Norfolk and Suffolk NHS trust deaths report 'watered down to spare bosses'

"We cannot have people watering it [the report] down when it's about deaths," campaigner Caroline Aldridge said

A critical report into how a mental health trust mismanaged its mortality figures was edited to remove criticism of its leadership, the BBC has found.

In June, auditors Grant Thornton revealed how the Norfolk and Suffolk NHS Foundation Trust (NSFT) had lost track of patient deaths.

But earlier drafts included language around governance failures that were missing in the final version.

NSFT and Grant Thornton said the changes were due to fact-checking.

A number of drafts of the report were produced, with the first dated 23 February this year.

The first version described "poor governance" in the way deaths data was managed, with governance also being called "weak" and "inadequate".

But many of these critical words were missing from the report released to the public, with "governance" also being replaced with "controls", according to leaked documents.

NSFT said: "We responded to requests from the auditors to check the factual accuracy of their early draft report and to provide further information. This is a standard process to make sure that such reports are evidence-based."

Grant Thornton said: "It is not uncommon for findings and language to be refined before being finalised.

"After the initial draft the engagement team at the trust changed, who then provided further information around controls and internal processes of which we were previously unaware."

Ms Aldridge's son Tim died in 2014 after what she said were his struggles to get the right support

But campaigners have described this as blame deflection.

After losing her son Tim in 2014, Caroline Aldridge has been highlighting what she and others claimed had been the trust's undercounting of deaths.

"I think people need to know what was removed and what was changed, because I suspect that the first report is a lot nearer to the truth," she said.

Ms Aldridge added: "It takes all responsibility from governance, removing the words 'inadequate', 'poor', 'weak' governance, removing significant pieces of information that's not factual accuracy.

"We cannot have people watering it [the report] down when it's about deaths."

Another section that did not make the final version highlighted a "culture of fear" among some staff, who reported anxiety around how the data was used.

It is understood this was removed after the trust challenged the number of clinicians Grant Thornton had spoken to.

Ms Aldridge (middle) has been campaigning with Emma Corlett (left) and Anne Humphrys

The auditor said the trust had demonstrated its governance was "in line with national expectations".

The review was launched at the behest of local NHS commissioners in October over confusion about the number of people in contact with the trust who had died.

In August last year, Norwich South Labour MP Clive Lewis cited claims from local mental health campaigners that there could have been as many as "1,000 avoidable mental illness-related deaths" - a figure the trust said it did not recognise.

Deputy chief executive at the trust, Cath Byford, told a local health scrutiny panel that Grant Thornton's review had been established to find a "single truth" regarding the number of deaths.

But the review instead looked at the trust's mortality data processes, finding that it could not provide assurance over the trust's figures.

'Demand just exceeds capacity'

Referrals to mental health crisis teams across the country were up 30% since before the pandemic, according to NHS England.

The number of people aged under 17 receiving NHS-funded support had increased to 702,000 since 2019.

NSFT's most recent annual report stated referrals to its children and young people's services had more than doubled in the same period.

Two NSFT clinicians, who asked for their identities to be protected, described how there were not enough staff to deal with demand.

"The service I work for, we're just not able to support as many people as we'd like to. We're only supporting around 66-65% of the people that are contacting us," one said.

They added: "One of my managers came up to me and said, 'Don't complete the patient incident forms,' and they were actively encouraging us to not do that, because they'd have to do more work and it looked badly on them as a team."

The other said: "Services have always been under pressure, but now it feels like demand just exceeds any capacity available.

"Staff don't have time to be recording things as they would want to so they might not record every incident on the patient safety records, which should be highlighting any risk incidents up the chain to more senior management."

Stuart Richardson, NSFT's chief executive officer, said: "Over the last year we have introduced safer ways of working and supported colleagues to raise concerns or ask questions so that we can address and help resolve them at the time."

The BBC showed the different versions of the report, and the responses from the trust and Grant Thornton, to the Parliamentary and Health Services Ombudsman.

Rob Behrens said: "I'm concerned at the difference between the draft report and the published reports, and because the differences in the texts at key points are so huge that this is not just a bureaucratic drafting issue."

Grant Thornton said: "Whilst the overall findings of the report did not change, the new evidence did adjust our assessment of significance in some areas. In addition, wording changed in some areas to highlight areas of good practice that were brought to our attention and which we believed could be broadened out to help resolve issues.

"We maintain that the final public report is an entirely independent, robust and thorough assessment of the historic matters at the trust."

Mr Richardson, from the trust, added: "We have been open and honest about the failings highlighted in this report, and are committed to bringing about the improvements that our service users and staff deserve."

Viewers in the East of England can find out more on this story on BBC Look East at 18:30 BST on Tuesday 29 August on BBC One, and nationwide on Newsnight at 22:30 on BBC Two.

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