Care Quality Commission review 2013

Background since 2013

2013: The Keogh teams reviewed the quality of the care and treatment provided by 14 hospital trusts in England, including ours, between February and June 2013. Read more on our Keogh Review webpage.

2013: The Care Quality Commission (CQC) issued a report on 5 November 2013, following an inspection at our Trust, regarding the quality of some services for cancer patients. The Trust was subsequently placed into special measures by Monitor in November 2013. See below.

2014: The Keogh team returned in February 2014 for a follow-up assurance review of their original visit. Again, more here.

2014: Publication in July of three quality reports by the CQC.

2014: CQC carries out inspections the A&E department and Emergency Assessment Unit (EAU) in November and December 2014.

2015: CQC publish their report in January 2015 into A&E and EAU.

Our Trust operates as an NHS Foundation Trust on special measures, led by its Board of Directors, supported by a Monitor-appointed Improvement Director.

nhs england logo

Thursday 19 December: NHS England on behalf of the Incident Management Team published the findings of its review of cancer services at our Trust. The primary aim of the immediate review was to answer the question "Are the cancer services safe?". Read their news release.

Read the report: Immediate Review of Cancer Services (855kb).

The Trust said: "We accept in full the report and its recommendations, and thank everyone who contributed for their work which shines a light on the way ahead for our cancer services." Read our full response Trust welcomes cancer report.

Remember: our Helpline is staffed 8am-8pm, seven days a week but will be closed on Christmas Day, Boxing Day and New Year's Day.

essex police logo

Tuesday 26 November: Essex Police issued a statement announcing that they have "decided it is necessary to begin a criminal investigation into the alleged manipulation of cancer waiting lists at the Trust". The investigation will aim to establish whether or not any criminal offences have been committed and then take any appropriate action dependent on the evidence.

NHS England issued a press release and Terms of Reference about their review of cancer services at our Trust. The Trust remains focused and determined to get to the bottom of all of the concerns and issued raised in the Care Quality Commission report into our cancer services, which was published on 5 November. That is why we have been working closely with many agencies, including Essex Police, professional regulators, NHS England and North East Essex Clinical Commissioning Group, and will continue to do so.

small image mainstream

Friday 23 November: Dr Gordon Coutts: "We did not wait before making changes. As soon as the CQC inspection team first visited in August, we recognised there were issues that the Trust needed to resolve," he writes in the November edition of Mainstream (pictured right). "We have already made improvements and will continue to make further changes..."

Read more in the November edition of Mainstream.

Thursday 14 November: Our Trust has been placed into special measures by health sector regulator Monitor. Read Monitor's press statement. Read our response statement in full.

Here you can read our specially prepared FAQs, including "what does it mean for Colchester?"

sally irvine

Monday 11 November: An independent investigation has begun into how our Trust responded to concerns about cancer waiting times.

The investigation is being led jointly by Professor Pat Troop, a former Deputy Chief Medical Officer of England, and Carole Taylor-Brown, former Chief Executive of NHS Suffolk and former Chair of the Anglia Cancer Network (see panel below).

The independent investigation has been commissioned at the request of Trust Chair Dr Sally Irvine (pictured) by Sir John Ashworth, the Senior Independent Director among the Trust's non-executive directors, following publication of a Care Quality Commission report


Background

The Care Quality Commission (CQC) issued a report on Tuesday 5 November, following an inspection at our Trust, regarding the quality of some services for cancer patients.

The Chief Inspector of Hospitals recommended that our Trust should be placed in to special measures. Professor Sir Mike Richards' call follows serious concerns, highlighted during a CQC inspection, regarding the quality of some services for cancer patients at our Trust.

The concerns and the recommendation have been referred to Monitor, the sector regulator for health services in England - see CQC and Monitor's joint press statement.

We are shocked and dismayed by the concerns raised...


Our Medical Director's response

Dr Sean MacDonnell, our Medical Director, said: "On behalf of the Trust, I apologise to the patients, relatives and carers who we have let down.

"We are very sorry for the worry, distress and concerns that have been raised by the publication of the CQC report into our cancer services.

"Patients and the public can be reassured that we are taking the findings extremely seriously and are determined to get to the bottom of the issues and sort them out..."

Read in full our response to the CQC report.

Dr Gordon Coutts

Our Chief Executive's response

Chief Executive Dr Gordon Coutts, said on Tuesday 5th November 2013: "We are very concerned by the findings of the CQC report.

"We are truly sorry that in some cases cancer patients, their carers and families have not always received the high quality of care that they should have expected from our Trust.

"We sincerely apologise to those who we have let down and for the worry, distress and concern that the publication of today's report is likely to raise..."

Read in full our response to the special measures recommendation.

Read in full FAQs issued 4 November.


Helpline for patients or relatives

We urge all patients currently using our cancer services to keep their appointments. The issues in the CQC report are primarily about delays to treatment and it is vitally important that patients continue with their treatment.

Cancer patients (past and present), their relatives and members of the public who have any concerns as a result of the CQC report can contact a special helpline that the Trust has set up.

0800 028 2026.

It is open 8am-8pm, seven days a week, except Christmas Day (25th December), Boxing Day (26th December) and New Years Day (1st January).

Download a poster advertising the Helpline.

phone


How staff can raise concerns

We are deeply concerned if staff cannot raise concerns openly and safely.

We hope that you can talk with your immediate manager, your union rep, HR or the Health & Wellbeing team.

We also have an anonymous confidential helpline: Raising Concerns confidential helpline*.

We also have an independent and confidential advice and counselling service for staff who may require practical advice or emotional support with either work or personal issues: Confidential Care helpline*

*These link to our staff intranet and won't be visible to the public.


Reviews

Here is a summary of the current reviews taking place at the Trust, following the CQC report...

NHS England review of the Trust's cancer pathways

A number of review teams have been examining all 14 cancer pathways at the Trust. These teams are independent of the Trust and are being co-ordinated by an NHS England-led Incident Management Team. Each cancer pathway is being examined by a dedicated team made up of senior clinicians including a cancer specialist, GP, senior nurse, cancer managers and other support staff. The teams will look at the clinical quality of services, waiting time information, treatment outcomes and the overall organisation of each cancer specialty. If a pathway review team has concerns it will identify immediate remedial action to make the services safe and indicate if further reform or improvements to services are required. A final report completed and published by NHS England by mid-December. (On 26 November NHS England issued a press release and Terms of Reference.)

NHS Intensive Support Team review of cancer pathways

The Trust invited the NHS Intensive Support Team in to review the Trust's cancer pathways. The IST has been looking at whether any aspects of the current processes for the cancer pathways at the Trust have placed patients at risk and are formulating an action plan for improving these processes. The review team has already been into the Trust a number of times in recent weeks and they will be visiting again over the next few weeks. A final report is expected by mid-December.

Internal reviews

The Trust has been reviewing each of the cases identified by the CQC and is also looking at other cases where patients could have been affected by similar issues. All the patients identified by the CQC, or their families, were contacted before the report was published and most of them have already been seen by a team to explain the issues in their case. Where other patient files are reviewed the Trust will also be writing to each of the patients to let them know that this has been done. Any patients where there have been problems in the way their case was handled will also be invited to come in and talk to a consultant.

Independent review of individual cases

Each of the cases that were identified by the CQC will also be reviewed by an external expert to determine whether the delays identified where avoidable or caused harm.

Troop/Taylor-Brown independent investigation

An independent investigation into how the Trust responded to concerns about cancer waiting times is being led jointly by Professor Pat Troop and Carole Taylor-Brown.

Police investigation

The police are carrying out an investigation to establish whether or not any criminal offences have been committed and will then take any appropriate action dependent on the evidence. As part of their investigation, the police have also commissioned a medical legal review of the 30 cases identified in the CQC report. Essex Police issued a statement on 26 November.


What other organisations said when the story broke

CCG view:
"CCG deeply concerned at CQC report into cancer services at Colchester".

Colchester MP view:
Sir Bob Russell's response

CQC and Monitor joint statement:
"...recommends Essex hospital trust is put into special measures"

Harwich and North Essex MP view:
Bernard Jenkin's response as reported in the Colchester Daily Gazette

A police spokesman said: "Essex Police has been contacted by the CQC and is currently reviewing the information it has provided to establish whether a criminal investigation is necessary."


What news organisations said when the story broke

There follows a selection of what the media reported, including links to TV coverage. (Some of the links may not be working as the media channels replace content on their websites.)

Tue 5th

BBC News video report:
"Police investigate Colchester hospital cancer treatment"

Guardian:
"Police may investigate Colchester hospital over cancer care"

Colchester Daily Gazette:
"Watchdog finds Colchester General Hospital staff changed cancer patient records"

BBC News | Watch Peter Carter, Royal College of Nursing:
Colchester hospital report 'shocking'

BBC News | Watch Sir Mike Richards:
Colchester cancer care 'serious' issue

BBC News | Watch Dr Gordon Coutts:
'We let Colchester cancer patients down'

ITV Anglia:
ITV coverage - including video - on Tuesday

Wed 6th

Guardian:
'NHS cancer specialists drafted in to check records'

BBC Essex broadcast their Breakfast programme from Colchester General Hospital:
Listen Again

BBC:
Newspaper review: Hospital concerns dominate papers

Thu 7th

Guardian:
"...scandal shows how deep NHS culture change needs to be"

Colchester Daily Gazette:
"Investigators take away patients' files for evidence of misconduct"

Fri 8th

ITV Anglia:
"Health Chiefs aim to stamp out Colchester Hospital cancer delays"

Sun 10th

Today, a national newspaper claimed one in three cancer patients may have been affected. The Trust issued a statement, refuting claims made in The Observer national newspaper. ITV Anglia broadcast our statement in full.

Mon 11th

BBC:
"Colchester hospital cancer waiting times inquiry begins"

Colchester Daily Gazette:
"Probe into Colchester's cancer scandal begins"

Fri 14th

BBC:
Watch BBC Look East's news programme from Thursday 14 November.

See more news reports, on our RSS feed of alerts webpage.

CQC webpage | About our Trust

Care Quality Commission logo

Here is the CQC webpage about our Trust.

Go to the 2014-2016 CQC review page