Report On The Stafford Hospital Case Study

Executive Summary

The corresponding study has been deliberative about the evaluation of the ethical context involving a specifically selected case study pertaining to the identified unethical practices perpetrated at the clinical healthcare settings of the Mid-Staffordshire Hospital at UK. Such practices had resulted in the death of approximately 1200 patients within a particular duration of four year. In this context, the consequent study has been formulated through four phases based analysis of the impacts of unethical behaviour on reputation under consideration, on the public confidence measure relating to the trustworthiness of the Stafford Hospital, on the medical staff involved and, finally on the NHS and associated mechanism of accountability management in the healthcare practices. Concerning each of the phases of analysis, the question regarding the justifiability of permitting the implicated organisation to continue the offered services has been evaluated as well. Ultimately, at the conclusive phase, an enlistment of recommendations has been generated for the purpose of future progression concerning the research topic under consideration. For those seeking further guidance, healthcare dissertation help can provide valuable support in refining these recommendations and addressing complex issues.

1.0 Introduction

Ethical considerations are reflective of the philosophical approaches based on morality concerning the safeguarding, systematically administering and recommendation of the most appropriate operational conducts under any situation. The concepts of justice and propriety are central to the considerations involving Ethics and the most pertinent reflections of this could be comprehended through the tenets of the Value Theory. Three categories exist in terms of defining the various dimensions of Ethics, namely the Normative ethics, Meta ethics and Applied ethics. In this context, the subsequent study has been developed regarding the case study related to the Stafford Hospital which is governed through the Mid Staffordshire, NHS Trust. The case study involves the death of 1200 patients due to negligence and impartation of poor quality care during January, 2005 to March, 2009(telegraph.co.uk, 2020). The case further involved dearth of proper quality in patient sustenance in the form of less than qualitative medications and edible provisions delivered to the patients. The casus belli have been inadequate measures of training of the hospital staff and subjection to work roles which were not within their capabilities.

To this effect, the primary aim of the report is to bring forth the aspects associated with unethical behaviour and the associated impact on the public perception about the Staffordshire Hospital through focusing on the behavioural aspects related to the medical staff of the organisation as well as that of the NHS. The Francis report has established the focal points relating to such an incident and also has outlined the rehabilitation perspectives of Staffordshire Hospital. The requirements involved enhancement of financial allocation to the hospital so that the incremental measure of pressure could be effectively managed. For the Provincial Administration Department of Staffordshire, it would be required to manage this case and the associated outcomes in the most proper manner for the long term benefits in spite of the fact that no significant impact on the global reputation of such incidents could be observed on that of the organisation under consideration. All of the involved factors of the emergent situation would be highlighted by the study concerning the case study of the identified hospital so as to determine the justification of continuation of services by the organisation under consideration.

2.0 Analysis

The analysis progression process of the available case study has involved the specification of the significance of the perpetrated unethical behaviour by the staff of the Staffordshire Hospital and, the subsequent impact of the same on the confidence measures of the general populace involving the considerations such as whether the organisation could be trusted in the future. Such confidence measure has a direct implication in terms of determination of the longevity of the hospital under consideration. Furthermore, the analysis undertaking is meant to highlight the implications of unethical behaviour on the functionalities of the NHS and the objective is to determine the future course of actions for NHS concerning the measure of disciplinary actions which could be taken by the regulatory authorities on the implicated Staffordshire Hospital under consideration. In this context, the proper assessment of the issues related to the Staffordshire Hospital, the measures implemented to rectify the same and the associated significance of the incidents on the perceptions of the general populace regarding the trustworthiness of the organisation under consideration are three points of crucial importance pertaining to the research analysis process (Kiewitz et al. 2016).

2.1 Significance of unethical behavior on the reputation of Stafford hospital

The incident involved the provisioning of improper services by the Staffordshire Hospital to the patients and this pertained to gross negligence and dereliction of the responsibilities care on part of the hospital management and medical staff (Hutchison, 2016). The reputation of the hospital has been affected to an extensive measure through the negative perceptions which accompanied the gradual revelation of the aspects of unethical behaviour perpetrated by the medical staff of the concerned hospital which culminated in the mortality of approximately 1200 patients since they had been served inadequate measures of sustenance, provisions and medication. Another particular issue has been related to the inadequacy of training of the existing hospital staff as this condition complicated the service provisioning efforts of the hospital staff since they have been subjected to duties to which they had not been suitable trained for (O’Mahony, 2018). Junior doctors had been assigned to take charge of the critical condition words during the night shifts which could not be considered to be logical under the conditions of medical exigencies. Furthermore, non-medical staff had been assigned to tend to medical urgencies when the patients were brought in for the first time and this constituted the most significant measure of medical negligence.

Patient Safety Bodies, Primary Care Trusts and Regional Health Authorities were collectively responsible for the monitoring and supervision of the medical practices performed at the Staffordshire Hospital. Consequently, the medical negligence and the associated failures to comply with the quality management guidelines issued by the NHS have been prevalently afflicting the geriatric patients as well as the patients who could be either terminally ill or could have been suffering from chronic diseases which require extensive and careful treatment at the hospitals for these to be cured (Whitby, 2019). This incident has highlighted the multiplicity of aspects involving ethical standards which could be considered as penal actions to be applied against the hospital under consideration. However, the enforced discontinuation of the Staffordshire Hospital could not be considered to be an appropriate disciplinary action to be implemented against the implicated organisation since the responsibility of general care provisioning to the people could not be ignored or let to be disrupted through such functionalities.

2.2 Significance of unethical behavior on the confidence of the public

The maintenance of ethical considerations and associated standards are incumbent upon the proper functionalities of the hospital under consideration regarding the prescribed threshold of care quality which is required to be maintained while imparting medical services to the patients. It is necessary to maintain the trust and positive image about the medical care provisioning capacity of the Staffordshire Hospital amongst the patients so they could be assisted during their periods of ailments and afflictions through convincing them that they could safely access and receive the qualitative care mechanisms provided by the hospital (Alnaqi et al. 2017). To this effect, the patients are required to be made cognizant about accessing and receiving relevant information involving the services available at the concerned hospital. The stipulations of the Health and Social Care Act (2012) would be required to be implemented in this context (Van Dooren and Hoffmann, 2018).

According to Williams (2017), the Francis Report has highlighted the distressing fact that unethicality of behaviour of the staff of Staffordshire Hospital extended into the realm of inhumanity as well since patients had been left without water or edibles for hours or in abjectly unsanitary conditions. The unethical aspects have been ignoring of distress of the patients and subjecting the vulnerable patients to inadvertent harm through inaction by the hospital staff and such incidents have been abject infringement of the stipulations enshrined in the "Health and Safety at Work Act, 1974".

This unethical behaviour has impacted the public perception about the hospital in a particular negative manner since such unethical dereliction of duty pertains to the Bystander Effect which implies that individuals such as hospital staff under consideration, completely stand by and do not assist the victims in distress, such as the patients. To this effect, the relevant questions involve the assessment of the numbers of staff members which had neglected their duties of care, the measure of general ambiguity of the situation and the extent of empathy which the staff members could have had towards the patients who later died due to improper health assistance services (bbc.com, 2019).

To this effect, the opinion regarding whether the Staffordshire Hospital could be permitted to continue or not, could be formulated only after evaluation of the pressing situational factors which could have contributed to the overriding of the explicitly enounced systems of ethical value based care. Furthermore, contrasting such evaluations to the extent of work pressure based urgency prevailing at the hospital throughout the duration when the patient mortality had taken place, would be required to be performed so that the accurate extents of either existence or complete absence of parallels of such ethical propositions, in actually performed operations by the hospital staff, could be identified.

2.3 Significance of unethical behavior on medical staff

The unethical behaviour of the staff members of the concerned hospital has been equated to the Stanford Prison Experiment of Philip Zimbrado, by Repullo (2016), since, both the incidents highlight the fact that those who had been put in charge of the inmates, had subjected they to unethical and inhuman behaviour which appeared to transcend the existing moral boundaries of the social context in general. However, Pedersen and Roelsgaard Obling (2019) have opined to the contrary through arguments that the case of Staffordshire Hospital has characterized the behaviour of the staff as to be omission based errors rather than active perpetration of harm to the patients. This implies both the deference to power as well as the acceptable norms prevalent within that organisation regardless of the suffering caused to the patients and numbing of sensitivities of the care staff through absence of empathy towards the patients in distress (Verleye et al. 2017). Thus, from the ethical perspective, the discontinuation of the hospital would not be a credible and advisable option since the findings of this study have indicated that a positive hospital culture is required to be instituted through development of strong leadership elements so as to foster greater human values and infuse the appropriate measures of peer supports for the purpose of counteracting the negative tendencies amongst the nursing staff which have culminated in the alarming death rate between 2005 to 2009(Gao and Dekker, 2016) .

2.4 Significance of unethical behavior on NHS

According to (independent.co.uk, 2020), the health secretary Jeremy Hunt has outlined the implication on NHS as and encapsulation of the general crisis in the standards of care impartation. Such a crisis has become evident through the less than adequate ability of NHS to cope with the expansion of demand at the moment of budgetary decline and this situation has been exacerbated by the responsibility of making efficiency savings at worth of £20bn which has required the NHS to reconfigure the existing hospital services. Such objectives have contributed to the development of the Ofstead-style of quality ratings of the hospitals. The mandatory fulfillment of such criteria has been responsible to a great extent at the Staffordshire Hospital for the humanitarian crisis which resulted in the avoidable deaths of so many patients. However, the hospital under consideration could not be subjected to discontinuation since various improvement based changes have been suggested from various quarters in the form of regulations through healthcare assistants, maintenance of minimum levels of staffing at each of the wards, enforcement of the legally mandatory Duty of Candour at all of the NHS directed hospitals and this has to encompass all of the staff at the Staffordshire Hospital as well and finally, the implementation of the blacklists of managers who could have failed to execute their responsibilities from the ethical perspectives.

3.0 Conclusion

The preceding study has been reflective of the various ethical considerations which have been undertaken to evaluate the outcomes associated with the assessed case study of the deaths of 1200 approximate patients at the Mid Staffordshire Hospital. From a conclusive perspective, it could be determined that NHS regulations at the hospital had failed completely and this requires introduction of extensive robust regulations. This has been the perspective of the NHS Confederation so as to represent the National Voices, which has been an alliance of 130 different associations of patients (Shadnam et al. 2018).

4.0 Recommendation

The envisaged recommendations could be specified in the following manner:

1: Appropriate review of ethical status of clinical practices.

2: Institution of proper survey mechanism for the determination of the professional ethical standards amongst the NHS directed health care organisations so that the ethical standards could be maintained at the care management levels. This would further facilitate to appropriately measure the suitability of the ethical conditions in comparison to the necessities of the patients at differential hospitals.

3:As per the stipulations of “Health and Social Care Act, 2012” Proper evaluation mechanism of the clinical ethics networks within the Staffordshire Hospital has to be developed so as to compare the case based outcomes even from a retrospective perspective. This would facilitate the NHS and the CQC to track the singular incidents of contravention of ethical standards so as to regulate the health operations based hospital atmosphere.

Reference list

Journals

• Alnaqi, H., McIntosh, B. and Lancaster, A., 2017. Cultures of fear: Perspectives on whistleblowing. British Journal of Mental Health Nursing, 6(3), pp.134-137.
• Gao, J. and Dekker, S., 2016. Heroes and Villains in Complex Socio-technical Systems. In Disaster Forensics (pp. 47-62). Springer, Cham.
• Hutchison, J.S., 2016. Scandals in health‐care: their impact on health policy and nursing. Nursing inquiry, 23(1), pp.32-41.
• Kiewitz, C., Restubog, S.L.D., Shoss, M., Raymund, P., Garcia, J.M. and Tang, R.L., 2016. Too many firms ignore their abusive boss problem. LSE Business Review.
• O’Mahony, S., 2018. Some thoughts on compassion inspired by Sir Thomas Legge. JR Coll Physicians Edinb, 48, pp.69-70.
• Pedersen, K.Z. and Roelsgaard Obling, A., 2019. Organising through compassion: The introduction of meta‐virtue management in the NHS. Sociology of health & illness, 41(7), pp.1338-1357.
• Repullo, J.R., 2016. Austerity: reforming systems under financial pressure. Strengthening Health System Governance, p.207.
• Shadnam, M., Crane, A. and Lawrence, T.B., 2018. Who calls it? Actors and accounts in the social construction of organizational moral failure. Journal of Business Ethics, pp.1-19.
• Van Dooren, W. and Hoffmann, C., 2018. Performance management in Europe: An idea whose time has come and gone?. In The Palgrave handbook of public administration and management in Europe (pp. 207-225). Palgrave Macmillan, London.

Websites

bbc.com, 2019, Stafford Hospital scandal: The real story behind Channel 4's The Cure, Accessed from: https://www.bbc.com/news/uk-england-stoke-staffordshire-50836324 [Accessed on: 16.03.2020]

independent.co.uk, 2020, Stafford hospital scandal: NHS staff responsible for 'terrible care of patients could face prosecution for wilful neglect or manslaughter', Accessed from: https://www.independent.co.uk/news/uk/home-news/stafford-hospital-scandal-nhs-staff-responsible-for-terrible-care-of-patients-could-face-prosecution-8491649.html [Accessed on: 16.03.2020]

telegraph.co.uk , 2020, Stafford-Hospital-the-scandal-that-shamed-the-NHS, Accessed from: https://www.telegraph.co.uk/news/health/heal-our-hospitals/9782562/Stafford-Hospital-the-scandal-that-shamed-the-NHS.html [Accessed on: 16.03.2020]