Much like the Francis report, which investigated failings at Mid Staffordshire, the Keogh review highlights the devastating consequences of a health system forced to ‘make do’. The review suggests that mortality rates at the 14 hospitals in question would not have exceeded the national average had they been better staffed and better equipped to manage patient care.
As a legal practitioner specialising in medical litigation, the narrative of over-worked doctors and over-stretched services is all too familiar. We can see from the Keogh review that there is a complete lack of consistency of care within the NHS. While our health service is overwhelmingly good, with many examples of superb practice, the Keogh review illustrates that some 10 per cent of practice is still below expected standards of care.
More worrying still are those hospitals not assessed in the review. The investigation was also not of individual deaths, and although Keogh has already seen these hospitals initiate changes for improvements, what the NHS could really use now are strong role models to help lift standards and ensure hospitals stay on track.
Individual NHS trusts have the option of applying a Duty of Candour, so that both hospital management and staff are obliged to admit when unnecessary harm has occurred, however the uptake on this is as yet unknown. For now, it remains the responsibility of the NHS itself to encourage patient and staff complaints and to respond appropriately.
The Keogh review puts a spotlight on a culture of form-filling and box-ticking that has somehow taken precedence over genuine care and the importance of patient safety. It may be up to the patients, the public and services like Fletchers‘ to continue to campaign for a rise in standards, from which everyone can benefit.