Feature NHS

What went wrong at Addenbrooke’s?

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5278 (Published 02 October 2015) Cite this as: BMJ 2015;351:h5278
  1. Richard Vize, freelance journalist, London
  1. richard.vize{at}gmail.com

The world renowned hospital is now in special measures. Richard Vize speaks to its newly departed leader, Keith McNeil, and other insiders about the “unforgiving” inspection regime, the NHS’s obsession with “grip,” and how the roots of Addenbrooke’s problems can be found in many other hospitals

The Care Quality Commission’s (CQC) decision to condemn Cambridge University Hospitals NHS Foundation Trust as inadequate forced out its physician chief executive and opened up serious questions about the inspection process.

The chief executive, Keith McNeil—a former sniper in the Australian special forces who became a transplant pioneer at Papworth—quit shortly before the commission published its inspection report last month and the regulator Monitor put the trust into special measures.

With a deficit running at around £1.2m (€1.6m; $1.8m) a week, staff shortages, major difficulties getting patients in and out of the hospital, and disruption caused by the implementation of its new electronic health record system, the inspectors must have expected to find serious problems. Yet overall the outcomes at Cambridge—better known by the name of its largest hospital, Addenbrooke’s—are impressive by national and international standards; its mortality rates are low and its safety record is strong.

McNeil believes the inspectors “came in with a preconceived idea of what they wanted to find.”

Artificial divide

It was clear almost from the start of the inspection that there was a fault line between what Addenbrooke’s was saying and what the CQC was hearing. The “well led” part of the assessment is of paramount importance, and inspectors are alert for any sign that the leadership and staff have different priorities. In his opening presentation to inspectors, McNeil stressed the value of being an academic specialist centre. However, after talking to ward staff, who described Addenbrooke’s as a district hospital with specialist services, the CQC concluded that “there was …

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