A former health authority chief executive has admitted its strategy over failings at Stafford Hospital was not effective.
But Cynthia Bower, who led the West Midlands Strategic Health Authority between March 2007 and July 2008, said her authority’s response to high mortality rates at the hospital was an “honest attempt” to find out what was going on there.
Ms Bower said it commissioned a University of Birmingham study into the Dr Foster hospital standardised mortality rates (HSMRs) in 2007, which was not a move to defend the hospital by discrediting the figures, but a way to understand them.
However, she came under criticism for not deploying her staff of 75 to investigate what was happening on wards in Stafford as between 400 and 1,000 patients were dying due to appalling standards of emergency care.
Ms Bower, who later became the head of health watchdog the Care Quality Commission, told a public inquiry this week: “What I believed at the time, and still believe, was this was an honest attempt to better understand what was going on.”
And instead of a hands-on investigation, which would have been a unique move for a health authority, Ms Bower said her team relied on assurances from Mid Staffordshire Hospital Trust that patient safety was not at risk.
“We were assured,” she said. “We shouldn’t have been assured, I absolutely accept that point. But I believed at the time the processes we were engaged in were a robust and appropriate response to the potential for concerns the HSMRs flagged up. We should have put an inspection in. Had we done that we may well have uncovered the issues that were subsequently uncovered by the Healthcare Commission.”
During her evidence, Ms Bower said key agencies failed to communicate key information in Stafford Hospital’s application to become a foundation trust. She said disease-specific mortality alerts, sent by the Healthcare Commission (HCC) were not passed on to the health authority by either the trust or the HCC.
“We didn’t know these individual mortality alerts were being generated.,” she said.
“Clearly Martin Yeates (the then hospital’s chief executive) should have ventured that information to us. I can’t explain or understand why the trust didn’t tell us they received these alerts. It was misleading they didn’t tell us.”
Ms Bower also defended the health authority’s failure to disclose mortality statistics to foundation trust watchdog Monitor during the application process. She said the figures were already in the public domain and she expected Monitor and the HCC to discuss the figures between themselves.
Ms Bower apologised for the health authority’s failure to spot hospital problems but maintained there was no evidence at the time of a problem.