Opportunity Cost of the £734,000 spent by University Hospitals Bristol NHS Foundation Trust on a Histopathology Inquiry

This is how the £734,000 cost to the public (confirmed by the National Audit Office), of a Histopathology Inquiry (1) commissioned by the Trust could have been used to improve the care of patients, in this example children with congenital heart disease, by reducing the risk of harm caused by too few skilled nurses at the Bristol Royal Hospital for Children.

A Department of Health Briefing (2) cleared by Sir Bruce Keogh, was issued following the CQC’s 2012 inspection of Ward 32 at the Bristol Royal Hospital for Children.

Paragraph 18 says:

“The major issue of concern is that there are no step down facilities e.g. a High Dependency Unit (HDU) between the Paediatric Intensive Care Unit (PICU) and the ward. The CQC consider that, given the complex case load, there should be such a facility as there are too many children with complex needs being treated by too few nurses who are not sufficiently skilled”

The first paragraph of the Histopathology Inquiry Report, published in December 2010, acknowledges that the cost of the Inquiry need never have been incurred if the Trust had ensured that concerns were properly investigated when managers first knew about them.

“An Inquiry of this nature, scope and cost would never have been necessary or probably even contemplated had concerns been thoroughly and promptly investigated when and whenever they were raised and the results of those investigations made clear to those who had made the allegations.”

The £734,000 of public money spent on the Histopathology Inquiry whose report fails to explain why senior doctors and NHS managers who knew about the concerns for years failed to adequately investigate them, could have paid for 23 Grade 5 staff nurses for a year (3). With appropriate skills, these nurses could have alleviated some of the staffing problems on Ward 32 which presented a risk to the safe care of children.

(1) http://drphilhammond.com/blog/2011/01/21/private-eye/medicine-balls-private-eye-issue-1280/

(2) https://www.whatdotheyknow.com/request/169406/response/419243/attach/3/796181.pdf

(3) https://www.nice.org.uk/guidance/sg1/documents/safe-staffing-guideline-consultation9

Table 2 page 18 – £734,000 divided by total cost of a band 5 staff nurse, £31,867 would pay for 23 band 5 staff nurses for a year, or 18 band 6 charge nurses or 15 band 7 sisters/ward managers.

© South West Whistleblowers Health Action Group 2015

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