Serious concerns about clinical care at a children’s hospital were not acted upon due to a lack of communication and joint working among senior managers, regulators have revealed.

A Healthcare Commission report published today says it is “deeply concerning” that problems at Birmingham Children’s Hospital foundation trust were not picked up sooner.

A lack of engagement with clinicians, added to staff vacancies and poor relationships with University Hospitals Birmingham foundation trust staff, resulted in “less than optimal care”, the report says.

For example, brain operations were carried out without specialist theatre nurses.

However, there was no evidence of any serious incidents causing harm to patients.

Serious potential risks

Healthcare Commission chief executive Anna Walker said the standard of care at the trust had “not been as good as it should have been” in some cases.

She said: “The response to safety concerns has been slower than ideal.

“It is deeply concerning that serious issues were raised but not properly or rapidly addressed over several months.

“While I would not say there were ‘third-world’ conditions, there were serious potential risks in the way care was provided.”

The investigation looked at paediatric tertiary care services in the speciality areas of renal transplant, liver transplant, craniofacial surgery, neurosurgery, interventional radiology and cardiac services.

It found that the trust was struggling to meet rising demands, leading to treatment delays and children being redirected to other services.

The findings follow the damning report two days ago on Mid Staffordshire foundation trust.

Recommendations

The report makes 12 recommendations concerning:

  • A lack of access to beds, theatres and interventional radiology
  • Poor support to surgeons who raised concerns about the knowledge and skills of theatre staff and the availability of equipment, and
  • Ineffective partnership working between Birmingham Children’s Hospital foundation trust and University Hospital Birmingham foundation trust.

Monitor

Bill Moyes, executive chairman of foundation trusts’ regulator Monitor, said: “The Healthcare Commission’s investigation confirmed that poor communication and ineffective joint working arrangements have been an important factor in the problems that gave rise to the investigation.

“We are taking each of the issues raised very seriously and have taken action to ensure that the two trusts resolve them as a matter of urgency.”

Hospital’s response

Birmingham Children’s Hospital interim chief executive Sarah-Jane Marsh said: “The quality of care for our young patients is our top priority.

“In some ways, we have been victims of our own success - as our services have grown ever more popular we have been faced with the challenge of meeting that demand and have been carrying out a great deal of work to make sure we do.

“Whilst we acknowledge that the issues raised were significant, the clinicians involved at the time managed all situations expertly. I sincerely regret any distress caused to children, young people and their families during this time.

The trust today announced it was gaining a £1.8 million expanded liver unit and a new £2.7 million renal unit. There are also plans to expand the cardiac wards and almost double the capacity for intensive care.

A project group has been set up with University Hospitals Birmingham to ensure plans benefit the staff and patients of both hospitals.