Chief hits out at safety guidance snub

Bosses at Stafford Hospital ignored vital national guidelines for patient safety but told the NHS watchdog it was compliant, a public inquiry has been told.

Sir Andrew Dillon, chief executive of the National Institute for Clinical Excellence (NICE), told the Francis Inquiry it was nev-er acceptable for hospitals to ignore its guidance. NICE issues national advice to hos- pitals to help ensure patients in England receive safe care at a consistent standard.

But the inquiry heard two examples where the hospital, which was later found to have delivered appalling care to hundreds of patients, decided not to act on advice. In 2007 the hospital ignored guidance that head injury patients should have a CT scan and instead left it to the "common sense" judgment of the doctors.

In the same year it also ignored advice on inducing labour in pregnant women because the hospital was "happy with the process" it had and felt it didn't need to alter it.

But in its self-assessment to the Healthcare Commission in 2007 the hospital said it was compliant with NICE guidance. Sir Dillon told the inquiry both examples "were not acceptable" and he added: "There is a prima facie case for being concerned that the guidance was being set aside."

He said NICE "had no idea this was happening at Mid Staffs" and he revealed an officer from the agency visited the hospital seven times. Sir Dillon said: "He has told me he was not left with the impression that the trust was struggling in any significant way to implement the guidance."

He said it was important the inquiry recognised NICE did not have the ability to force the hospital to act on its advice and it was unable to check which hospitals were taking action or not.

Counsel to the inquiry Mr Ben Fitzgerald said: "Should it ever be acceptable for a hospital to say as an organisation we are not going to follow a particular guidance?"

Sir Dillon replied: "No, I don't think it's acceptable for the organisation to say that," adding: "It is no excuse to say the trust is too busy or there is not enough money."

The inquiry heard implementing NICE guidelines was part of the hospital's contract with the local primary care trust in both 2005 and 2007.

But NICE has no way of inspecting hospitals and does not have any powers to force hospitals to act.

Sir Dillon said using NICE guidance would help hospitals and health professionals avoid errors but he said it would not exclude the possibility of individual errors.