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NHS whistleblower treated unfairly, report finds

Published 12/05/2016

Clinical coding helps to determine how much money a health trust gets paid, by recording what services patients have received
Clinical coding helps to determine how much money a health trust gets paid, by recording what services patients have received

An NHS whistleblower who claimed she was badly treated by a hospital trust after alleging it had been fixing its death rates was treated unfairly, a report has found.

Manager Sandra Haynes-Kirkbright was head of clinical coding at the Royal Wolverhampton NHS Trust when she first alleged there were systematic flaws in its data, leading to overpayments to the hospital trust.

An independent review by consultants Verita into how the trust subsequently handled her allegations uncovered "evidence of a lack of proper governance and management at senior levels" of the trust.

There were "several examples of the trust not having followed due process in its policies and procedures", it also found.

The damning report, which is critical of the trust's chief executive, its medical director and the director of finance, concluded: "Mrs Haynes-Kirkbright was not treated fairly by the trust."

After joining the Royal Wolverhampton from the now defunct Mid-Staffordshire NHS Trust in October 2011, Mrs Haynes-Kirkbright was employed to improve the accurate coding of patients including those receiving palliative care, based on the treatment they received.

The codes, used in every NHS hospital, help to determine how much money a health trust gets paid, by recording what services patients have received.

Coding also affects a hospital's recorded death rate, also known as the hospital standardised mortality ratio (HSMR).

The report's authors, who were not asked to examine the truth of Mrs Haynes-Kirkbright's claims, said she alleged some of the hospital's codes "seemed to have no other purpose than to increase the income of the trust".

Mrs Haynes-Kirkbright, who alleged she was pressurised into not rocking the boat, is said to have told one of her coding colleagues: "If I'm forced to code these things I'll blow the f*****g lid off this place.

"I'll go to the Express & Star (newspaper)."

The report concluded: "She was put under strong pressure and when she resisted she was seen as obstructive and difficult.

"Her refusal was in accordance with good practice.

"Her expressed concern about this matter was not recognised by her line manager as whistleblowing, as it should have been."

The trust, which employs about 8,000 people, runs hospitals and community services including walk-in centres in the West Midlands.

It operates Wolverhampton's 800-bed New Cross Hospital, and the smaller West Park and Cannock Chase hospitals.

The report found that despite initially working "successfully with colleagues", in April 2012 Mrs Haynes-Kirkbright's co-workers complained about her management style and reforms, triggering a disciplinary investigation.

The authors of the review, published on Thursday, concluded that the trust's chief executive David Loughton had failed to launch a whistleblowing inquiry despite knowing of his coding manager's concerns by the time her co- workers had complained.

"He did not, as he should have, initiate a whistleblowing investigation," the report said.

"Rather, he instructed two of his executive directors to ensure that Mrs Haynes-Kirkbright's concerns did not interfere with the (health watchdog) Monitor visit."

The report also found her line manager, finance director Kevin Stringer, failed to follow good practice and was "unfair" in his handling of the disciplinary process towards Mrs Haynes-Kirkbright.

It was only in July 2012 that a whistleblowing inquiry was eventually correctly undertaken, but the independent report found its conclusions to be "significantly flawed".

Mrs Haynes-Kirkbright then took her concerns to a national newspaper, which led to another inadequate whistleblowing investigation by the Royal Wolverhampton Trust, the report's authors said.

After the story appeared in the media, the NHS Trust Development Authority commissioned independent consultants Verita to carry out its investigation published on Thursday.

The report also found the first whistleblowing inquiry by medical director Dr Jonathan Odum failed to ask "important questions" and the justification for the subsequent disciplinary process was "flawed".

Following Thursday's publication, a trust spokesman said: "The trust acknowledges the findings of the report, none of which are related to any issues around patient safety or patient care or patient experience.

"The report relates to events from over four years ago.

"It does not reflect adequately the significant information provided by the trust to Verita at its request."

A separate review of governance arrangements at the trust is now being carried out.

The trust added: "We take whistleblowing extremely seriously and would always encourage any member of staff, or patient, to come forward if they have any concerns at all."

Mrs Haynes-Kirkbright is still an employee of the NHS trust.

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