Patient safety

06.12.18

Inspectors find feuding surgeons’ ‘tribalism’ and culture of hostility at cardiac unit contributed to higher death rate

Inspectors have reported weak leadership, a culture of bullying, and “tribalism” between feuding heart surgeons after a review of a troubled cardiac unit in London.

Hostilities between surgeons at St George’s Hospital became so intense they required mediation when complex heart operations were moved out of the hospital in September after a leaked document revealed a “toxic” row had contributed to a higher than average death rate.

The CQC said that mediation only worked briefly before “poor behaviour” returned, and reported that “strong” personalities were unable to work together effectively.

In their report, the health inspectorate stated that “consultant surgeons mistrusted each other, as well as cardiologists, anaesthetists and senior leaders.”

Staff told inspectors that the cardiac surgical team “had not worked effectively for several years” and described poor working relationships and a “culture of bullying and harassment” as harming the effective running of the unit.

A number of high-risk patients were being diverted to other hospitals, and the CQC also pointed at a culture of not learning from incidents, problematic patient records, and a lack of oversight.

The CQC said the cardiac surgery unit in Tooting must improve, but the trust said the services provided were safe.

An external oversight panel was brought in in September to “deal with the long-standing issues” facing the cardiac surgical services, and the week before a barred heart surgeon at the trust won a High Court battle after being accused of bullying.

England’s chief inspector of hospitals, Professor Ted Baker, said: “Issues such as weak leadership, internal unrest and multiple electronic patient record systems are just some of the problems affecting St George’s Hospital cardiac surgery unit.

“We have told the trust it must now take steps to improve the morale, culture and systems within the unit. Colleagues at NHS Improvement have set up an independent scrutiny panel for cardiac surgery to advise, challenge and support the trust through this difficult time.

“I expect to see improvements at the cardiac surgery unit and CQC will be monitoring the situation closely. We did note that there were no immediate concerns regarding patient safety, which is our paramount concern at all times.”

The report in the summer leaked by former NHS England deputy medical director Mike Bewick showed that the unit had a cardiac surgery death rate of 3.7%, which is above the national average of 2%.

Image credit - John Stillwell/PA Wire/PA Images

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

‘Damaging’ NHS targets ‘have had their day’ claims Lord Prior

15/02/2019‘Damaging’ NHS targets ‘have had their day’ claims Lord Prior

NHS targets “have had their day” according to Lord Prior as the head of the health service launches an attack on 25 years of flawed h... more >
Controversial shake-up of Kent stroke services given rubber stamp amid calls for judicial review

15/02/2019Controversial shake-up of Kent stroke services given rubber stamp amid calls for judicial review

A major reorganisation of stroke services across Kent and Medway have been approved following a unanimous decision by the Joint Committee of CCGs... more >
A&E waiting time performance hits all time low as NHS ‘buckles under the strain’

15/02/2019A&E waiting time performance hits all time low as NHS ‘buckles under the strain’

A&E waiting time performances in NHS trusts in England have hit their lowest level since regards began, according to the latest NHS statistic... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now bey... more > more last word articles >

the scalpel's daily blog

Blog: 5 minutes with Dr Tracy Vell MBE, Associate Lead for Primary and Community Care, Greater Manchester, Health and Social Care Partnership.

14/02/2019Blog: 5 minutes with Dr Tracy Vell MBE, Associate Lead for Primary and Community Care, Greater Manchester, Health and Social Care Partnership.

Ahead EvoNorth we caught up with Dr Tracy Vell MBE, Associate Lead for Primary and Community Care, Greater Manchester, Health and Social Care Partnership. Dr Tracy Vell MBE shares her thoughts on the Northern Powerhouse, what it means to her and why she thinks it’s important to attend EvoNorth.  What does your role as ... more >
read more blog posts from 'the scalpel' >

comment

Maximising volunteer potential in hospitals

14/02/2019Maximising volunteer potential in hospitals

Sam Ward, director of commissioned services at the Royal Voluntary Service, argues that the right training can help harness the power of voluntee... more >
Leading and managing experts

14/02/2019Leading and managing experts

A coaching conversation is likely to yield the best results. Managing experts in the health industry can be a challenging and varying responsibil... more >
Mesothelioma in the UK: a growing fight

14/02/2019Mesothelioma in the UK: a growing fight

The health impacts of asbestos in the UK can cast a much wider net than those in the construction and building sector. Liz Darlison, head of serv... more >
ICO: Cyber security and the NHS

14/02/2019ICO: Cyber security and the NHS

Peter Brown, acting head of technology policy at the Information Commissioner's Office (ICO), explains the importance of good practice in data pr... more >

interviews

How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >

health service focus

View all News