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A DAMNING report into Alder Hey’s surgical department prompted by the concerns of two whistleblowers concluded the hospital does not provide “world class care”.

The ECHO can reveal a review was carried out by the Royal College of Surgeons (RCS) after staff raised concerns about care in 19 cases between 2004 and 2010.

The report, released by the renowned children’s hospital today, reveals:

Criticism of health chiefs’ “world class care” claims. The report said its current standards are not at this level.

Some relationships within the department are “beyond repair”, after “conflict”.

In the 19 cases of children’s surgery reviewed, five were found to have flaws and were described as “suboptimal”. In two of these there were “clinical issues”.

Despite problems, overall surgical performance was classed as “safe”.

The hospital has released the panel’s conclusions and recommendations, along with actions taken so far in response. Families involved in the report, whose details have been left out for confidentially reasons, have been informed, as have staff.

Health chiefs today repeated the report classified surgery as safe.

The RCS began the investigation in May, after two separate whistleblowers raised concerns in June 2010 and January this year.

It was completed in August, and trust chiefs said they have already begun to address concerns raised. A total of 28 members of staff were interviewed, and a panel spent four days at the West Derby site.

Histories of all the cases were also analysed in detail, and included general surgery, urology and neonatal surgery.

At least 14 individual cases were looked at, along with cases relating to specific surgical conditions.

Other concerns included:

Problems relating to consent from families for operations.

Failure to act when concerns about a trainee doctor were raised – the report said assessment at times “lacked reasonable objectivity”.

Problems with keeping staff’s skills up to date in “new surgical techniques”, with processes described as “weak or unclear”.

Whistleblowing procedures needed improvement.

“Considerable stress” had been felt within the department – counselling was recommended for some individuals.

But the report found no evidence of “systematic prejudice” and stated a “reasonably open culture” to raise concerns was present.

The clinical director was also currently providing “effective clinical leadership,” and the report also acknowledged the trust is already taking steps to improve.

The report reads: “The panel is aware that the majority of those involved in the current conflict consider the working relationship between X and other members of the department to be beyond repair.

“It does not fall to the panel to advise the trust on how it should resolve this situation. The panel can, however, comment on the discrepancy it observes between Alder Hey’s aspiration to be a world-class centre for paediatric surgery, and the standards that it currently achieves.

“In the view of the panel, Alder Hey is not at the present time attaining world-class standards of care or world-class standards of research in the department of paediatric surgery.”

A summary on care provided read: “The conclusion of the reviewers is that overall the surgical care of patients referred to in the specific cases reviewed within the department of paediatric surgery at Alder Hey did not fall below the general standard of acceptable practice prevalent within the UK at the time the events took place.

“However, in five of the 20 cases/case series that the witnesses identified, either the care given was sub-optimal, or clinical governance appears to have been weak.”

Steps it has already taken include:

A review of its whistleblowing policy.

Strengthening processes including staff appraisals and how to carry out effective meetings about patient deaths.

The establishment of a new clinical ethics committee.

A spokeswoman for the hospital added: “Alder Hey has an excellent clinical record.”

The full summary can be viewed at www.alderhey.nhs.uk

‘Our surgery is safe’, says Alder Hey Hospital chief executive Louise Shepherd

CHIEF executive at Alder Hey, Louise Shepherd, said: “The safety of the children in our care is our highest priority. We are pleased that the review concluded that clinical standards of surgical practice were within UK acceptable standards and that we provide a safe surgical service at Alder Hey.

“The RCS highlighted some clinical concerns in two cases relating to clinical care. Additionally three cases highlighted process issues such as taking of consent, supervision and approval of new procedures. The Department of Paediatric Surgery has treated over 27,000 cases during the six years covered by the review. To address these issues, the RCS has provided a number of recommendations. These recommendations are helpful and we have begun putting actions in place.”

Parents or families who wish to discuss the review should contact the hospital’s patient advice and liaison service on 0151 252 5161.

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