‘Corrosive’ bullying culture at ‘toxic’ NHS trust could put patient care at risk, probe finds
A culture of bullying at one of England’s biggest NHS trusts could put the care of patients at risk, a report has found.
An independent review of the University Hospitals Birmingham NHS Trust (UHB) has found the number of patient deaths at the trust is higher than would be expected and has warned that “if the cultural environment at UHB has not already affected mortality it is likely to be affecting the patient experience and morbidity”.
The report revealed “extensive complaints” had been made by staff about the organisation’s conduct and that “many were concerned about the ‘toxic atmosphere and bullying at all levels of management'”.
It said the report team “heard many examples of concerning comments following a range of topics, including issues over promotion processes, bullying of staff (including junior doctors), and a fear of retribution if concerns were raised”.
It also highlights concerns around staffing levels. In November 2022, 13.35% of nursing posts at the trust were vacant, compared with an England average of 10%.
It warns that “any continuance of a culture that is corrosively affecting morale and in particular threatens long-term staff recruitment and retention will put at risk the care of patients”.
The report chaired by Professor Mike Bewick, a former deputy medical director at NHS England, who is now an independent consultant, was commissioned last year after a number of complaints were raised about the trust which employs 22,400 people across several sites and operates four major hospitals in the West Midlands.
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Father of junior doctor: ‘Our lives stopped on 22 June’
It followed the death by suicide of Dr Vaishnavi Kumar, 35, who was working at the Queen Elizabeth Hospital Birmingham when she took a fatal overdose in June of last year.
“She wrote a letter,” her father, Dr Ravi Kumar, told Sky News. “She very clearly mentioned that she was doing this because of the QE hospital.”
After taking the overdose she waited three hours to call an ambulance. Her father says that when paramedics arrived “she said under no circumstances was she going to the QE hospital”.
Dr Kumar says his daughter was “bright, fun-loving and compassionate” but things changed soon after she began working at the Queen Elizabeth Hospital.
Dr Vaishnavi Kumar took her own life in June 2022
“She started facing this toxic environment and she started getting a bit more worried and tearful,” he said, adding sometimes when she returned from work she would say “people are belittling her and demeaning her”.
The report found there was “considerable unrest and anger at the trust’s response” to Dr Kumar’s death, both from her family and “the wider junior doctor community”.
It also found that “this was not the first death by suicide of a doctor at UHB”.
It revealed there was “disappointment and anger” from staff at a lack of senior representation by the trust at Dr Kumar’s funeral, and that the trust only formally wrote to her family two months after her death.
Shockingly, the report found a senior member of staff within medical staffing was unaware of Dr Kumar’s death and emailed the medic personally 26 days after her death to ask why she had been removed from her post and if she was still being paid.
The report concluded the case showed a need for “a fundamental shift in the way an organisation demonstrably cares about its staff as people”.
Dr Kumar’s father said: “It makes me angry and at the same time worried about other junior doctors who are going to follow her.
“Our lives stopped on the 22 June and it’s very hard. Each day is a struggle.
“Now my main worry is to stop it happening to others and that is why I want to bring this forward so people realise that there is a toxic atmosphere.”
A spokesperson for University Hospitals Birmingham said: “Dr Vaishnavi Kumar was a much loved and respected doctor, who was popular with colleagues and patients alike. Her unexpected death was a tragedy and our heartfelt condolences remain with Vaishnavi’s family.
“We have reflected on our response to Vaishnavi’s death, have learnt lessons from this, and are acting on them.
“Dr Kumar wants his daughter’s death to result in improvements in the support offered to all doctors in training and to see a change in the culture of the trust. We are pleased that he has agreed to work with the trust on this.”
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Jonathan Brotherton, chief executive at University Hospitals Birmingham NHS Foundation Trust (UHB) said in response to the report’s findings: “Patients can continue to be confident that the care and treatment provided at our hospitals is safe. We are pleased that Professor Bewick’s overall view ‘is that the trust is a safe place to receive care’.
“We fully accept his recommendations and welcome the additional assurance that has been asked for through further independent oversight.
“There are a number of significant concerns that we need to, and have started to, address; we will continue to learn from the past, as we move forward.
“We want to develop a positive, inclusive work environment where people want to come to work, in a place that they are proud to work in, to do their very best for our patients. While we will not be able to fix things as quickly as I would like, we do need to do it as quickly as possible, for the benefit of patients and staff; I am committed to ensuring this happens.
“We must now focus on continuing to provide the best possible patient care, building a values-led culture and supporting our incredible colleagues.”
:: Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.
Prosecutions of sub postmasters by the Department for Work and Pensions could be “tainted” as Sky News reveals officials worked with now discredited Post Office investigators to secure convictions.
Around 100 prosecutions of Post Office staff were led by the Department for Work and Pensions (DWP) between 2001 and 2006.
It is understood that these usually involved the cashing in of stolen order books.
The Post Office itself wrongly prosecuted hundreds of sub-postmasters between 1999 and 2015 – based on evidence from the faulty Horizon accounting system.
The role of government
A Sky News investigation, however, has discovered that information was shared between Post Office investigation teams and the DWP.
Chair of the Justice Select Committee, Sir Robert Neill KC, said as a result DWP convictions “need to be looked at”.
“I hadn’t been aware of that, for example, there may have been material in the DWP case as a result of joint investigations – which suggests a disclosure failure,” he added.
“I think that’s the area they need to look at if we are saying their approach was tainted from the beginning – in the way the investigators adopted things – then joint operations I suspect would be just as tainted arguably as something where it has been the Post Office on its own.”
What was known?
A 2003 DWP report into fraud describes “joint working” and the “sharing of information” with the Post Office.
It also outlines a “Fraud Prevention Board” established by the DWP and Royal Mail Group plc which includes “the exchange of information that directly assists fraud prevention and investigations”.
In addition, separately, a 2003 letter seen by Sky News also indicates a connection between DWP and Post Office investigations.
The letter, from the then post affairs minister Stephen Timms, references the case of Roger Allen, a sub-postmaster from Norwich.
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It states: “Subsequent investigations by the police, the Post Office Investigation Department and the Department for Work and Pensions (DWP) led to a prosecution by DWP…”
Roger Allen was convicted in 2004 of stealing pension payments and was sentenced to six months in prison. He died in March of this year.
Mr Allen had pleaded guilty to spare his wife – after his lawyer told him in a letter that there had been “an indication from the Crown that they may discontinue the proceedings against Mrs Allen were you minded to plead guilty”.
Despite the Criminal Cases Review Commission deciding Mr Allen had grounds to appeal against his conviction – it was upheld by the Court of Appeal in 2021.
DWP prosecutions are not covered in upcoming government legislation that will overturn Post Office convictions.
Roger Allen. Pic: Keren Simpson
Fighting to clear names
Keren Simpson, Roger’s daughter, has vowed to fight to clear his name posthumously.
She describes her father as a “proud” and “honest” man who “couldn’t face or deal” with the fact his conviction would not be overturned.
She says “in the end he obviously gave up” and there is “very little surviving evidence” because of the passage of time.
“He’s the innocent one,” Keren states. “I don’t see why he’s got to try and prove it. They have got to try and prove it, and show what evidence they actually had on my dad.
“Because the Department of Work and Pensions have put a statement out saying there was surveillance and witness testimonies and physical evidence to show it.
“Show me it.”
Roger Allen. Pic: Keren Simpson
Investigation failures?
Sky News has also seen documents that suggest failures by DWP investigators in a different case in the 2000s.
It involved a sub-postmaster who decided to plead not guilty and was acquitted of stealing by a jury.
In one extract it says a “senior investigating officer” was “willing to admit in open court that (they) had been neglectful in (their) duty in securing evidence”.
Another document appears to show a failure to review transaction logs used as evidence against the sub-postmaster.
Some logs appear to show that the accused did not cash the “dockets”, used to collect pension payments.
Other transaction logs indicate the sub-postmaster was not present at a particular branch when the theft was alleged to have occurred.
Christopher Head
Chris Head, former sub-postmaster and a campaigner for others, has also seen the documents and says they point to a “deeply flawed” DWP investigation.
“…they failed to obtain all transaction logs for the entirety of this case, but the ones that they have, they have they clearly haven’t looked at.”
He believes there are “more cases out there” which could be “part of a miscarriage of justice”.
A Department for Work and Pensions spokesperson said: “We do not recognise these claims.
“DWP investigates offences against the welfare system to protect taxpayers’ money, and between 2001 and 2006 a small number of Post Office staff were convicted for welfare-related fraud.
“These cases involved complex investigations and were backed by evidence including filmed surveillance, stolen benefit books and witness statements – they did not rely on Horizon evidence, and this has been accepted by the Court of Appeal.”
The Post Office says it “continues to help other prosecuting authorities to ensure that they have every assistance in taking their work forward”.
“This includes sharing all the information we have in relation to prosecutions which have been brought by other prosecutors.”
Meanwhile, Lord Sikka has tabled an amendment in the House of Lords to the Post Office (Horizon System) Offences Bill to include all DWP convictions.
An outbreak of a waterborne disease in Devon has prompted urgent warnings for residents to boil their tap water.
At least 22 cases of cryptosporidiosis disease have been confirmed in and around the town of Brixham in South West England.
But what is the parasite that is making people sick, what are the symptoms of being infected with it and how serious can it be?
What is cryptosporidiosis disease?
Cryptosporidiosis is the disease caused by the parasite cryptosporidium.
Often shortened to crypto, infections can be caused by drinking contaminated water or swallowing contaminated water in swimming pools or streams.
It can also be acquired through contact with the faeces of infected animals or humans.
What are the symptoms?
The symptoms of cryptosporidiosis include:
• profuse watery diarrhoea
• stomach pains
• nausea or vomiting
• low-grade fever
• loss of appetite
How long does it last?
Most people develop symptoms within one to 12 days of picking up the parasite.
Symptoms usually last for about two weeks, but can last up to six weeks or longer when the immune system is not working properly.
During the illness, you might think you are getting better but the illness returns a couple of days later before you fully recover.
How serious is it?
Most people recover, but in people with severely weakened immune systems it can cause severe disease and can be fatal.
Serious cases and death used to be more common, according to Paul Hunter, professor in medicine at the University of East Anglia (UEA).
This is because before effective antiretroviral treatments were introduced for HIV/AIDS, people living with these illnesses would not recover if they picked up cryptosporidiosis.
Who is most at risk of serious illness?
People with weak immune systems are at greater risk of serious illness. This includes:
• people on some immunosuppressive drugs, for example cancer or transplant patients
• people with untreated HIV/AIDS
• malnourished children
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Residents ‘worried’ over water parasite
Does it need treatment?
There is no specific treatment for cryptosporidiosis.
It important to drink plenty of fluids as diarrhoea or vomiting can lead to dehydration, according to advice from the UK Health Security Agency (UKHSA).
You might also want to talk to a pharmacist about oral rehydration sachets to help replace the sugar, salts and minerals the body has lost.
Dr Lincoln Sargeant, Torbay’s Director of Public Health, said anyone with “severe symptoms like bloody diarrhoea” should contact NHS 111 or their GP.
Severe cases may require hospital treatment.
How do you know if you have crypto?
The symptoms of crypto are similar to other stomach bugs, so the only way to know for sure if you have it is for your doctor to send a sample of your faeces to be tested in a laboratory.
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How can you stop the illness spreading?
If you are ill, stay away from nursery, school or work while you have symptoms, and for at least 48 hours after they stop.
You should also avoid swimming for two weeks after being unwell.
You should not prepare food for anyone else until 48 hours after diarrhoea has stopped.
Make sure you’re using good handwashing practices too, washing your hands thoroughly when handling food and after using the toilet.
The UKHSA also advises washing bedding and towels on the hottest possible cycle.
UK
Lucy Letby: Families of victims want inquiry live streamed to stop ‘grossly offensive’ conspiracy theories
The inquiry into how nurse Lucy Letby was able to murder babies at a hospital in Chester will begin to hear evidence in September.
Lawyers for the families of Letby’s victims told a preliminary hearing that the inquiry should be live streamed to the public to prevent the spread of “grossly offensive” conspiracy theories.
Letby was sentenced to 14 whole-life orders after she was convicted of murdering seven babies and attempting to murder six others while working on the neo-natal unit at the Countess of Chester Hospital in 2015 and 2016.
At the preliminary hearing, inquiry chair Lady Justice Thirlwall heard submissions on whether the hearings should be publicly broadcast.
Peter Skelton KC, on behalf of the families of six babies, said Letby’s crimes continued to be the subject of conspiracy theories online.
“One of the most effective antidotes to those theories and the damage they cause will be to see and to hear the people involved in the hospital give a true and comprehensive account of the facts,” he said.
But Andrew Kennedy KC, representing the Countess of Chester, said there was a “high level of anxiety” from staff at the prospect of giving evidence which was live streamed.
He said: “If a witness is concerned about live-streaming then if we can remove that concern we can, we would suggest, encourage candour, frankness and openness.”
Letby was given multiple whole-life terms and will be re-tried on one charge next month
Richard Baker KC, representing some of the other families, said: “Their desire in this case is for change and so that others do not experience what they have experienced.”
They were “saddened” and “concerned” at the suggestion the lack of transparency might continue, he said.
Lady Justice Thirlwall will give her decision on whether the hearings will be broadcast at a later date.
She had begun the proceedings with a pause for reflection on the “lives lost”, “injuries sustained” and “suffering” of the families.
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The hearing was told 188 requests for information had been made to individuals including midwives, nurses, doctors, managers and members of the hospital board.
The inquiry hearings are scheduled to begin on 10 September at Liverpool Town Hall.
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The parents of the babies will be among the first to give evidence.
Counsel to the inquiry Rachel Langdale KC told the hearing: “There are no sides. It is a search for the truth.”
Last month Letby asked the Court of Appeal for permission to mount a full legal challenge to her conviction. Judges are due to rule on this at a later date.
The former nurse is due to face a re-trial next month on one charge of the attempted murder of a baby in February 2016.
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