National Ombudsmen
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Ombudsman extremely concerned about culture at University Hospitals Birmingham

Recent and ongoing investigations by the Parliamentary Health Service Ombudsman (PHSO) into University Hospitals Birmingham (UHB) have uncovered a number of significant concerns.

Our investigations flagged serious issues around the culture and leadership of the Trust. These concerns have further been heightened by:

  • the defensive approach when discussing patient safety issues with us
  • UHB’s failure to fully accept or acknowledge the impact of our findings from investigations, including an avoidable death
  • UHB’s approach to the duty of care towards its staff.

Since the Ombudsman triggered the Emerging Concerns Protocol in August 2022, the Trust has made some changes to its leadership team with the appointment of a new Chair and an interim Chief Executive.

The Protocol provides a process for regulators and oversight bodies to share information that may indicate risks to people using services, their carers, families or professionals.

Parliamentary and Health Service Ombudsman Rob Behrens yesterday said:

“Our decision to trigger the Protocol was not taken lightly, but we had significant concerns about the Trust. It’s vitally important that the NHS learns from its mistakes. To do that there needs to be a culture of openness, not defensiveness. We need to see significant improvements in culture and leadership and how the Trust engages with our investigations.”

Three reviews have been commissioned to investigate the Trust:

  • the rapid response review, led by Mike Bewick, Deputy Medical Director at NHS England
  • the Well-Led review, commissioned by NHSE
  • UHB’s culture review, commissioned by the new interim Chair, Dame Yve Buckland. An external provider will carry out the review.

The Ombudsman had understood that it would be able to participate in the second and third reviews relating to leadership and culture. However, we have recently been advised that we will not be able to contribute to NHSE’s Well-Led review.

Rob Behrens yesterday said:

“I’m extremely disappointed that NHSE denied us the opportunity to contribute to its review. It’s hard to see how the review can be evidence based if it doesn’t consider all the evidence. It raises real concerns around the completeness and transparency of these reviews.

“We all share the same goal in wanting to see improvements at UHB so that people living in the West Midlands and using its services can access the best possible care with confidence. Working together and feeding our evidence and expertise into those reviews is by far the best way to achieve that goal.”

PHSO’s Chief Executive Amanda Amroliwala has written to NHSE to highlight our concerns and to seek to understand why partner organisations have been excluded from contributing to these important reviews.

A letter has also been sent to UHB’s interim Chief Executive to express our disquiet regarding the previous leadership’s response to patient safety incidents at the Trust and its refusal to accept accountability or learn from past failings.


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