) said that Mid Staffordshire NHS Foundation Trust had responded positively to concerns that the Commission had raised about the safety of patients in Stafford Hospital’s accident and emergency department (A&E).

The trust has improved medical staffing levels and increased the numbers of nurses in A&E, the Commission said.

But further recruitment is required for staffing to reach the levels recommended by the College of Emergency Medicine and to reduce reliance on temporary and junior staff.

Last March, the Commission launched an investigation into Mid Staffordshire NHS Foundation Trust, which is still ongoing.

Investigators are looking into concerns about the trust’s mortality rate, as well as concerns about poor nursing care.

When carrying out an investigation, the Commission always raises issues that represent a serious risk to the safety of patients straight away to ensure that they are addressed as quickly as possible.

In May, Commission representatives met with the trust and outlined serious concerns about the A&E Department at Stafford Hospital. These were about low staffing levels in relation to medical and nursing staff, poor leadership, the structure and operation of the department, and the governance arrangements to ensure the quality of care and protect the safety of patients.

The Commission wrote to the trust detailing its concerns and asking for immediate action to address the issues.

The trust responded rapidly to the concerns and developed an action plan. This included seeking expert advice from neighbouring hospitals and reviewing its model of care in A&E.

The Commission has been in close contact with the trust to monitor progress, including a visit on the 9, 10 and 11 September. The Commission found that senior doctor (consultant) cover in A&E had increased to two and a half whole-time equivalents – up from one person in May. Investigators also noted that the trust is currently recruiting further consultants in conjunction with the University Hospital of North Staffordshire NHS Trust. The recommended level of cover by the College of Emergency Medicine for a department of this size is four.

The number of middle grade doctors had also increased from four to eight whole-time equivalents. The level recommended by the College of Emergency Medicine is nine.

The Commission says it is fundamentally important to have adequate medical staff to make sure patients are safe and get a good standard of care. Bolstering levels of mid-grade doctors also helps support junior doctors.

The Commission also expressed concerns in May that there were too few nurses in A&E and no leader with clear accountability for nursing. The trust has taken these issues seriously and has responded by employing a matron and increasing the numbers of nurses in A&E.

Nigel Ellis, Head of Investigations at the Commission, said: “Clearly, in any investigation, it is critical that matters that represent an immediate risk to patients are dealt with straight away. The trust has taken positive steps to bring staffing levels in A&E up to acceptable levels. It has heard our immediate concerns and taken action.

”The trust now needs to make sure that it maintains appropriate staffing levels in all areas. For our part, we will be continuing our thorough investigation and will be publishing a full report in due course”.

The investigation is ongoing and will continue to look at other aspects of emergency care, including the care and treatment provided on wards that take patients admitted as emergencies. Further interviews, observations of patient care and case note reviews will be carried out.

The Commission expects to publish its findings early in the New Year.


Notes to editors

Information on the Healthcare Commission
The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.

Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.

The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.

For further information contact Sarah Robertson in the press office on 020 7448 9313, or on 07917 232 143 after hours.