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Mid Staffordshire Foundation Trust

Peer review finds 'serious concerns' at Mid Staffs

A peer review of breast cancer surgery services at Mid Staffordshire Foundation Trust has uncovered a catalogue of concerns and safety fears - despite the trust assessing them as being largely compliant with national standards.

While the trust’s self-assessment said the services were almost 94 per cent compliant with standards drawn up by the National Cancer Action Team peer review programme, the team’s peer review said they were just 9.7 per cent compliant.

The peer review, undertaken in March, described the the trust’s multi-disciplinary team as “deeply dysfunctional”.

The team also noted “open hostility” between clinicians and the trust management, which it said was “incompatible with an open safety culture”.

It added: “The review team is seriously concerned about the effect on patient management and safety… and continues not to be assured of the quality and safety of the service.”

The peer review said Mid Staffordshire’s two breast surgeons did not support the trust’s new lead clinician - something it said “could seriously impede the addressing of the multiple problems faced by the service”.

Every single form supposed to be used for confirming the correct site for surgery was left blank, the network reported. This “could lead to surgery being undertaken erroneously on the wrong anatomical site and needs to be addressed urgently”.

Oncology notes were not available to the wider health community in the event of an emergency.

The review also found there was the possibility of “selection bias” by the surgeons on mastectomy and immediate reconstruction surgery. It recommended an urgent audit of practice was carried out.

Mid Staffordshire’s team was unaware of national evidence supporting surgery techniques without the use of drains. Meanwhile, it took two weeks to get the results of MRI scans performed at Burton Hospital, just 25 miles away.

The review group said the trust’s team “provided no evidence, no knowledge about or understanding of the local results of the national cancer patient survey data” and “they could not describe how many of the various procedures for breast cancer they actually performed”.

Trust medical director Robert Courteney-Harris said breast surgery services at the trust were safe. He said concerns were “being addressed”. He added: “We continue to work closely with our commissioners so that they are kept fully informed.”

Readers' comments (3)

  • At a recent meeting with Engaging Communities Staffordshire - the would-be patient representative body for the county - I was told that 'Mid-Staffs has moved on' - clearly not! This is my local hospital and worrying stories about it still dominate our local newspapers, months after the end of the Francis inquiry public stage and the national press has moved on to other things. Will anyone be taken to task over the 'discrepancy' between the self assessment and peer assessment? Who signed off the self assessment in the first place and will anything be done about it? I am not an NHS basher - far from it - but Mid-Staffs absolutely takes the biscuit.

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  • Anita, "would-be" is correct. 'Engaging Communities' will do nothing, as far as I could understand from the AGM it will have little real public involvement. It is our group which has ensured that this story got into the media. The peer review reports for this year and the previous two are all online; all are shocking. You will read who signed off the self-assessments. There is a great deal more to emerge and it goes to the heart of the regulation of our hospitals and in particular of our doctors. The two breast surgeons initially refused to take part in a CCG requested RCS 'invited review' of the service but I believe they have now acquiesced. Sadly the care at Mid Staffs can be as bad as ever, our group has members who have experienced it. A recent CCG inspection found drinking water still not available in one ward and various other failings while the SHA's Accountability Review was scathing on some issues, notably RTT. Yesterday the board recommended the nighttime reopening of A and E in spite of admitting that the service may well be unsustainable because of staffing issues. Do please contact us through our website and we can tell you much more, or just drop in to the cafe. Cure the NHS, Stafford.

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  • I would be very interested to know what the Trust's Internal Validation panel rated the service as, in terms of compliance. Did a discrepancy by the internal team cause the external validation to take place, or was it just a coincidence?

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