Hospital boss praised by Matt Hancock told to end ‘toxic management culture’

  • 9/11/2020
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A hospital boss championed by Matt Hancock has been told to end “a toxic management culture” after doctors were asked to provide fingerprint samples to identify a whistleblower. The Royal College of Anaesthetists (RCoA) has urged the chief executive of West Suffolk hospital, Steve Dunn, who Hancock described as an “outstanding leader”, to take urgent action to improve the wellbeing of senior clinicians and “thereby the safety of patients”. In a strongly worded letter sent to Dunn in July, seen by the Guardian, the RCoA president, Prof Ravi Mahajan, reminded him that “undermining and bullying behaviour is unacceptable”. Following a three-day review of the hospital, Prof Mahajan’s letter said senior anaesthetists had complained about a “toxic management culture that risks impairing their ability to care safely for patients”. It comes after the Guardian revealed an unprecedented “witch-hunt” for a whistleblower who had tipped off a family about a potentially botched operation. The family of Susan Warby, who died five weeks after an operation in August 2018, was sent an anonymous letter highlighting errors in her procedure. This week a coroner concluded that errors in her care contributed to her death. After the anonymous tip-off, staff complained of harassment by hospital managers, who demanded they provide fingerprints to identify which of them had alerted the family. The incident, and other failings in patient safety, contributed to the hospital becoming the first ever to be relegated by Care Quality Commission (CQC) inspectors from “outstanding” to “requires improvement” in January. Prof Mahajan’s letter to Dunn said the RCoA’s concerns about the trust were “reinforced not only by press coverage and a recent CQC report, but – more significantly – by confidential information given to the college by clinicians in your hospital”. Weeks before Warby’s operation, Patricia Mills, a consultant anaesthetist at the trust, had raised alarm internally about patient safety over a doctor who had been seen injecting himself with drugs. As the same doctor was involved in Warby’s care, Mills was immediately suspected by managers of alerting her family to the errors. Mills has consistently denied this. But managers demanded that senior staff, including Mills, provide fingerprint and handwriting samples in an attempt to identify the writer of the letter. The trust was criticised for its tactics by regulators and promised in January that it had “no intention of pursuing fingerprint requests further”. But Mills still faces disciplinary action by the trust for refusing to provide her fingerprints. Prof Mahajan’s letter did not mention Mills by name, but alluded to her treatment her after she raised concerns about the drug-taking doctor. It said: “I write to seek your personal assurance that action has been taken to ensure the wellbeing of anaesthetists, and thereby the safety of their patients, is being held as a key focus point by trust management … The college asks that senior management reflects upon previous behaviour and demonstrates a commitment to improving the management approach and morale of staff.” The RCoA removed West Suffolk hospital, which treats many of Hancock’s constituents, from its voluntary list of accredited hospitals. It also shared its inspection report with the CQC. Dunn and Hancock both described each other as “brilliant” in a Twitter exchange in December 2018 after Dunn was awarded a CBE for services to “services to health and patient safety”. In January the government ordered a rapid review of West Suffolk, which Matt Hancock recused himself from because of his ties to Dunn. It had been due to conclude in April, but has been delayed until December because of the coronavirus crisis. In March the British Medical Association urged the trust to drop its disciplinary action against Mills. In a letter to the trust, it said: “West Suffolk Hospital does not need to wait for the recommendations of a rapid review in order to bring Patricia’s process to a close.” It added: “There is strong evidence to support a clear link between Patricia raising patient safety concerns … within the trust’s whistleblowing policy and being subsequently investigated … these actions are at odds with the principles of a ‘just culture’ that is a guiding philosophy for NHS employers.” A spokesman for the trust said: “Ensuring our colleagues work in a supportive, safe environment is good for our staff and means better patient care, which is why we have done extensive work this year to act on feedback about our working culture, including taking action to address the concerns raised by the Royal College of Anaesthetists.” It said it could not discuss issues about individual members of staff.

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