NHS review into scandal-hit hospital condemned by watchdog

A health watchdog has condemned a scandal-hit hospital for failing to cooperate with reviews into safety following “avoidable” patient deaths.

The Parliamentary Health Service Ombudsman, Robert Behrens, who investigates patients’ complaints, said University Hospitals Birmingham Foundation Trust was being “defensive” over investigations into patient complaints and had failed to show a willingness to learn from past failings.

In a letter to the NHS’ chief nurse Dame Ruth May, Mr Behrens also warned that an NHS-led review into the trust’s leadership will lack “transparency” and “completeness” after he was excluded from giving evidence.

Mr Beherens has received 521 complaints against the trust since 2021. So far, two investigations have found patient deaths could have been avoided, while a further 60 active cases are under review.

The leadership review was one of three to be launched into the trust following reports of a “toxic” culture within the organisation.

The outcome of the first, which investigated patient safety risks, is due to be published this month and is expected to find “substantial” cultural and behavioural issues within the trust, according to a report to the local council last week. The second review will look at whether it is well-led and the third will look into its culture.

In the letter to Dame Ruth on 7 March, Mr Berhens raised concerns about the NHS excluding him from taking part in its leadership review.

He said: “As a partner that holds valuable insight and evidence about the issues under consideration within the three reviews, we are disappointed not to have the opportunity to actively contribute. PHSO’s exclusion from the review process leaves me concerned about the completeness and transparency of the reviews…

“Through our interactions with the previous leadership team at UHB, we have been very concerned by their dismissive attitude in response to complaints about serious patient safety incidents. We have not seen evidence of a culture of accountability, nor a willingness to learn from past failings. These insights are directly relevant to the well-led review. Through the Emerging Concerns Protocol, it has become clear that other oversight bodies and regulators share similar concerns relating to the culture at UHB.”

In August, the watchdog issued an unprecedented alert to health regulators and NHS England about UHB, warning that the organisation had “serious concerns” about the trust’s response to its patient safety investigations.

However, seven months later and the regulator has been forced to write again to the trust over his continued concerns over its “defensive” attitude towards patient safety investigations.

In a letter sent on 7 March to its interim chief executive Jonathan Brotherton, Mr Berhens said: “We have been concerned by the defensiveness of some senior leaders at the trust in relation to recent and ongoing investigations, eroding confidence that there is a willingness to accept accountability or learn from failings. We have recently seen some engagement with our investigation recommendations. However, there are a number of recommendations from PHSO investigations that UHB have not yet complied with. We have found UHB to be consistently slow in responding to requests for information with multiple reminders necessary before relevant information is provided.”

The anticipated patient safety review was due to be published last week has been delayed, however, according to a report to the local council, first reported by Birmingham Mail, it has found “substantial issues around culture, behaviour, leadership and governance”.

A spokesperson for NHS England in the Midlands said: “The reviews into University Hospitals Birmingham Trust have been commissioned to rigorously scrutinise leadership and culture in the organisation to ensure they are providing safe care for patients, as well as providing transparent information on any areas where support and challenge are needed at the trust.

“We welcome the offer of support from the Ombudsman’s office who we have recently met, and we are continuing to work with them to use their expertise where it can offer most value as part of the planned cultural review.”

A spokesperson for University Hospitals Birmingham said:“The Chief Executive has responded to the PHSO’s letter, to provide reassurance that their concerns have been taken seriously and we have been working to arrange further meetings to agree how our organisations can work better together in the interests of our patients and staff.

“We are committed to working with the PHSO to ensure that all families have a clear understanding of any issues relating to their loved one’s care.”

NHS England has been approached for comment.

The headline of article was amended on the day of publication. It originally said that the hospital had been condemned for blocking the ombudsman’s input into the inquiry, but this was not accurate. The hospital did not block the watchdog.