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Concerns raised over missed and delayed cancer diagnoses at Barking and Dagenham’s NHS trust, report finds

PUBLISHED: 17:21 05 October 2017

Queen's Hospital

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Concerns have been raised over an “increasing number of serious incidents” at Barking and Dagenham’s NHS trust due to missed or delayed diagnoses for cancer.

BHRUT response

Dr Nadeem Moghal, medical director of Barking, Havering and Redbridge University Hospitals NHS Trust, writes:

We are all aware of the issues highlighted, and have been working together with the CCG for some time, along with other key partners and experts to take appropriate action. We have made significant progress in recent weeks, and this picture is therefore somewhat out of date.

Mortality rates are influenced by a huge number of complex and interrelated factors, so we are working to explore exactly what the underpinning causes are, so we can work with key partners to tackle them together.

Our internal data is showing an improvement already, but as the national benchmarking is on a rolling basis, it will take some months before this is shown in the reported national figures.

Regarding our processes in theatres, we have already made substantial progress in analysing and changing our approach in the light of the never events we reported.

This has included comprehensive training, more cross-site checks, standardising our approaches to reduce the risk of variation and ensuring all disturbances and disruption during procedures are minimised.

We have previously acknowledged our areas to develop around certain radiology procedures. We have made significant changes and improvements in the light of recent feedback.

This has included the introduction of a new way of working to ensure all our procedures in the specific area of visipaque swallows are robust and in line with national standards and best practice. More broadly, we are delivering a comprehensive review of the entire department, working closely with the Royal College of Radiologists.

Redbridge Clinical Commisioning Group (CCG) has highlighted this, the levels of staff during surgery and the mortality rate at Queen’s and King George hospitals in its latest board papers.

Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) responded saying it has been working with key partners for some time to address these issues, as Dr Nadeem Moghal’s comments to the right show.

The board papers, published last week, read: “Over the past few months we have seen an increasing number of serious incidents coming through specifically related to missed or delayed diagnosis for cancer.”

The CCG also cites a “case of potential clinical harm as a result of delayed reporting and the trust not acting on the radiology results”.

The coroner issued a Regulation 28 notice in March, over similar concerns.

This is an order for BHRUT to provide regular updates on how it will prevent future deaths, following an inquest.

The CCG also said it was “significantly concerned around the trust’s Mortality Reduction Improvement Plan”, which is designed to reduce deaths in hospital. The board papers read: “Although an improvement plan has been put in place, we are yet to see a reduction.”

The CCG was so worried it has since raised the issue with NHS England and NHS Improvement.

Regarding surgery the papers stated: “There are also concerns that operations are being carried out without a full complement of staff, as staff are leaving the theatre to scrub for emergency operations.”

Dagenham and Rainham MP Jon Cruddas said in a statement: “Cancer is a terrifying disease and I am deeply alarmed to here about diagnosis failings and an increasing number of serious incidents, including at least one death, within the health trust.

“It is vital we get to the bottom of this matter urgently.

“I will be contacting both the trust and the coroner immediately asking for full details of these incidents.”

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