Hospitals are concealing evidence when patients are harmed, claims the outgoing NHS ombudsman.
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, on occasions, acting in a ‘dreadful’ way to prevent bereaved families from finding out the truth, and claimed some parts of the £160billion-a-year service still put ‘reputation management’ first.
During investigations, Mr Behrens had stumbled across ‘the disappearance of crucial documents after patients have died’.
Latest figures suggest there are around 11,000 avoidable deaths per year in 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, on occasions, acting in a ‘dreadful’ way to prevent bereaved families from finding out the truth, and claimed some parts of the £160billion-a-year service still put ‘reputation management’ first
During investigations, Mr Behrens had stumbled across ‘the disappearance of crucial documents after patients have died’. Latest figures suggest there are around 11,000 avoidable deaths per year in the NHS due to patient safety failings
Mr Behrens, who will soon step down as ombudsman for England after seven years in the post, told the Guardian: ‘NHS leaders, including ministers, set the tone for the whole organisation.
‘Time and again we hear that patient safety is a priority but actions too often suggest otherwise.
‘We need to see urgent significant, joined-up intervention 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 organisation but also from its top leadership.’
While the NHS was staffed by ‘brilliant people’ working under intense pressures, Mr Behrens said that to often his investigations into patients’ complaints had revealed cover-ups.
These have included, ‘the altering of care plans and the disappearance of crucial documents after patients have died and robust denial in the face of documentary evidence’, he said.
Mr Behrens also singled out avoidable deaths as being too common, particularly in maternity care, mental health and the treatment of sepsis — the body’s life-threatening response to an infection.
He warned that the NHS’s legal ‘duty of candour’ was not requiring hospitals to be open about failures and urged ministers to reform how the NHS deals with complaints and regulatory checks and balances.
It comes just months after a scathing report by the ombudsman last year also found the NHS was beset with a culture of ‘defensiveness’ when patients are harmed, with hospitals ‘routinely’ failing to accept their errors.
He today acknowledged, however, that Martha’s Rule — set to be introduced next month in England — was a major step forward.
Under the rule, patients and relatives have the right 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 Mr Behrens also told The Guardian he was alarmed by a recurring pattern of hospitals intimidating whistleblowers rather than taking their concerns seriously.
He pointed to University Hospitals Birmingham trust for referring 26 of its medics over 10 years for alleged misconduct to the General Medical Council, which regulates doctors, in alleged attempt to punish them for raising concerns.
None were found to have committed any wrongdoing.
Following his remarks, Paul Whiteing, chief executive of the patient safety charity Action Against Medical Accidents, said the Countess of Chester NHS trust’s failure to act on doctors’ concerns over the serial baby killer Lucy Letby — including forcing them to apologise to her for doubting her integrity — was an example of Mr Behrens’s concerns.
Last year, a third of NHS personnel during their work saw errors, near misses or incidents that could have hurt staff or patients, according to the latest annual NHS staff survey, he added.
‘Martha’s Rule’, which formalises access to a critical care team for a second opinion, will be available 24/7 and advertised throughout 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, Merope Mills (pictured), an editor at the Guardian, and her husband Paul Laity, raised concerns about Martha’s health a number of times but these were brushed aside
Responding to Mr Behrens, an NHS spokesperson said it was ‘absolutely vital that everyone working in the NHS feels they can speak up and that their concerns are acted on.
‘The NHS has updated its freedom to speak up guidance [and] brought in extra 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 major efforts to prioritise patient safety in England and progress in creating a more positive safety culture amongst the workforce, which has led to higher levels of patient safety incident reporting than ever before and a widespread focus on improvement, including through the new patient safety incident response framework.
A Department of Health and Social Care spokesperson said: ‘The safety of all patients is of vital importance, and we have made significant improvements to strengthen protections for patients including publishing the first NHS patient safety strategy.
‘We are determined to make the health service faster, simpler and fairer. We are putting record levels of investment into the NHS, and training and retaining staff through the long-term workforce plan to properly resource our NHS for decades to come.’
