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Resignations after Manchester's Tameside General Hospital comes under fire

Author: Neil Fearn  Bullet  Dated: 05/07/2013

2 health bosses at Tameside General Hospital in Manchester have resigned following previously unpublished criticism of poor levels of care, management and leadership.

CEO Christine Green and medical director Tariq Mahmood stepped down from their posts after 2 highly-critical hospital-commissioned reports. The reviews said that poor management and A&E overcrowding had led to some patients being left unattended and without pain relief for up to 4 days.

In February, the Department of Health earmarked Tameside for scrutiny by NHS medical director Prof Sir Bruce Keogh in the wake of the Mid-Staffs scandal. Sir Bruce's report, due soon, will assess 14 hospitals in England alleged to have excessive death rates and is likely to be highly critical of the Manchester facility.

The 2 previously unseen reviews, based on visits by NHS professionals in March and April, noted that patients are placed at risk due to overlong delays between arrival and being seen by consultants. The hospital beds are often full, doctors and nurses are in short supply and relatively few consultants are available for ward rounds.

The 1st report followed a visit in March from an NHS Interim Management and Support (IMAS) team. It found that individual patient experiences and outcomes are being severely compromised by the accident unit's "delays in assessment, treatment and admission".

Investigators found that "up to 8 patients at a time had recently been managed in the corridor with delays of up to 2 hours. 1 patient had waited up to 7 hours in the corridor."

Describing consultants' leadership and availability as "weak" and "variable", the IMAS report called on Tameside to make sure senior staff spend more time with inpatients. "Consultant ward rounds still appear to be undertaken twice or three times a week only with ad hoc visits to the ward on non-ward round days."

A 2nd report was by the North West Utilisation Management Unit (UM), which encourages performance improvements at hospitals in the Greater Manchester area. This asserted that some patients were left for too long without pain relief and referred to staff concerns that "responsiveness to analgesia needs" could be better.

The UM review went on to state that patients sent by their GPs to the medical assessment and admission unit – for serious, if not life-threatening conditions – "may wait several more hours before being seen by an admitting/assessment doctor" with patients often waiting "overnight on chairs" prior to treatment.

Although Tameside has announced "an action plan" to look into the findings of the Monitor-approved reports, it has yet fully to concede there is a depth of concern, referring only to "some specific issues".

In February, the hospital website even noted that it had received a "clean bill of health" from the regulatory Care Quality Commission (CQC). And while a spokesman said the hospital took staff worries "very seriously", it felt some of the concerns raised could not be substantiated.

In light of Tameside's apparent unwillingness to act on warnings that major improvements are essential, the GP-based Tameside and Glossop clinical commissioning group (CCG) was among those bodies calling on Ms Green and Mr Mahmood to resign.

Minutes of a private CCG board meeting in May said: "Although there had been some progress in a number of areas more recently, opportunities to address others had been missed over a number of years. Many of the key failures reflected on executive and medical leadership.

"Our governing body considered the evidence and felt strongly that it didn't consider that current senior management arrangements are capable of progressing change at the required depth and pace, and that we need a managed transition from the current medical and chief executive leadership."

Prior to the resignation announcements, a Tameside spokesman said the hospital had been "surprised" at the CCG's position, claiming that its relationships with local doctors were "excellent" and that no such opinions had been expressed by "the body" of GPs.

However, Tameside has come under fire from the Department of Health. "Substandard care in hospitals is completely unacceptable," said the Health Secretary, Jeremy Hunt. "Patients should not face excessive waits for treatment and junior doctors must have the support they need from consultants to provide patients with that treatment."

Noting "some very good care" at Tameside, Andrew Gwynne MP (Lab, Denton and Reddish) said: "The problem with Tameside is that… there are also far too many examples of poor care, and care that's frankly way below standard, and it has never managed to tackle that."

In a joint statement, Mr Gwynne and 2 other local MPs, Jonathan Reynolds and David Heyes, welcomed the resignations.

"We have all said on numerous occasions that Tameside Hospital needs a change of leadership. The problems that do exist at Tameside have not been sufficiently addressed and we believe that the senior management have to answer for this."

The MPs said that the trust must now put in place someone who is up to the task of implementing the change that the hospital needs.

"Hopefully, this will be a turning point and patients, staff and the wider public will now be able to rebuild their confidence in Tameside Hospital."

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