Hospital fined £200,000 after four babies exposed to ‘serious risk of avoidable harm’

By Dave Higgens, Reporter26th October 2022News EnglandCare Quality Commission, Care Standards, Hospitals, Inspection, News England, NHS, Nursing / Midwifery, Yorkshire

A hospital has been fined £200,000 after four babies were exposed to “serious risk” when they were found to have non-accidental injuries which were not spotted in earlier admissions.

Rotherham NHS Foundation Trust, which runs Rotherham General Hospital (pictured), in South Yorkshire, had been repeatedly warned by the Care Quality Commission (CQC) about problems with its safeguarding training and other systemic deficiencies before the four youngsters’ multiple admissions between January 2019 and February 2020, Sheffield Magistrates Court heard.

On Wednesday, District Judge Naomi Redhouse imposed the £200,000 fine stressing that the case was about failures in the systems and processes of the hospital trust and not those of individual doctors and nurses working under “immense pressure”.

Ms Redhouse said she calculated the figure for the fine taking into account the financial pressures the trust and the wider NHS was under and after hearing it was looking at a £2.7 million deficit this year.

She said she also accepted that the prosecution by the CQC was based on the harm children had been exposed to rather than any evidence of actual harm as a result of the hospital’s actions.

The trust earlier admitted a charge that it exposed service users to “a serious risk of avoidable harm”.

The court was told how one eight-day-old baby was brought into the hospital on December 23 2019, suffering from breathing difficulties and bleeding from their nose and mouth.

It was only on the fifth visit to hospital – after a GP raised concerns – that a child safety examination took place revealing rib and leg fractures that were deemed non-accidental.

And the district judge heard how a month-old baby brought in with a mouth injury on January 20 2019 was on a child protection plan but this was not spotted by the paediatric nurse who examined the youngster.

This child was twice released from hospital with no safeguarding concerns before a scan and other examinations revealed multiple fractures, the court heard.

Ryan Donohue, prosecuting for the CQC, said failings had been identified in areas including policy implementation, training, reporting, auditing and governance.

Eleanor Sanderson, for the trust, said: “The trust wishes to express to the court its deep regret for the circumstances which gave rise to these offences and the risk posted to those who required safeguarding.”

Ms Sanderson said: “The trust accepts that its systems and processes were not operating effectively and not sufficiently embedded.”

The barrister asked the district judge to take into account the “truly challenging” circumstances the hospital was operating in at the moment when assessing the level of the fine.

She told the court: “A fine will further reduce funds available for direct patient care.”

Ms Redhouse said: “The doctors, nurses and other healthcare works worked very hard under immense pressure. We all, I hope, acknowledge that.”

The district judge told the court that inspections by the CQC from 2015 revealed a history of safeguarding and governance concerns.

She said the core of the problem lay in a “failure to embed” good safeguarding practice and policies in front lines services.

The district judge said: “Having a policy is not the same as how do you ensure on the front line that that policy is carried out.”

Ms Redhouse said: “The reality of safeguarding is that those professional healthcare workers, at whatever level, need information and, perhaps, alerts through that information that will help them identify safeguarding issues.”

She acknowledged the trust had worked hard to improve all these matters, replacing most of the senior executive posts, including the chief executive.

But she said: “These were serious failures and there is no question that these issues had been part of previous inspections. The attempt to deal with them was simply not enough.”

The trust was ordered to pay £33,068 in costs and a £170 victim surcharge.

Sarah Dronsfield, CQC head of hospital inspection, said: “These young children were let down by The Rotherham NHS Foundation Trust’s lack of good policies and processes around safeguarding, which sadly in this case has had very real-world consequences for them.

“Anyone using health and social care services should have the right to be seen by staff with the right training, who have the right processes in place, to keep them safe. This was not the case at Rotherham General Hospital.”

Ms Dronsfield said: “This lack of good systems or training meant vulnerable young children, all less than six weeks old, were let down by the trust, sometimes on several occasions, when they failed to identify safeguarding concerns which could have prevented them from coming to further harm.”

Dr Richard Jenkins, chief executive of Rotherham NHS Foundation Trust, said: “On behalf of the Rotherham NHS Foundation Trust, I unreservedly apologise for the deficiencies in how the trust safeguarded children from the risk of harm in 2019 and early 2020.

“The court focused on failures in our policies, training and oversight of safeguarding and we fully accept the findings of the court. It’s important to note that the court was clear that the failings were not the result of actions of clinical staff and that no child came to harm as a result of the failings.”

Chief nurse Helen Dobson said “robust action” has been taken to improve policies, training and oversight.

Ms Dobson said the trust recently invited NHS England to independently review children’s safeguarding arrangements and that initial feedback had been positive.