Hospitals are withholding evidence when patients are harmed, the outgoing NHS ombudsman has claimed.
Rob Behrens said ministers, NHS bosses and board members are not doing enough to end the health service’s ‘cover-up culture’.
He accused the NHS of occasionally acting in ‘terrible’ ways to prevent relatives from discovering the truth, and claimed that ‘reputation management’ is still paramount in some parts of the £160bn-a-year service.
During investigations, Mr Behrens had come across ‘the disappearance of crucial documents after patients died’.
The latest figures show that there are around 11,000 avoidable deaths per year within the NHS due to patient safety failings.
Rob Behrens (pictured) said ministers, NHS bosses and board members are not doing enough to end the health service’s ‘cover-up culture’. He accused the NHS of occasionally acting in ‘terrible’ ways to prevent relatives from discovering the truth, and claimed that ‘reputation management’ is still paramount in some parts of the £160bn-a-year service.
During investigations, Mr Behrens had come across ‘the disappearance of crucial documents after patients died’. Latest figures show there are around 11,000 avoidable deaths a year in the NHS due to failings in patient safety
Mr Behrens, who will soon resign as Ombudsman for England after seven years, told the guard: ‘NHS leaders, including ministers, set the tone for the entire organisation.
‘We hear again and again that patient safety is a priority, but actions too often suggest otherwise.
‘We need urgent, significant, joint interventions to accelerate improvements in culture and leadership, not just in trusts or primary care, but also in NHS England and government.
‘Culture is determined not only from the core of an organization, but also from top leadership.’
While the NHS was staffed by “brilliant people” under enormous pressure, Mr Behrens said his investigations into patients’ complaints had too often uncovered cover-ups.
These include “altering care plans and the disappearance of crucial documents after patients die and robust denial in the face of documentary evidence,” he said.
Mr Behrens also cited preventable deaths as too common, especially in maternity care, mental health care and the treatment of sepsis – the body’s life-threatening response to infection.
He warned that the NHS’s legal ‘duty of candor’ does not mean hospitals must be open about failures and urged ministers to reform the way the NHS handles complaints and regulatory checks and balances.
It just comes months after a damning report The ombudsman also found last year that the NHS suffered from a culture of ‘defensiveness’ when harming patients, with hospitals ‘routinely’ failing to accept their mistakes.
However, he today acknowledged that Martha’s Rule – due to be introduced in England next month – was a major step forward.
According to the rule, patients and relatives are entitled to a second medical opinion and review of treatment.
It follows a campaign by the parents of 13-year-old Martha Mills who died in hospital in August 2021 after developing sepsis.
But Behrens also told The Guardian that he was alarmed by a recurring pattern of hospitals intimidating whistleblowers rather than taking their concerns seriously.
He pointed to the University Hospitals Trust in Birmingham for referring 26 of its doctors over a decade to the General Medical Council, which oversees doctors, for alleged misconduct in an alleged attempt to punish them for raising concerns .
No one appeared to have committed a violation.
Following his comments, Paul Whiteing, chief executive of patient safety charity Action Against Medical Accidents, said the Countess of Chester NHS Trust has failed to act on doctors’ concerns about serial baby killer Lucy Letby – including forcing of them to apologize to her for questioning her integrity – was an example of Mr Behrens’ concerns.
Last year, a third of NHS staff saw mistakes, near misses or incidents in the course of their work that could have harmed staff or patients, the latest annual NHS staff survey found, he added.
‘Martha’s Rule’, which formalizes access to an intensive care team for a second opinion, will be available 24/7 and advertised in all hospitals. The move follows the death of 13-year-old Martha Mills in 2021. She developed sepsis while under the care of King’s College Hospital NHS Foundation Trust in south London.
Martha’s parents, Guardian editor Merope Mills (pictured), and her husband Paul Laity, raised concerns about Martha’s health on a number of occasions, but these were brushed aside.
Responding to Mr Behrens, an NHS spokesperson said it was ‘absolutely essential that everyone working in the NHS feels they can speak out and have their concerns acted upon.
‘The NHS has updated its freedom to speak out (and) introduced additional background checks for board members to prevent directors involved in serious mismanagement from joining another NHS organisation.’
They added: ‘As the Ombudsman is aware, there have been significant efforts in England to prioritize patient safety and progress has been made in creating a more positive safety culture among the workforce, leading to higher levels of reporting of patient safety incidents than ever before and a widespread focus on improvement, including through the new Patient Safety Incident Response Framework.
A spokesperson for the Department of Health and Social Care said: ‘The safety of all patients is vital, and we have made significant improvements to strengthen patient protection, including publishing the first NHS Patient Safety Strategy.
‘We are committed to making healthcare faster, simpler and fairer. We are investing record levels in the NHS, training and retaining staff through the Long Term Workforce Plan to keep our NHS adequately resourced for decades to come.”