NHS and private hospitals told to improve after patient death

The NHS and private hospitals need to improve how they work together after the death of an NHS patient treated privately during the pandemic, a watchdog has warned.

An investigation by the Healthcare Safety Investigation Branch found some private hospitals took on more complex patients than they were used to, while problems with communication and confusion over responsibilities created safety risks.

It has called on the Care Quality Commission to do more to inspect how the two sectors work together and how patients are transferred between hospitals safely.

It launched an inquiry after the death of a patient, known as Rodney, aged 58, who was due to have keyhole surgery to remove part of his bowel due to cancer.

His NHS operation was cancelled and rebooked at a nearby private hospital after cancer services were transferred to the independent hospital due to Covid-19.

Rodney was asked to sign a consent form for open bowel surgery, rather than the less invasive keyhole procedure, due to guidance at the time around a "potentially increased risk of Covid-19 transmission with laparoscopic surgery", the HSIB said.

The cancerous part of his bowel was removed but eight days later his condition he deteriorated rapidly and was transferred to the local hospital so he could receive intensive care - which was not available at the private hospital.

When he arrived at the NHS hospital, a scan and more surgery showed a leak in his bowel which led to sepsis and organ failure. He died later that day.

As a result of the case, the HSIB launched a wider investigation into NHS surgical services being carried out in independent hospitals.

It found the capability and capacity of independent hospitals to provide surgical care varied across the country.

It said national and local NHS organisations had a "limited understanding" of independent hospitals' capabilities which resulted in variation in how independent hospitals were used during Covid-19.

The investigation also identified safety risks associated with the assessment of patients prior to surgery, but the HSIB said these could be reduced with "successful collaboration between the NHS and the independent sector".

Kathryn Whitehill, principal national investigator, said: " The reference case we examined and the national investigation findings highlight that, if there are any gaps in the surgical care pathway, the impact can be devastating on patients, families and healthcare staff.

“NHS patients are being cared for in the independent health sector now more than ever before.

"The health service continues to deal with the repercussions of the pandemic and the services and pathways that have been implemented between the NHS and the independent sector are likely to continue in response to these ongoing pressures.”