'Special measures' for hospital where baby was left in cupboard due to 'unsafe' A&E units

 
Sareena Ali: Died along with her unborn baby in January 2011
Sareena Ali who died giving birth along with her newborn baby pictured with husband Usman Javed. Picture taken from Facebook profile page with permission from family.
18 December 2013

The hospital trust where a baby was left in a cupboard was placed in special measures today after its A&E units were found to be providing “unsafe care”.

Queen’s in Romford and King George in Ilford are now the only London hospitals unable to run their own affairs, after failing to address repeated warnings over patient safety.

Averil Dongworth, chief executive of Barking, Havering and Redbridge University Hospitals trust, confirmed she would stand down in March after a troubled three-year reign blighted by maternity deaths and casualty units with the longest delays in the capital.

A report by the Care Quality Commission, published today following an investigation in October, said: “The A&E departments at both hospitals are at times unsafe because of the lack of full-time consultants and middle-grade doctors.”

It added there was an “over-reliance on locum doctors” and “long waiting times” for patients to be assessed by specialists. Last week the trust failed to treat almost 15 per cent of its 4,650 casualty patients within the four-hour target — three times the maximum five per cent allowed by the Government.

Professor Sir Mike Richards, the Chief Inspector of Hospitals, said it was “very disappointing” that improvements in maternity care at Queen’s had not been replicated across the trust. He added: “The long-standing issues in the two A&E departments are clearly affecting patients — and all attempts to address these problems over the last few years have had insufficient impact.

“While we understand that this trust serves a large and diverse population and that the leadership team is trying to resolve the issues, it’s clear to us the trust is unable to do so without help.”

The NHS Trust Development Authority ordered Barking, Havering and Red-bridge to appoint an “improvement director” urgently and publish an im- provement plan. It vowed to take “every necessary action” to raise standards.

But Margaret Hodge, Barking’s Labour MP, said a radical approach was needed after years of sub-standard care. She told the Standard: “Officials have consistently failed to come up with an answer that will bring about the sustained improvements we so desperately need. Their only response is to put the trust into special measures and I just do not think that is sufficiently radical enough to tackle the entrenched cultural problems across these two hospitals.”

Queen’s is one of London’s busiest A&Es and receives more 999 ambulances than any other hospital in the capital. But it and King George — whose casualty department is set to close at night from 2015 — have long struggled to recruit A&E consultants and other senior staff.

Last month midwife Yvonne Musonda-Malata, 35, was given a three-year caution by the Nursing and Midwifery Council for leaving a four-day-old baby face down in a cot in a cupboard while she worked a night shift at Queen’s.

Figures reported by the Standard revealed that Barking, Havering and Redbridge had paid more than £23 million for maternity blunders in five years, including when five women died over an 18-month period.

Victims included Sareena Ali and her unborn child Zainab, who died in 2011 after staff failed to identify a ruptured womb, and Violet Stephens, who died the same year after delays in giving birth and having a blood transfusion.

The CQC inspection was carried out after the trust was identified as “potentially high risk”. The CQC said that while trust bosses were aware of many issues raised over safety and care, attempts to address them had “insufficient impact”. It called for improvements in patient movement within the hospitals, better infection control and better planning for discharge of patients.

But it found good practice, including care for stroke patients, the positive attitude of many staff and a system that allowed patients to receive care at home. Ms Dongworth insisted the hospitals were “performing well in many areas” and it was “business as usual”.

She said: “Today’s decision provides the opportunity for the whole health system to come together to give our hospitals the level of support that we have been asking for.”

The patients who lost their lives

Sareena Ali: Died along with her unborn baby in January 2011
Sareena Ali who died giving birth along with her newborn baby pictured with husband Usman Javed. Picture taken from Facebook profile page with permission from family.

QUEEN’S Hospital was at the centre of controversy last Christmas when a woman discharged from its A&E died a day later.

Della Callagher, 46, contracted food poisoning after a Christmas Day pub lunch and was admitted to the casualty department the following day.

Her husband John said she was given an anti-sickness injection and sent home. But her condition deteriorated and an ambulance was called and she was readmitted. However she failed to recover and died the following day.

An inquest has yet to be held. Despite Mr Callagher’s belief it was an “avoidable tragedy”, the hospital maintains it did nothing wrong and “followed all nationally-agreed processes”.

While the trust’s A&E departments have battled with long delays and staff shortages, it is a series of disastrous maternity blunders at Queen’s that has blighted its reputation. Maria de Jesus, 33, miscarried and died in November 2011 after doctors removed one of her ovaries rather than her appendix.

Sareena Ali and her unborn baby died in January 2011 after staff failed to identify that she had a ruptured womb which triggered a heart attack and a major organ failure. She had an emergency caesarean — on the antenatal ward in front of other women in labour — but the baby was stillborn. Staff tried to resuscitate Ms Ali with a disconnected oxygen mask. She died five days later.

Violet Stephens went to Queen’s when she was 31 weeks pregnant suffering gastric pains and high blood pressure in June 2011. After four days, she was diagnosed with a life-threatening complication. She had an emergency caesarean and, although the baby was delivered healthily, she died.

In August 2010 Saira Choudhri was sent home from Queen’s even though she was having contractions every two minutes. She was found blood-soaked and in agony by two nurses in the car park. She and her baby survived.

The alarm had been raised as long ago as June 2011 when Labour MP Margaret Hodge told Parliament five women had died in the trust’s maternity units in the past 18 months. In March 2011 a Care Quality Commission report said Queen’s maternity services were so understaffed mothers and babies were at risk. In July this year it was ordered to make “urgent improvements” and in August local GPs sent in a “hit squad” to monitor the trust.

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