The long road to a Public Inquiry into poor patient care

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By March 2009, it was possible to describe the Trust as having suffered whole organisation failure.  It was wholly unreactive to patient complaints, and did not otherwise utilise data collected in order to monitor the standard of care within the Trust – or identify the serious failings occurring. Staff shortages had been a problem within the Trust for a number of years, with 1722 incident reports being filed by staff within the period 2005-2009 in relation to staffing levels. In response to financial pressure throughout the NHS, exacerbated by the cost efficiencies required to qualify as a Foundation Trust, the Trust embarked on a £10 million cost improvement programme, which relied significantly upon reducing its workforce.

Meanwhile, the Trust was highly reliant upon unqualified, unregulated Healthcare Assistants in caring for its patients. Staffing decisions were taken to effect savings without considering the impact on quality and ultimately, the Trust was unable to ensure that patients were provided with safe standards of basic care. The Trust leadership was of poor quality and the Chief Executive unsupported.  During this period, there were concerns being raised by whistleblowers, patients and their families, and from November 2007, through Cure the NHS, a local patient group established by those affected by the failings within the Trust. 

After long campaigning by Cure and other parties including AvMA, first an Inquiry and then a public inquiry were held, looking at the reasons for those failings.  Now the public Inquiry has finishing hearing evidence, Caron Heyes, a Senior Solicitor in our Clinical negligence team, who worked with AvMA in providing evidence to the Inquiry,  looks at the evidence heard and what it may mean for the NHS of the future in an article in Clinical Risk. 

The article in full, which was published in The AvMA Medical & Legal Journal, can be read by following this link.

For further information, please contact Caron Heyes, a Senior Solicitor in our Clinical negligence team on 020 7814 6902 or at

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