Dr Minh Alexander retired consultant psychiatrist 12 October 2023
Further to Devon ICB’s brief appointment of controversial former Welsh Health Board CEO Allison Williams as interim ICB CEO, followed by her resignation within weeks, Devon ICB confirmed that it applied a Fit and Proper Person process.
The information was provided via FOI Ref NHSD23/442, 28 September 2023:
“All NHS Devon Board-level appointments are subject to full engagement checks, including the Fit and Proper Person Test and an appropriate DBS check, before the candidate formally takes on the role.
Allison was due to take over the interim CEO responsibilities from November and her appointment to the role was announced to staff pending the engagement checks, as she had already been supporting the system for two years, and to provide reassurance to staff during an unsettling time (due to the organisational change process necessitated by the requirement to reduce running costs).
Like all NHS organisations, NHS Devon is currently updating its processes to ensure compliance with the requirements of the revised Fit and Proper Persons Test Framework (to be introduced on 30th September 2023) which will improve and strengthen further the existing process.”
Williams’s appointment was revealed through enquiries by NHS whistleblower Clare Sardari @SardariClare following reports:
Letby murders: McLellan’s arse, NHS Stalinism and reported NHS management recycling at Devon ICB
The ICB now claims there was an announcement about Williams’ appointment on 14 August 2023. If so, it was presumably internal as there appears to be no sign of any external announcement on the ICB website or otherwise.
Since then, Mr Thomas a member of the public whose late wife suffered serious harm at Cwm Taf Health Board where Allison Williams was CEO has shared concerns.
I have written to Dr Sarah Wollaston Devon ICB Chair to ask for more information about the ICB’s governance, and to pass on Mr Thomas’ concerns.
Some of the personal detail about Mr and Mrs Thomas’ experiences is held back for reasons of privacy.
The letter is hopefully self explanatory
BY EMAIL
Sarah Wollaston
Chair Devon ICB
12 October 2023
Dear Sarah,
Appointment of Allison Williams as Devon ICB CEO – further questions and review
Thank you for the attached FOI response by Devon ICB which indicates that it applied a Fit and Proper Person test when it appointed Allison Williams (CEO Cwm Taf Health Board 2011 to 2019 ) as ICB CEO.
I note that the ICB repeats its assertion that Ms Williams could not take up the ICB CEO post because of the travelling.
I find this hard to understand given that the ICB also indicates that Ms Williams had been working for the ICB for two years, and would presumably have been making the journey for that time, without it deterring her application for the CEO post.
Nevertheless, I would be grateful for more information about Devon ICB’s Fit and Proper Person process which was applied when appointing Ms Williams.
What did it comprise? How did the ICB satisfy itself that the very serious concerns in the public domain about her performance at Cwm Taf did not impair her fitness to be ICB CEO?
What steps did the ICB take to evaluate Ms William’s responsibility and contribution to very serious governance and patient safety failures at Cwm Taf?
Did the ICB conclude that those events were no longer relevant?
Or did the ICB either conclude that Ms Williams was not responsible, or if responsible, was no longer a risk in terms of repeating governance and patient safety failures?
What evidence did the ICB use to come its conclusions?
What screening and interview processes were followed that culminated in Allison Williams’ appointment?
What parties were involved in shortlisting and what parties were on the panel(s) which interviewed Ms Williams and made the final decision to appoint?
Please give the names, seniority and job descriptions of all those who took part in the appointment interview(s).
In hindsight, does Devon ICB accept that it has any learning arising from the Williams appointment, and should Devon ICB review its Fit and Proper Person process?
The experience of Mr and Mrs Thomas at Cwm Taf
Mr Thomas responded to my post about Allison Williams’ appointment by Devon ICB.
For your information, I provide below in the appendix the account of Mr Wayne Thomas whose late wife was very seriously and multiply harmed by Cwm Taf Health Board, where she received treatment.
You will see that it is an extraordinary and harrowing story. It includes the fact that another Welsh Health Board had to take Mrs Thomas back to theatre after surgery at Cwm Taf for an abdominal abscess, whereupon it was discovered that a Cwm Taf surgeon had completely divided Mrs Thomas’ bowel.
I also attach a letter from the relevant surgeon to Mr Thomas about what they found on re-opening Mrs Thomas’s abdomen. Names are redacted to protect the privacy of the staff involved. As you can see, the surgeon remarks: “To divide the colon and leave two ends inside is an extremely unusual finding”.
Mr Thomas believes there were other errors in Mrs Thomas’ care and she later died. The additional errors included such matters as a grade three pressure sore because Mrs Thomas had not been turned frequently enough by nursing staff (only two to three times a day instead of every two hours), and the right type of mattress was not available. There was also reportedly injury to her liver because total parenteral nutrition was given at the wrong rate on repeated occasions. There were also other issues including as spinal fracture due to Mrs Thomas being dropped, mis diagnosis of Steven-Johnson’s syndrome, an undisclosed heart attack possibly related to mismanagement of IV fluids and E coli infection.
Mr Thomas naturally wanted a proper investigation of all the harm caused to his wife and her death.
But he felt it was just “one big cover up”.
He wrote to Allison Williams in 2019 asking for the case investigation to be reopened because of new information, but she reportedly refused. The relevant correspondence is in hard copy only and currently with another party. But I have seen his correspondence to her.
Mr Thomas reports that there has never been a proper investigation, and only internal investigations took place. He has many unanswered questions, and is pursuing matters further.
I cannot imagine the suffering Mr Thomas has been through, witnessing the care failures in his late wife’s treatment.
And a question arises of how many other patients and families are in a similar position as a result of the failures at Cwm Taf. The Royal College maternity review at Cwm Taf threw up evidence of organisational cover up and failure to learn. An earlier expert report about failings was not given to the Royal College, and only came to light during the review.
It became evident that staff concerns were ignored.
The experience of one Cwm Taf maternity whistleblower is described here by the local media:
“She said despite reporting countless serious incidents and near-misses with her senior colleagues, her concerns were rarely addressed.
And after writing a letter to the chief executive of Cwm Taf Morgannwg University Health Board Allison Williams in 2017 in a desperate plea for more support, she said the problems only worsened.”
“”The midwives’ skill and compassion is second to none – despite the fact they end their shifts extremely stressed and normally in tears,” said the midwife.
“I discussed my concerns with my managers about staff numbers, but they often fell on deaf ears. This would often leave the unit dangerously short.
“I was very aware that I was failing these patients. There were so, so many near misses.”
“And she added that the bullying culture within the organisation made it almost impossible for frontline workers to air their complaints without fear of repurcussions.
“It would take all my strength to approach my line manager when we needed help,” she added.
“But most of the time they wouldn’t even get out of their office. They would just blame me as the clinician for not managing my workload.
“I feel like I’m a pretty strong character, but even I was intimidated by certain managers.”
As you put it in 2015, the mistreatment of whistleblowers is a stain on the NHS’ reputation, and “inexcusable”.
Should those who have overseen poor culture and serious related patient harm be trusted to hold senior positions again?
It would be reassuring if Devon ICB acknowledges the depth of the suffering by patients, families and staff at CwmTaf, and honestly examines how it came to appoint Allison Williams, in order to learn and strengthen its safeguards for public protection.
How can it be right that someone, who has apparently not acted on concerns from patients, families and staff, was put in a position of such great power again?
The last words belong to Mrs Thomas, who at one point in her terrible patient journey asked Mr Thomas to feed the following back to Health Board staff:
“You lot have no idea what i have been through these last few years how i shouldnt be alive in REDACTED words and the nursing staff at UHW, I had to learn to sit up, learn to stand, learn to walk and learn to eat and drink and in a wheelchair for over 3 years and in and out of hospital since and also in high dependancy unit critical care where they told my husband we think we just about caught her my body was physically tortured and i am mentally scarred from it.”
I blind copy this letter to Mr Thomas to protect his privacy.
With best wishes,
Minh
Dr Minh Alexander
APPENDIX
[Correspondence from Mr Thomas about care failures at Cwm Taf Health Board, redacted]
Attachment – letter from another Welsh Health Board confirming that Mrs Thomas’ bowel was found to have been completely divided – withheld
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