- Coroner raised concern over escalation policies and emergency responses in private hospitals
- Simon Healey died after being “abandoned” in Ramsay Health Care Hospital then transferred back to NHS, says family
- Case follows concern last year when Jeremy Hunt warned the sector to get its house in order
- Ramsay has apologised and said it has changed processes
A coroner has issued warnings over safety at private hospitals after a patient referred out of the NHS by his consultant died following surgery.
Businessman and father-of-two Simon Healey died from sepsis after bowel surgery to remove colon cancer at the Independent Berkshire Hospital, run by Ramsay Health Care, in 2017.
Failures in his care meant his deterioration and suspected sepsis were not escalated or dealt with, prompting coroner Heidi Connor to call for a review of the way private hospitals monitor warning signs of serious problems with patients.
The coroner said in a notice issued earlier this year she was worried private hospitals were relying on off-site consultants to review patients in an emergency and she questioned whether private hospitals which lacked critical care facilities should be carrying out surgeries without specialist nurses.
Mr Healey’s wife Alison told HSJ her husband agreed to pay for his operation to take place privately after Daniel McGrath, a medical consultant at the Royal Berkshire Hospital offered to carry it out in August 2017. Dr McGrath had practising privileges with Ramsay Health Care.
The case follows concerns last year about the safety of private hospitals which resulted in former health and social care secretary Jeremy Hunt warning the sector to “get your house in order on quality and safety”.
Following surgery, nurses suspected Mr Healey had sepsis but the national early warning score protocol was not followed.
He was transferred back to the Royal Berkshire after becoming seriously unwell and died after a third surgery identified a bowel leak, which caused the sepsis and had not been considered earlier.
Professor John Scholefield, an independent expert, told the inquest into Mr Healey’s death in December, that the leak should have been suspected and detected five days before his death and had it been, he would have survived.
The coroner issued a warning both to Ramsay Health Care and the Independent Health Providers Network, which represents the sector nationally, saying: “I believe that the NEWS policies in place at private hospitals should be reviewed.”
She said most private hospitals lacked critical facilities and while national policy, developed by the Royal College of Physicians, required a team with critical care expertise to respond, the policy at Ramsay Health Care was for a nurse to inform the resident medical officer and consultant.
The coroner warned: “This policy clearly anticipates initial review by a consultant, outside the hospital, who may well not be available to attend on an emergency basis.”
The hospital had only performed four other similar operations between 2016 and 2018 with post-operative care delivered on a general ward. The coroner said: “I accept private hospitals cannot realistically provide separate specialist wards for this.
“It does however raise the question of whether private hospitals should be carrying out procedures like this without specialised nurses and without facilities to escalate care without delay.”
Mr Healey’s wife told HSJ her husband would not have agreed to be treated by Ramsay Health Care if he had known it was unprepared to deal with his complications.
She said: “I am absolutely convinced that Simon was abandoned. There was no open and honest communication with me from the staff, no one told me he had sepsis. I was completely in the dark. Simon placed his entire trust in them. He was a very thorough man and had an attention to detail and at a time in his life when he needed the same they utterly failed him.”
She said her husband didn’t want to wait on the NHS because he was worried about his cancer, and agreed to be referred privately by Dr McGrath.
“If Simon had been treated at the Royal Berkshire he would be here today. Patients are in the dark when they go into the private sector. It should be operating at the same standards as the NHS.”
Responding to the coroner’s concerns the IHPN said: “Unanticipated deterioration in the condition of patients is a factor in all healthcare settings and so the right response is to have plans in place to deal with it when it occurs.”
It said only 0.12 per cent of admissions to private hospitals resulted in an emergency transfer to the NHS and added: “The NICE guidelines on patient transfers do not suggest that patients should only be treated where there are intensive or high dependency facilities on site. Instead the focus should be on ensuring that patients can be safely transferred under structured arrangements to the right place should they require a higher acuity of care.”
Ramsay Health Care has apologised to Mr Healy’s family and told HSJ: “Significant progress has been made in the areas identified by the coroner, including implementing changes to the out of hours escalation process, and the practising privileges of the consultant have been terminated.”
HSJ contacted the Royal Berkshire Hospital and Dr McGrath for comment but none was received before publication.
- PDF, Size 0.12 mb