Revealed: Trust sent secret “partisan” briefings on Dr Day’s whistleblower case to NHS top brass and four trusts -including to Dr Amanda Pritchard, now head of NHS England

Amanda Pritchard: then CEO of Guys and St Thomas’s Trust now chief executive of NHS England

Andrew Allen QC attacks the trust for its unprecedented ” brazen attitude” throughout the hearing

New hitherto undisclosed documents by Lewisham and Greenwich NHS Trust in the Dr Day employment tribunal, sent the night before it was hearing closing submissions from lawyers, reveal the trust secretly briefed the chief executives of NHS national bodies and four trusts on an inaccurate view of Dr Chris Day’s whistleblowing case.

The so called “briefings” were the same as a press release written by David Cocke, the trust’s communications director who has destroyed a large number of “potentially relevant” emails held by the trust and declined to give evidence.

The documents disclosed by the Trust on Thursday night revealed these “so called briefings” had been sent to the heads of NHS England and NHS Improvement.

Ben Travis, the chief executive of Lewisham and Greenwich NHS Trust also wrote in a memo that he was talking to Chris Hopson, then chief executive of NHS Providers, to brief him about Dr Chris Day’s case..

Chris Hopson, then chief executive of NHS providers now Chief Strategy Officer, NHS England. He was a key figure on our TV screens handling the pandemic.

The trust had already failed to disclose (and was criticised in 2021 by an employment judge) that it sent them to 18 other stakeholders, including MPs and council leaders, which is at the centre of the dispute between Dr Day and the trust.

They are a key part of his claim that he suffered detriment for his protected disclosures nine years ago on patient safety and inadequate staffing at Queen Elizabeth Hospital, Woolwich’s intensive care unit.

Sir Norman Lamb, the former Liberal Democrat health minister, described the content of these documents released in 2018 as ” inaccurate, damaging and defamatory” .

Dan Tatton Brown QC, said, in his summing up for the trust, described them as ” partisan” needed by the trust to counter what he called a misleading press article in the Sunday Telegraph about the case at the time. He also said part of the release praised Dr Day for his whistleblowing, although Andrew Allen, QC, pointed out that the entire document does not have to be critical of Dr Day for a detriment to succeed.

Mr Allen told the tribunal that the letters had gone in 2018 to 4 CEOs of neighbouring Trusts: Amanda Pritchard, CEO, Guy’s and St Thomas’, Peter Herring, Interim CEO, Kings, Matthew Trainer, CEO, Oxleas, Dr Matthew Patrick, CEO, South London and Maudsley ; and to Steve Russell at NHS Improvement and Jane Cummings at NHS England.

The latest disclosure contradicts evidence given to the tribunal by Ben Travis last week, who said nobody else had received any statements.

Andrew Allen QC

Mr Allen’s submission said: “C [Dr Day] believes that R’s[the trust’s] conduct of this litigation – in particular the failure to preserve evidence; the inadequacy of the initial discovery exercise; the destruction of Janet Lynch’s[ former director of workplace and education] emails; the destruction of emails by David Cocke ; and the other various ways in which evidence has been placed beyond reach a has placed the fairness of the hearing in jeopardy. C believes that R’s response should have been struck out. R’s behaviour since the outset of this litigation, as highlighted through the revelations during this hearing has been contemptuous towards C and towards the tribunal. R’s attitude towards tribunal rules and tribunal orders appears to have been to use them to seek advantage.

Mr Allen tore into the trust for the derogatory way it treated Dr Day. He said it had repeated accused him of lack of integrity. claimed he wanted to become a millionaire through his patient safety disclosures, described him of having unreasonable beliefs including conspiracy theories and being of a ” suspicious disposition”.

Mr Allen reminded the Tribunal of Dr Smith’s evidence on Dr Day’s protected disclosure, quoting Dr Smith (the Consultant anaesthetist the Trust tried to exclude from the Tribunal)  who stated,” For the avoidance of doubt, in my view, based on my own practical experience, the ratio of 1:18 in the Respondent’s ICU was, prima facie, unsafe and (if more than a one-off incident) was something that was required to be rectified.”

With the addition of the transcript that has been running throughout hearing, Dr Smith’s verbal warning to the Tribunal on Dr Day’s warning about patient safety in 2013 which Dr Smith clearly endorsed with the words, “There was a clear and present danger to patient safety: absolutely no question about that.”

Instead Mr Allen said the trust had failed by not doing a proper search of documents or even the right people’s documents, not disclosing relevant documents and deleting documents involving key people.

As a result people gave untrue statements to the tribunal.

Mr Allen told the tribunal that trust had “presented two institutional witnesses (Ben Travis and David Cocke ) whose witness statement evidence is so undermined by the fact of and the content of R’s late disclosure (not to mention Ben Travis’s own oral evidence) that they can no longer be regarded as reliable witnesses of truth. These witnesses were the people in charge of carrying out a discovery exercise involving searching their own in boxes for relevant material – which they clearly failed to do adequately given that plainly relevant material had been squeezed out of R over last two weeks – produced in a piecemeal fashion only because of questions upon questions from C pointing out the inadequacy of the exercise being conducted.”

Mr Cocke could have destroyed 90,000 emails

He then gave a run down of a coruscating cross examination he would have given David Cocke if he had turned up – pointing out Cocke in his second witness statement destroyed 90.000 emails altogether, questioning in detail that statement he had sent out to the stakeholders and challenging him that he had made misleading statements to the press by downplaying Dr Day’s patient safety disclosures  and misrepresenting investigation findings..

He then went on to the witnesses who were never called by the trust including the four doctors who handled Dr Day’s protected disclosures and the two directors that were the current and former legal client in the Trust that instructed the lawyers in the case. These individuals were present in the public gallery

Janet Lynch- entirte archive of her emails destroyed by Mr Cocke

“As well as Drs Harding, Brooke, Patel and Luce, the other ghosts at the banquet are Janet Lynch and Kate Anderson. Ms Lynch is happily alive and well and working as Interim Director of People and Organisational Development at Hertfordshire Partnership University NHS Foundation Trust.

Kate Anderson -watched the tribunal but was never called to give evidence

Ms Anderson (a key witness in relation to detriment 4.2 concerning the lack of adequate response) is not only happily alive and well and working at R, but she watched some of the hearing. No reason has been offered by R for failing to call these people as witnesses.

“The tribunal is asked to infer that this is because presenting people to give evidence whose knowledge of the issues could not be disputed would have detracted from R’s aim which was to present DC and BT as the innocent people responsible for the public statements made by R and who were largely ignorant of any inadequacies in the content.
“That strategy has imploded under the weight of the content of the late disclosure that we have seen and the revelations about the inadequacy of the disclosure exercise that we have begun to learn about.”

Mr Allen asked the tribunal to discount David Cocke’s evidence entirely. because of his non appearance and his action in destroying documents. Mr Tatton Brown maintained earlier he had done the latter in a panic and because he thought he had failed his colleagues.

Dan Tatton Brown QC

Mr Tatton Brown earlier told the tribunal that ” the trust has not instructed me to put the boot into Dr Day” but went on to accuse him of being a difficult witness who didn’t answer questions, having conspiracy theories criticising distinguished judges and the medical establishment and accused him of using his crowdfunding money to go on a holiday. All these allegations were refuted by Mr Allen.

Mr Allen exposed the smear about the holiday with the fact that the Doctors Association had presented Dr Day and his wife with a surprise gift of funding for a holiday and that as a surprise gift it clearly had nothing to do with Dr Day’s Crowdjustice campaign that has been used only on legal fees.

Mr Allen defended Dr Day’s criticism of numerous appeal judges that had engaged in fact finding. Mr Allen also described that Simler LJ had granted him leave to appeal on all three grounds to challenge the controversial settlement in the case and then rescinded the permission on the basis that it had been a clerical error, a frankly bizarre set of circumstances even for a lawyer, it was this context that Dr Day  was asked: “Is this part of the great medical legal coverup that you believe in?”. Dr Day maintained it was more than a clerical error and at the very least was a professional mistake.

The tribunal reserved judgement and will announce its decision later.

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Are top NHS officials Stephen Powis and Zoe Penn “fit for purpose”?

They can’t or won’t explain internal NHS procedures used to dismiss the perfectly competent cardiologist Dr Usha Prasad

The long drawn out saga over the dismissal of cardiologist Dr Usha Prasad by Epsom and St Helier University Hospital Trust reported earlier on this blog continues. I will be reporting soon on a lengthy Employment Tribunal recently finished where Dr Prasad made serious protected disclosures about patient and staff safety at the trust and senior consultants were cross questioned about the way they treated Dr Prasad.

In the meantime two retired cardiology consultants Professor Jane Somerville and Dr David Ward, who are championing Dr Prasad’s cause, have tried to get explanations from two of the most senior people in NHS England, Professor Stephen Powis, national medical director and Zoe Penn, Medical Director for the NHS London region and lead official for professional standards. Dr Zoe Penn took time out during the pandemic to sit on the internal Maintaining Higher Professional Standards panel which decided Dr Prasad’s future.

Claire McLaughlan , chair of the MHPS inquiry which found ” unfit for purpose”

At the heart of the matter is a ruling by the internal tribunal that Dr Prasad is ” not fit for purpose” to do her job. This was made by Claire McLaughlan, the never practised barrister who chaired the inquiry. with Zoe Penn. She has refused to explain what that term means which led to the two retired consultants going to the senior NHS officials for an answer.

What the panel could not rule was that Dr Prasad was ” not fit to practice” medicine even though the trust tried its best to be able to do so by sending 43 cases to the General Medical Council to show her failings.

The GMC not only threw out the Trust’s cases but decided to revalidate her to keep on working – taking away the power the trust had to stop her medical career.

Professor Powis’s response to this is: “Fitness for purpose is a phrase used to refer to behaviours which are not in keeping with the doctor’s ability to practise in a particular professional role but do not breach the threshold for GMC action, to be distinguished from those which are not in keeping with GMC
requirements on good medical practice and therefore may have an impact on a doctor’s licence or registration (“fitness to practice”).”

This is a cut and paste job from Claire Mclaughlan’s findings and takes us no further. It almost suggests the panel was upset that the GMC had ruled she was competent and made up something else to get rid of her.

Nobody can point to where in employment law this phrase comes from – let alone any case law of anybody being dismissed for being ” unfit for purpose”. Any employment lawyer who reads this blog is welcome to come forward to explain with some case law.

Disturbing Disclosures

The other disturbing disclosure from Professor Powis is the way he dealt with requests from the two consultants for an inquiry into the whole saga.

As they say : “How is it possible for Trusts to use cost threats, expensive lawyers and dubious (and unregulated) “independent management consultants” (aka hired guns) of the type used in this case, to push whistleblower claimants into submission and thereby achieve the “desired” outcome, i.e. their dismissal? It seems to us that this case is a particularly bad example.

They also say: “NHS Improvement has a duty to oversee behaviour of NHS Trusts. Will it continue to overlook the gravity of this and similar injustices? It is time for a review and improvement of NHS disciplinary and dismissal processes which should include senior NHS managers as well as medical personnel.
Professor Powis’s response was to refer the case to the regional medical director for London, Dr Vin Diwakar, a close colleague of medical director, Zoe Penn. He is a distinguished clinician and a former medical director of Great Ormond Street Hospital in London.

But was he the right person to do this review? He sits on the committee in charge of the re-appraisal and relicensing of medical directors in London with Zoe Penn. Given she was also on the same panel that found Dr Prasad was” unfit for purpose”, it is not surprising that Professor Powis in his own words was ” assured that a fair and independent process has been carried out.”

A really independent review would have called someone outside the London region to do this just as the General Medical Council did when a cardiologist from the North East reviewed her case. His solution would be like Epsom and St Hellier University Trust appointing a friendly cardiologist who would find in their favour at the GMC.

Professor Powis said: “It is not the responsibility of NHS England and NHS Improvement nor that of the
National Medical Director, or NHS England and NHS Improvement more generally, to intervene to resolve in individual employment matters,… although we will consider whether employment matters could indicate wider problems with how a trust is being run.”

Daniel Elkeles Pic credit: London ambulance NHS Trust

However perhaps the most damning issue he is silent about is the disclosure in Dr Ward and Professor Somerville’s letter about the behaviour of the former chief executive of the trust, Daniel Elkeles ( now at the London Ambulance Service) during this period.

I quote:”. It would appear that the CEO acted outside his powers by offering to bribe Dr Prasad to “drop all the actions you are taking against ESTH” and leave the Trust in exchange for which ESTH will “agree to cease the MHPS process”…..By offering these terms he was, in effect, cancelling the investigation. We think this is highly irregular. Do you agree?

What this shows is that Professor Powis is prepared to ignore unethical behaviour in one of London’s health trusts. Either this internal official process was necessary or it shouldn’t have been brought. It is not a bargaining chip to negotiate with a competent consultant. Frankly I think it is akin to blackmail – drop your complaints against the trust or we will make sure you will regret it.

What this nasty little saga shows is that unaccountable officials at the top of the NHS are either too frightened of health trusts or happy to go along with unethical behaviour in the NHS. It is also reveals that this complicated MHPS system is in need of a radical overhaul. It is like those at the top “unfit for purpose”.

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Exclusive on Byline Times: How a highly controversial contract to collect data on thousands of English Covid-19 hospital patients was never put out to competitive tender

Image by Syaibatul Hamdi from Pixabay

An expose by The Guardian earlier this month revealed that confidential data from patients being treated for Cofid-19 in England was being collected and processed by tech companies – two of which were highly controversial companies.

Now after persistently chasing up officials NHS England have admitted that the contracts which involved the US company Palantir – run by Trump supporting right wing billionaire Peter Thiel – and British start up Faculty – which has links to Dominic Cummings, the Prime Minister’s chief adviser – were never put out to tender.

Read how they did it on Byline Times here

How the NHS wasted £16m of your money on a botched privatisation that collapsed within months

portrait-meghillier

Meg Hillier MP:,chair of the Commons Public Accounts Committee, condemned the failings in the scheme

CROSS POSTED ON BYLINE.COM

New ways of  helping the elderly and mentally ill survive in the community and not continually end up in hospital is a cornerstone of government policy.

So when a limited liability partnership offered a cash strapped  NHS commissioning group an initiative which promised better services for these people and could save them £178m over five years it sounded too good to be true.

The trouble is it was. As a devastating report from the National Audit Office reveals today the £800m scheme  ran into trouble just four weeks after it was launched and collapsed seven months later. You can read the full story on the Exaro website.

The scandal of the £800m scheme run by UnitingCare Partnership for Cambridgeshire and Peterborough clinical commissioning group may not be an isolated instance.That is why sources at the National Audit Office have highlighted it in their report – because it exposes an alarming lack of financial expertise inside the NHS and a flawed system to monitor whether projects like this are financially feasible  andcan  be properly checked.

The promised aim of the project was to establish  tapering payments to the partnership – with £152m up front and less money later, ¬ so that the financially challenged commissioning group could put money to better use.

But within four weeks of starting the contract the partnership was asking for an extra £34m, blaming a delay by the commissioning authority in starting the work. When the money was not forthcoming the scheme collapsed after eight months and the NHS was forced to provide services directly.

The NAO report reveals that despite employing reputable financial companies and lawyers, basic errors were made – including a failure to realise that sub-contractors could not recover the VAT from the partnership – a cost that had not been factored into the contract.

Auditors also report that nobody had overall oversight of the contract.

No wonder both Amyas Morse, the head of the NAO, and Meg Hillier, the Labour chair of the Commons Public Accounts Committee have been withering in their criticism.

Amyas Morse said: “This contract was innovative and ambitious but ultimately an unsuccessful venture, which failed for financial reasons which could, and should, have been foreseen.”

Meg Hillier said: “The result is damning: a contract terminated before the ink had even dried out, at an unnecessary cost of £16m.”

What is disturbing is that the NAO point out that Monitor, the body which checks health bodies, had no locus to check whether the scheme was viable and NHS England were too remote to act.”

The report says: ““No organisation was responsible for taking a holistic view of the risks and benefits of this approach, or considering whether the anticipated longer‐term benefits were sufficient to justify additional short‐term support.“

What is really disturbing  is that £16m was wasted -plus £8.9m  on setting up a complex tendering operation and start up costs.

Far better to have spent this extra money on patient and community care – instead of throwing our money down the drain on a scheme that anyone would have thought to be too good to be true.

 

The next NHS scandal: Taking cash from the deprived and handing it to the affluent

Sunderland Clinical Commissioning Group- the biggest loser of NHS funds in England

Sunderland Clinical Commissioning Group- the biggest loser of NHS funds in England

Next April NHS England plans to take away money from some of the most deprived parts of the country and give it to areas that are the most affluent.
An arcane formula that decides how much your local NHS clinical commissioning body has to spend on you is expected to be changed by removing a weighting that automatically gives a bit of extra cash to areas of social deprivation. It will also mean that less money will go to areas where people die younger and more to areas where people live longer.
I am indebted to research by the Royal College of Nursing who have recalculated the effect of the change and I have already written about it for Tribune Magazine.
The political implications of this change- just over a year before the next general election are enormous. While NHS England is obviously not a branch of Conservative Central Office, its decisions will be remarkably helpful to the coalition government.
Without spending an extra penny it will appear that there is more spending on the NHS in many Conservative and Liberal Democrat marginals by election day and far less spending in many Labour strongholds where there is more social deprivation.
As the table illustrates the changes at the top and bottom are going to be dramatic.
Losers and Gainers; Health spending per head

Losers and Gainers; Health spending per head


Translate this into Westminster politics this means extra help for Tory and Liberal Democrat seats in the south. Gainers include Tory strongholds in Royal Windsor, Ascot and Maidenhead – the latter the seat held by Theresa May, the home secretary; South East Hampshire, Eastbourne, Hailsham and Seaford ( Liberal Democrat seats); the West Sussex coast, Gosport and Fareham and Newbury.
Most useful is Reading North and West, which includes a Tory marginal, and has an extra £98 per person to spend; Dorset (£89) which is both a Liberal Democrat and Tory area, and South Gloucestershire, part of the Cotswolds, which gains £86.
While the losers with the exception of Carlisle ( a Labour Tory marginal with a 853 Tory majority) are all Labour.Worst affected will be Sunderland which will lose health care spending worth £146 per person. Nearly equally badly affected will be South Tyneside, Newcastle West and Gateshead.
Also if you take the latest Office of National Statistics life expectancy figures you will live much longer in Dorset than in Blackpool.
In 2009–11, male life expectancy at birth was highest in East Dorset (83.0 years); 9.2 years
higher than in Blackpool, which had the lowest figure (73.8 years).
• For females, life expectancy at birth was also highest in East Dorset at 86.4 years and lowest in
Manchester where females could expect to live for 79.3 years.
• According to 2009–11 mortality rates, approximately 91% of baby boys and 94% of girls in East
Dorset at birth will reach their 65th birthday. The comparable figures were 77% and 86% in
Blackpool and Manchester respectively.
No wonder the RCN is furious. As Glenn Turp, regional director for the RCN Northern region says: “The North East and Cumbria suffers from some of the worst health inequalities in the country. NHS England should be aiming to reduce inequalities in health outcomes, not make them worse.
“Given the size of health inequalities in this region, I believe that NHS England should actually be increasing funds to the areas with the worst outcomes. However, NHS England’s own data shows these proposals will do the opposite.”
Of course this figures are not yet in stone. But taken together with welfare cuts, big drops in the standard of living for the majority,and slashing support for the disabled – NHS England is merely helping the wealthy and rich in Windsor, Maidenhead and Hampshire villages get better NHS services all paid by the taxpayer at the expense of a Sunderland council tenant. All helping the coalition win the next general election.