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Lack of capital spending on equipment is a problem for many trusts – but rarely is it made as public as at Medway Foundation Trust, where board papers have revealed patients are getting higher doses of radiation than would normally be needed because of out-of-date equipment, which it is struggling to keep running.

It has now decided to replace its interventional radiology machine – which was given an “end of life” certification in 2020 – but only after medical physicists in the trust put their collective foot down and set a six-month deadline for it to be decommissioned. A second-hand part was already being used to keep it going but had actually caused further problems.

But that is not the end of the equipment woes for the trust. Among other issues, an outdated X-ray machine also needs higher doses to get readable images, birthing beds may be past repair and present potential harm if they malfunction, and theatre lights are becoming unusable.

The patient safety issues are obvious but, like others, the trust has limited capital to replace items (even those which would improve productivity). It’s mitigating risks as far as possible but only more cash will eliminate them.

Successful challenge

A mental health trust has been found not guilty of care failings relating to the death of an inpatient in a rare case of a provider challenging a prosecution brought by the Care Quality Commission.

Tees Esk and Wear Valleys Foundation Trust was being prosecuted by the CQC for alleged care failings in relation to the deaths of three young women under its care.

The trust pleaded guilty in two cases, but contested charges in relation to the death of Emily Moore, who took her own life at Lanchester Road Hospital in Durham in February 2020. The trial concluded with a “not guilty” verdict on Monday.

The CQC said it was “very disappointed” with the verdict, saying that it had brought the prosecution as it believed TEWV “had exposed Emily to a significant risk of avoidable harm”.

But trust CEO Brent Kilmurray said the trust had to defend this case – believing the CQC’s prosecution was unwarranted.

He added that the trust maintains its previous apologies for “unacceptable failings” in Emily’s care at another hospital.

Also on hsj.co.uk today

In North by North West, Lawrence Dunhill says Lancashire has got itself in a mess with the procurement of a shared electronic patient record across its hospitals. And in Comment, Mary Fleming, the CEO of Wrightington, Wigan and Leigh Teaching Hospitals FT, writes about the digital solutions undertaken by the trust to tackle patient flow challenges.