By Charlotte Webster-
The damning independent review of the University Hospitals Birmingham NHS Trust (UHB) which found the number of patient deaths at the Trust is higher than would be expected, is a wake up call for the Nhs and all hospitals in the uk.
The report warned that “if the cultural environment at UHB has not already affected mortality it is likely to be affecting the patient experience and morbidity”.
The Bewick report – led by former NHS deputy medical director Prof Mike Bewick – was launched to investigate claims made by former and current staff, some of them aired on a special BBC Newsnight series of programmes, into the leadership of University Hospitals Birmingham
The report also revealed “extensive complaints” had been made by staff about the organisation’s conduct and that “many were concerned about the ‘toxic atmosphere and bullying at all levels of management'”.
It said the report team “heard many examples of concerning comments following a range of topics, including issues over promotion processes, bullying of staff (including junior doctors), and a fear of retribution if concerns were raised”.
The concerns it raised around inadequate staffing levels is one that must be immediately addressed by the Health Secretary, Stephen Barclays. Inadequate staffing levels are a negative reflection on the government, and that which calls for urgent attention. This publication has a few members of the Nhs who are forever petrified to identify themselves openly about the failings of the Nhs. because of the victimization they say would inevitably follow. Some even fear losing their jobs.
The report reveals that in November 2022, 13.35% of nursing posts at the Trust were vacant, compared with an England average of 10%.
It warns that “any continuance of a culture that is corrosively affecting morale and in particular threatens long-term staff recruitment and retention will put at risk the care of patients”
“She wrote a letter,” her father, Dr Ravi Kumar, told Sky News. “She very clearly mentioned that she was doing this because of the QE hospital.”
After taking the overdose she waited three hours to call an ambulance. Her father says that when paramedics arrived “she said under no circumstances was she going to the QE hospital”.
Dr Kumar said his daughter was “bright, fun-loving and compassionate” but things changed soon after she began working at the Queen Elizabeth Hospital.
“She started facing this toxic environment and she started getting a bit more worried and tearful,” he said, adding sometimes when she returned from work she would say “people are belittling her and demeaning her”.
The report found there was “considerable unrest and anger at the Trust’s response” to Dr Kumar’s death, both from her family and “the wider junior doctor community”.
It also found that “this was not the first death by suicide of a doctor at UHB”.
It revealed there was “disappointment and anger” from staff at a lack of senior representation by the Trust at Dr Kumar’s funeral, and that the Trust only formally wrote to her family two months after her death.
Shockingly, the report found a senior member of staff within medical staffing was unaware of Dr Kumar’s death and emailed the medic personally 26 days after her death to ask why she had been removed from her post and if she was still being paid.
The report concluded the case showed a need for “a fundamental shift in the way an organisation demonstrably cares about its staff as people”.
Dr Kumar’s father said: “It makes me angry and at the same time worried about other junior doctors who are going to follow her.
“Our lives stopped on the 22nd June and it’s very hard. Each day is a struggle.
“Now my main worry is to stop it happening to others and that is why I want to bring this forward so people realise that there is a toxic atmosphere.”
A spokesperson for University Hospitals Birmingham said: “Dr Vaishnavi Kumar was a much loved and respected doctor, who was popular with colleagues and patients alike. Her unexpected death was a tragedy and our heartfelt condolences remain with Vaishnavi’s family.
“We have reflected on our response to Vaishnavi’s death, have learnt lessons from this, and are acting on them.
“Dr Kumar wants his daughter’s death to result in improvements in the support offered to all doctors in training and to see a change in the culture of the Trust. We are pleased that he has agreed to work with the Trust on this.”
Jonathan Brotherton, chief executive at University Hospitals Birmingham NHS Foundation Trust (UHB) said in response to the report’s findings: “Patients can continue to be confident that the care and treatment provided at our hospitals is safe. We are pleased that Professor Bewick’s overall view ‘is that the Trust is a safe place to receive care’.
“We fully accept his recommendations and welcome the additional assurance that has been asked for through further independent oversight.
“There are a number of significant concerns that we need to, and have started to, address; we will continue to learn from the past, as we move forward.
“We want to develop a positive, inclusive work environment where people want to come to work, in a place that they are proud to work in, to do their very best for our patients. While we will not be able to fix things as quickly as I would like, we do need to do it as quickly as possible, for the benefit of patients and staff; I am committed to ensuring this happens.
“We must now focus on continuing to provide the best possible patient care, building a values-led culture and supporting our incredible colleagues.”
Today its findings were published and describe a health organisation with deep seated toxic cultural issues that ‘risk patient safety’ – while also finding the hospitals are ‘safe for patients’. The review was commissioned by Birmingham and Solihull Integrated Care Board in response to public disquiet over the culture and potential clinical safety issues at the Trust.
In a preview, NHS Birmingham and Solihull chief executive David Melborne said the report had not found any significant patient safety issues but had found substantial issues around leadership, governance and culture.
The aftermath of the tragic death of junior doctor Vaishnavi Kumar, claims of doctors being disciplined if they blew the whistle on poor practice, and allegations of a ‘toxic’ culture formed the backdrop to the rapid review. Prof Bewick and colleagues carried out interviews, reviewed data and hosted feedback sessions as part of their probe.
MP Preet Kaur Gill (Birmingham Edgbaston), whose constituency includes the Trust’s flagship Queen Elizabeth Hospital, has chaired a cross party steering group overseeing the review and two further probes leading on from it. Healthwatch Birmingham has also been at the forefront of raising concerns and holding the Trust to account. Both have previously called for a full independent public inquiry.
Publication of the first review is unlikelyto turn the spotlight away from University Hospitals Birmingham, which oversees the Queen Elizabeth, Heartlands, Good Hope and Solihull Hospitals.
Dr Tristan Reuser, an eye specialist, has called for a greater cull of those in leadership roles as a result of the findings. He told the BBC: “All the people who have been participating in this culture of fear… they need to go because these people have been a part of this and the perception of how this trust is governed will not change unless these people go, in my view.”
Dr Manos Nikilousis, who raised the alarm over his concerns around haematology, tweeted he was ‘not surprised’ there had been no resignations resulting.
Today, news that satisfaction with the NHS plummets to lowest level in 40 years shows the sorry state to which it has degenerated over the years.
Satisfaction with the NHS has plummeted to a record low of just 29% amid intense public frustration with long waits for care, understaffing and lack of government funding.
Opposition parties and the leader of Britain’s doctors described the findings as a “damning indictment” of the Conservatives’ handling of the service since they became the government in 2010.
The striking picture of deep and growing disenchantment with the health service is mirrored by a recent spike in dissatisfaction with the NHS overall to 51% – double what it was in just 2020 – as well as a range of key services including GP care (42%), dentistry (42%) and A&E (40%).
Opposition parties and the leader of Britain’s doctors claimed the findings, from a long-established annual survey of attitudes towards the NHS, were a “damning indictment” of the Conservatives’ handling of the service since they became the government in 2010.
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.