SaTH: Not Fit for Purpose

That’s the only possible view of the leadership of Shrewsbury and Telford Hospitals Trust following the farce of a Board meeting yesterday.

In the midst of overwhelming crisis, the Board had a brilliant plan: ‘Let’s ignore it’. The periodic injections of reality came from the many members of the public present, and from the one honourable Non-Executive Director who did a decent and principled job of challenging the positive spin.

The horrors of unsafe care exposed by hospital inspectors were touched on (momentarily) by Chief Executive Simon Wright. The Trust “will work closely with the CQC and ensure that we can evidence the learning and evidence those things where there may have been confusion”. Not a mention there of staff telling inspectors of unsafe and degrading care; of patients treated like ‘animals’ and ‘cattle’; of inspectors repeatedly going to the aid of patients because there weren’t enough staff. Members of the public expressed horror that staff have to speak to hospital inspectors about unsafe care because they don’t trust internal reporting mechanisms. There’s no evidence the Trust Board is too bothered about this.

One section of the meeting dealt with maternity. Every single person in the room will have known of the terrible emerging scandal of avoidable deaths or serious harm to babies in SaTH’s care. It was the lead item on the BBC news that morning. This is set to be one of those rare and terrible events in the NHS that no one ever forgets; a crisis on a par with that at Mid-Staffordshire a few years ago.

Left to their own devices, the Board probably wouldn’t have mentioned it. Instead, they would have heard a bland report on a smaller number of ‘legacy cases’. Reality was brought crashing into the room by Richard Stanton, father of Kate Stanton Davies who died in 2009. Richard and his partner Rhiannon have done more than anyone to expose what has gone wrong in SaTH’s maternity service and to get things put right. Chair Ben Reid refused to let him speak. Chief Executive Simon Wright spoke over him. Director of Nursing and Midwifery Deirdre Fowler was instructed by Ben Reid to ignore him and give her report; she too spoke over him. The disrespect and lack of empathy were shocking.

Richard was allowed to speak only after members of the public resorted to shouting and a chant of “Let him speak, let him speak” – and when he did speak, he outlined the lack of openness and transparency, and the information on safety risks in maternity withheld from last week’s Council meeting (the ‘Joint HOSC’). He highlighted the latest CQC enforcement notice – and asked why, so long after Kate’s death, the lessons still had not been learned.

It was a brave and powerful contribution – but why does it fall to a bereaved parent to force the Board to understand what is happening in their services?

And when it came to the plans for overnight closure of the A&E in Telford, there was no actual sense that most Board members had read or understood the paper. (And if they had, how could they have agreed to something so stupid?). The Board agreed to Telford becoming a healthcare desert overnight. A&E will close from 8pm. Urgent care will continue to close at 8pm, as it does now. Shropdoc is being devastated by cuts, so won’t be filling those gaps.

One member of the public accurately described these as ‘back of a fag packet’ plans. Ambulances will be diverted to other hospitals, particularly to Wolverhampton, but also to Stoke, Birmingham and perhaps to Wrexham. The diversions will include some patients from Powys and from the South and West of Shropshire. Health bosses don’t know if the ambulance services have the capacity, they don’t know if there’s money for more ambulances, they don’t know if all these other hospitals can take extra patients – and they don’t know if displaced patients will be safe. No matter. Agree it, and sort the detail later.

Another layer of patients, people who manage to get themselves to A&E, will have to travel to Shrewsbury instead of Telford’s Princess Royal. Does the Royal Shrewsbury have the A&E capacity or the hospital beds to treat extra patients? Of course not. There is also a frightening lack of clarity about what will happen to sick children with arbitrary changes made between the report issued on Wednesday evening and the verbal explanation given on Thursday afternoon. Our hospital ‘leaders’ are people who don’t know what they doing – and they can’t be trusted with our health.

There are two messages, then, from Thursday’s Board meeting. As members of the public, WE have to safeguard the NHS. The people who run it will not. In particular, we have a sharp fight ahead for our A&E in Telford. And there’s a second message. The Board is not fit to lead. There are two people in particular who should be considering their positions. Chief Executive Simon Wright and Medical Director Edwin Borman have a professional responsibility to safeguard patient safety. They have failed in that. They should resign.