Hospital bosses say they are taking action to address serious concerns raised by Noble’s consultants about standards of care for acutely ill patients.
Meanwhile, an independent working party, set up to consider the recommendations of the inquiry into the Mid-Staffordshire NHS Trust scandal, is considering an anonymous letter distributed to Tynwald members last month which claims problems at Noble’s bear many similarities to the Mid Staffordshire crisis.
It refers to a letter sent six months ago to medical director Stephen Upsdell signed by 10 named consultants - and now leaked to the Examiner - which called for urgent action to review services in light of their increasing concerns at ‘shortcomings in the management of acutely unwell patients presenting to the hospital’.
That letter adds: ‘We feel that these are not isolated incidents but instead represent a continuing trend we have all observed. Attempts to raise concerns about poor practice and systems failures are not, we feel, taken sufficiently seriously by the hospital management.
‘This is a cause of considerable professional anxiety and frustration, with serious consequences for patients.’
Hospital manager Barbara Scott said the concerns raised were being taken seriously and an action plan was being developed that would lead to possible significant changes to systems and processes.
‘We were so shocked when we got that letter,’ she said. ‘It came out of the blue.’
A number of the consultants had withdrawn their support for the letter immediately, she added.
She denied there was comparison with the situation at Mid-Staffs – and she claimed the anonymous letter contained significant inaccuracies.
She added: ‘We can always do better. I want people to feel comfortable and able to raise any concerns they have. They will be listened to, their concerns taken on board and action taken.’
The anonymous letter sent to MHKs and MLCs claims there has been ‘absolutely no meaningful or definitive action’ taken by hospital management or the Department of Health since the consultants put their concerns in writing.
That letter, also seen by the Isle of Man Examiner, urges Health Minister David Anderson and chief executive David Killip to ‘take full responsibility for the current state of Noble’s Hospital, which at present bears many similarities to Mid Staffs, particularly regarding the style of management’.
It alleges patient safety is regularly put at risk by understaffing on the wards, staff are actively discouraged from reporting incidents and the Air Ambulance service is in ‘complete disarray’.
It says people would be horrified to learn that there was not round the clock qualified anaesthetic assistance available for expectant mothers and emergency patients. This is a ‘grave cause for concern’ which had the potential to lead to the death of a mother and her unborn child, says the author.
But hospital manager Ms Scott insisted there was no neglect of patients at her hospital, mortality ratios were in line with the UK average and numbers of complaints were slightly lower than the UK average.
She insisted that understaffing on wards was not an issue generally. The case for a consultant lead trauma team was being looked at, she explained. The hospital does have a trauma team during TT, she pointed out and it was a question of whether it was necessary and relevant to operate one year-round.
Asked if there were problems with the Air Ambulance, Ms Scott replied: ‘None whatsoever. The service is working extremely well.’
She said that any members of clinical staff could log an incident report with the hospital’s PRISM system which would be investigated. ‘We can’t stop people putting a complaint on PRISM. It’s open and anybody with access to the system can see it.’
She said number of incidents remained fairly static. ‘There’s no massive unexpected peak,’ she said.
Ms Scott said the hospital does not have a resident operating department assistant working with an anaesthetist and instead ODAs are on-call. She confirmed that Noble’s had not been complying with the changed guidelines on this due to lack of resources although patient care had not been affected.
She said headcount had not been found to support a full-time ODA working on site round the clock.
The hospital managers said the author of the letter was wrong to hide behind anonymity. ‘It contains sigificant inaccuracies. They have not got their facts right, If people are going to raise concerns and they’ve got evidence we need to be able to talk to them.’
Liberal Vannin has called for an external independent audit of Noble’s Hospital.
Douglas South Lib Van MHK Kate Beecroft said: ‘I do not understand why the department has been dragging its heels. I applaud the writer of this anonymous letter for bringing the issues detailed to the attention of all MHKs and I hope that this courage will be rewarded by the Health Minister finally taking appropriate action.’
Mike Coleman MLC will be the independent chair of the working group set up to respond to the 18 recommendations of the Francis Report into the scandal at Mid-Staffs where as many as 1,200 patients lost their lives as the result of appalling care.
Health Minister David Anderson said the working group will identify those recommendations of Francis that apply to the Manx NHS and prioritise any areas that require further work.