West Midlands hospital is investigated over ‘inadequate care’ after 54 patients die

West Midlands hospital is investigated over ‘inadequate care’ after 54 patients die in a six month period

• Russells Hall Hospital in Dudley will undergo an independent inquiry
• The former deputy chief executive of NHS England will carry out the inquiry
• The Care Quality Commission rated the emergency department ‘inadequate’
• Inspectors raised concerns that staff may not be correctly diagnosing sepsis 

A hospital in the West Midlands is being investigated after 54 people died within the first six months of this year.

The Russells Hall Hospital in Dudley is under scrutiny after concerns were raised about the A&E department’s ability to spot the deadly infection, sepsis.

Inspectors rated the hospital’s emergency care ‘inadequate’ in a report yesterday and have ordered an inquiry to investigate the 54 deaths between January and June. 

The inquiry will be carried out by Mike Bewick, the former deputy chief executive of NHS England, to establish why the patients died in the emergency department.

The Care Quality Commission (CQC) – the watchdog for health and care across the UK – said investigating deaths is outside of its remit but it is taking enforcement action against the hospital for its failings.

During the CQC’s June inspection, staff revealed they would not want relatives treated at the hospital out of fear they would die there.   

And inspectors saw three ‘very unwell’ looking patients in reception, one of whom was bleeding heavily until the inspectors stepped in and called for help. 

Russells Hall Hospital in Dudley, West Midlands, is under investigation because 54 patients died in its emergency department between January and June this year and the A&E has been rated ‘inadequate’ by the Care Quality Commission

The health watchdog said it raised a ‘number of concerns’ about urgent and emergency care the hospital, which was overall rated ‘requires improvement’.

In particular, inspectors were worried about whether staff were correctly identifying patients with suspected sepsis, the BBC reported.

Sepsis is a serious, life-threatening complication which can arise from unrelated infections, and it kills almost one in five people in the UK who get it.

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A CQC spokesperson said: ‘The CQC has raised concerns about deaths at Russells Hall Hospital and, following our June inspection and discussion with partner agencies, an independent review has been commissioned to look into a number of deaths.

‘The review of deaths falls outside CQC’s remit. However, we continue to monitor the trust very closely and have taken enforcement action.’

The trust which runs the hospital, the Dudley Group NHS Trust, claims it has the lowest mortality rate in the region.

And its chief executive, Diane Wake, said an early report suggested many of the 54 patients were already dead by the time they entered the hospital.   

One patient who died was 33-year-old Natalie Billingham, a mother of six children, who reportedly had necrotising fasciitis – a rare but deadly form of sepsis.

Ms Billingham, from Tipton, died in March, 72 hours after visiting the hospital while suffering with foot pain and flu-like symptoms.   

Natalie Billingham, a mother of six, died in Russells Hall Hospital in March this year after being admitted with foot pain and flu-like symptoms which turned out to be deadly necrotising fasciitis

Marina Tranter, Ms Billingham’s mother, told the BBC the hospital has ‘destroyed me, they’ve destroyed my family’.

‘Natalie left six children and one only nine months old who’s never, ever going to know their mum.’  

In the CQC’s report, published on Thursday, September 6, inspectors also said that care records were not always written and managed in a way that kept patients safe.

And some staff raised concerns regarding the leadership style of some of the executive team, speaking of a poor culture and working environment.

Inspectors raised issue with the fact that death reviews in the emergency department could be carried out by the same staff who cared for the patient.

In a number of cases, robust reviews had not been done, the report said.

In one example, a patient died after being sent back to the waiting room despite staff knowing they needed to be treated immediately, but this was not made clear in their mortality review.

Heidi Smoult, deputy chief inspector of hospitals in England’s Central region, said: ‘We have had ongoing concerns about the emergency department at Russells Hall Hospital and were extremely concerned at what we found during our inspection.

‘Patients were not being consistently assessed in a safe way, in particular, whether staff were identifying patients with suspected sepsis effectively.

The Care Quality Commission revealed on patient died in A&E at Russells Hall Hospital after being sent back to a waiting room despite staff knowing they needed immediate treatment

‘As a result of this we have varied conditions on the trust’s registration, meaning it must provide regular updates to CQC surrounding staffing, triage of patients and its management of sepsis.

‘Inspectors returned to the department in August to carry out a further inspection and a full report of this inspection will be published in due course.

‘Meanwhile, we continue to monitor the trust extremely closely.

‘The trust knows what it must do to ensure people receive the care they should be able to expect and we will return to check on whether sufficient improvements have been made.’

In response to the report the hospital’s chief executive, Ms Wake, said the trust had recently appointed a new clinical lead for urgent and emergency care.

And she said the trust planned to receive best practice advice from a nearby hospital which has an A&E rated ‘good’ by the CQC.

In April it emerged that inspectors were forced to intervene at Russells Hall to help a patient with suspected sepsis after staff failed to properly monitor and treat them.

The CQC also said it was concerned by a lack of safety and leadership in the emergency unit and rated its services ‘inadequate’.

Senior clinicians deliberately left blood oxygen saturation readings off a national scoring system used to quickly identify acutely ill patients, inspectors were told.

When these findings were highlighted to the trust, one consultant said ‘it would trigger too many medical emergency calls’ if they were included, the CQC report said. 

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