Watchdog gives no assurances over hospital deaths repeat

A health watchdog says it cannot give "strong assurances" that a situation like the Mid Staffordshire scandal is not happening in the NHS in Wales.

An inquiry highlighted the "appalling and unnecessary suffering of hundreds of people" at Stafford Hospital.

The Healthcare Inspectorate Wales (HIW) told a committee of AMs staffing issues meant it could not deliver "sufficient coverage" in terms of tests.

The health minister said he previously had concerns about HIW's capacity.

The Health and Social Services Committee is reviewing HIW's work.

The Francis report into failings at Stafford Hospital in Staffordshire earlier this year found systemic failures that went right to the top of the NHS in England.

Data showed there were between 400 and 1,200 more deaths than would have been expected.

The Mid Staffordshire NHS Trust, which operated Stafford Hospital, went into administration earlier this year after a report concluded it was not "clinically or financially sustainable".

HIW, based in Merthyr Tydfil, is the independent inspectorate and regulator of all healthcare in Wales.

Kirsty Williams AM, leader of the Welsh Liberal Democrats asked the watchdog's officials if they were "confident whether you would know if you had a Mid Staffs on your hands?"

In response, Kate Chamberlain, HIW chief executive, said: "I am not convinced that we have sufficient coverage in terms of testing for me to be able to give you that strong assurance."

Ms Chamberlain added that staffing levels were not adequate to carry out inspections sufficiently.

She said: "Given that we haven't been able to fill all the posts that we wanted to fill there has been a conversation around whether if we were fully staffed we would be able to do a sufficient amount of testing.

"Certainly on the back of some of the preliminary analysis that I've done I've got some concerns over whether even with a full compliment we would be able to do enough to satisfy myself to that extent."

The watchdog is currently undertaking a recruitment drive to supplement its 58 staff.

'Knock-on effect'

An increase in responsibilities since it was set up in 2004 has led the HIW to carry out a review of its operations which will form the basis of a proposed delivery plan for 2014/15.

Ms Chamberlain told AMs that the staffing issue meant that responding to concerns as they arise was having a "knock-on effect on some of our other parts of work."

She added: "The way in which we're currently using our capacity I'm satisfied is responding to the issues and concerns we are finding.

"I think probably a very good example of that is the fact that we did go up to Betsi Cadwaladr and do the review in response to the things that we found.

"I think though that in order to be able to do that what you're finding is a knock-on effect on some of our other parts of work.

"I'm certainly aware that the team that went to Betsi, in order to do that have had to delay reporting on a number of other pieces of work they were involved in," she added.

An outbreak of Clostridium difficile (C. Diff) between January and May caused the deaths of 30 patients at Glan Clwyd Hospital, Denbigshire.

The chairman and vice-chairman of Betsi Cadwaladr University Health Board (BCUHB) stood down after the NHS body was severely criticised by health and audit watchdogs over its handling of the disease outbreak, among other management failings.

At the committee, Health Minister Mark Drakeford was asked whether he was satisfied that HIW had the capacity to provide the services he would want to see from an independent inspectorate.

He replied: "I have had concerns about its capacity, in the last year, those concerns have more been about its ability to recruit and retain the staff it needs to discharge those responsibilities than it has been about the quantum of financial resource available to it as an organisation.

"However the new chief executive, since coming into post, has been undertaking a thorough review of what she thinks the organisation will need in order to go on discharging its responsibilities into the future."

He added discussions about the size of HIW's budget were ongoing with the local government minister, adding: "I think they didn't manage to spend their budget last year, but that was because they didn't have the staff in place to do so."