Dr Minh Alexander retired consultant psychiatrist 14 September 2023
This is a short post to note that Medway NHS Foundation Trust, which has links with Brighton and Sussex University Hospitals NHS Trust (later University Hospitals Sussex NHS Foundation Trust), extraordinarily simply did not respond to an Employment Tribunal claim, and lost the case by default under Rule 21.
The claim in question (ET case number 2300248/2023)was one of unfair dismissal and disability discrimination, Mr A Prew v Medway NHS Foundation Trust:
Why did the trust not respond to the claim?
If the trust considered the claim meritorious, why did it not seek to resolve it at an earlier stage, instead of making the former member of staff suffer for even longer through a legal process?
Was the trust avoiding the public airing of damning information by not responding to the claim and was it suppressing evidence of serious managerial misconduct?
How much public money will have been wasted by the mishandling of this case?
Who are the directors of Medway NHS Foundation Trust?
These are the non executive directors.
These are the executive directors.
The Medway Chair is a former Lloyds banker with expertise in offshoring, who was appointed as NED on 1 September 2015 on Hunt’s watch.
Medway’s chief executive since August 2022, Jayne Black a nurse, has sparse biographical details published on the trust’s website:
According to her LinkedIn entry, Black was formerly the Chief Operating Officer at Brighton and Sussex Hospitals University NHS Trust:
The Board of Western Sussex Hospitals NHS Foundation Trust, of which Black was a member, took over the running of Brighton and Sussex Hospitals University NHS Trust in 2017. The two trusts formally merged to become University Hospitals Sussex NHS Foundation on 1 April 2021.
There have been multiple failures of whistleblowing governance at Brighton and Sussex, now acknowledged by the Care Quality Commission. A CQC inspection at the Royal Sussex County Hospital which took place during September to October 2021 resulted in a highly critical inspection report.
The report from the 2021 inspection noted “at the time of inspection there were 128 incidents within the service that had not been reviewed and investigated by managers.”
A police investigation is now also taking place into untoward trust deaths that whistleblowers have been raising concerns about for years. Some of the deaths being investigated occurred during Black’s tenure as Chief Operating Officer at Brighton and Sussex.
It was revealed yesterday by The Guardian that the police investigation is widening and that there is evidence of continuing risk to the public. Disturbing details of harm suffered by patients, and families’ difficulties in getting the truth about loved ones, are now coming into the public domain:
Sussex police widen inquiry into Brighton hospital deaths
Of note, George Findlay the medical director and now Chief Executive of University Hospitals Sussex NHS Foundation spent a short period at Medway, as CEO, preceding Black’s appointment. These are the relevant details from his LinkedIn entry:
I have asked Jayne Black for information on why Medway NHS Foundation Trust failed to respond to the ET claim by Mr Prew.
Medway NHS Foundation Trust is currently rated “Requires Improvement” overall by the Care Quality Commission, and also “Requires Improvement” on the Well Led domain.
The most recently published CQC inspection report of July 2021 from an inspection which took place between April and June 2021, states:
“There have been significant cultural, relationship and leadership issues within urgent and emergency care which have had a demonstrable negative impact on patient outcomes. The trust had commissioned mediation for staff and had relied on external intervention from the NHSE/I’s Emergency Care Improvement Support Team (ECIST) to help to engage staff and deliver improvements in performance on length of stay and ambulance handovers.
Our conversations on the Freedom to Speak-Up agenda, focus groups with Junior Doctors and discussions with others with roles intrinsically linked with cultural change reflected a lack of engagement with staff. As did the trust’s 2020 staff survey results with the majority of relevant indicators falling below the national average, with many falling significantly below.
These cultural issues, along with a lack of meaningful clinical engagement had created a disconnect between management and clinical staff. A clinical summit was held in February 2021 to bring these groups together to look to bridge the gap and work together to make improvements and to begin to reform the medical model. However, a recent follow-up to this summit, around the time of our inspection, showed that this work had proved unsuccessful and the pace of delivery (and reform) had not been improved through this process.”
That’s something to chew on, for the pro management lobbyists who have been criticising the Secretary of State for suggesting that poor managerial performance may be grounds for disbarring NHS managers.
“Serious mismanagement” is a ground for action under CQC Regulation 5 Fit and Proper Persons, as it should be, because serious mismanagement of healthcare services can kill thousands.
CQC Regulation 5 states:
“5(3)(d) the individual has not been responsible for, been privy to, contributed to or facilitated, any serious misconduct or mismanagement (whether unlawful or not) in the course of carrying on a regulated activity or providing a service elsewhere which, if provided in England, would be a regulated activity.” [my emphasis]
NHS healthcare management is critical to the wellbeing of millions. It should be professionalised and consistent with Nolan Principles of public service, and not a morass of club culture.
PETITION FOR REGULATION OF NHS MANAGERS
This is a Westminster petition calling for regulation of NHS managers:
https://petition.parliament.uk/petitions/642631
If the petition reaches 100,000 signatures, the government will consider a related debate in parliament.
RELATED ITEMS
Robert Francis appeared on BBC Newsnight on 11 September 2023 and supported NHS England’s claims that full regulation is not needed for NHS managers:
Francis suggested on Newsnight that NHS employers are unaware of errant managers’ histories. By doing so, he drew a veil over what is an organised system of mutual protection and recycling, which has NHS regulators at its heart. The system even has a nickname, “The Donkey Sanctuary”.
The case of Paula Vasco-Knight exemplifies the collusion running throughout the system:
Postscripts on Paula. NHS England’s apologia & regulatory reticence
Historically, Medway NHS Foundation was one of fourteen “Keogh” trusts found to have high mortality:
2013 Report out today will highlight major failings across 14 NHS hospital trusts
Letby murders: McLellan’s arse, NHS Stalinism and reported NHS management recycling at Devon ICB
Lucy Letby murders: Former Countess of Chester Non Executive Director James Wilkie
Alexander's Excavations 