Mid Staffordshire NHS Trust pleads guilty to HSE charges
Mid Staffordshire NHS Trust ("the Trust") has pleaded guilty to criminal charges brought by the Health and Safety Executive ("HSE") following the death of Gillian Astbury in April 2007. The Trust was
Mid Staffordshire NHS Trust ("the Trust") has pleaded guilty to criminal charges brought by the Health and Safety Executive ("HSE") following the death of Gillian Astbury in April 2007. The Trust was charged under section 3(1) of the Health and Safety at Work Act 1974 which states that an employer has a duty to ensure, as far as is reasonably practicable, that persons not employed by them (in the case of a hospital, this would include patients) are not exposed to risks to their health or safety. Whilst this is a relatively general duty, the HSE specifically alleged that the Trust 'failed to devise, implement or properly manage structured and effective systems of communication for sharing patient information, including in relation to shift handovers and record-keeping'.
The Trust entered a guilty plea at Stafford Magistrates Court on 9 October 2013 and the case was committed to the Crown Court for sentencing, where they have the ability to impose an 'unlimited' fine.
Previous prosecutions of NHS Trusts under this legislation have warranted significant fines. In 2006 the case of HSE v Southampton University NHS Trust initially saw a fine of £100,000 imposed against that Trust following the death of Sean Phillips, who developed toxic shock syndrome whilst under the care of two junior doctors. The HSE alleged that that Trust had failed to ensure patients' health and safety by not adequately supervising the doctors. However, the Court of Appeal reduced the fine to £40,000 due to the risk that a substantial financial penalty would inhibit the performance of that Trust’s public duties and on the basis that the breaches were not causative of the death.
The case of HSE v Great Western Hospitals NHS Foundation Trust (2010) resulted in a fine of £75,000 following the death of a patient who was given an epidural drug intravenously instead of a saline solution. Investigations showed that the two drugs were stored in the same racking system, despite having almost identical packaging and that this constituted an unacceptable risk to patients.
Whilst the imposition of a significant fine therefore has established precedent, the Court will pay particular regard to the Sentencing Guidelines Council's guidelines on imposing appropriate sentences for health and safety offences causing death. These guidelines recommend that when considering the financial consequences of a fine against a public body such as an NHS Trust, the court should consider 'the effect upon the provision of services to the public'.
We note that the Trust is currently in administration (with a reported annual operating deficit of around £11m) and that the NHS Litigation Authority (which provides indemnity cover for legal claims against NHS Trusts) has claimed that the Trust's insurance would not cover a fine from the HSE. Given the obvious financial difficulties faced by the Trust, it will be interesting to see how the Court balances the need to impose a punitive sentence in recognition of the admitted failings, against the effect a fine will have on the continuing provision of services by the Trust.
Whilst this is the first criminal prosecution brought in relation to the broad Mid Staffordshire investigation, it is an acknowledgement of the corporate responsibility owed by NHS Trusts to the public under their care. It remains to be seen whether any further criminal action in relation to individual or corporate failings at Mid Staffordshire will be brought, and we await any formal announcement from the CPS at the conclusion of their investigations.
The Trust entered a guilty plea at Stafford Magistrates Court on 9 October 2013 and the case was committed to the Crown Court for sentencing, where they have the ability to impose an 'unlimited' fine.
Previous prosecutions of NHS Trusts under this legislation have warranted significant fines. In 2006 the case of HSE v Southampton University NHS Trust initially saw a fine of £100,000 imposed against that Trust following the death of Sean Phillips, who developed toxic shock syndrome whilst under the care of two junior doctors. The HSE alleged that that Trust had failed to ensure patients' health and safety by not adequately supervising the doctors. However, the Court of Appeal reduced the fine to £40,000 due to the risk that a substantial financial penalty would inhibit the performance of that Trust’s public duties and on the basis that the breaches were not causative of the death.
The case of HSE v Great Western Hospitals NHS Foundation Trust (2010) resulted in a fine of £75,000 following the death of a patient who was given an epidural drug intravenously instead of a saline solution. Investigations showed that the two drugs were stored in the same racking system, despite having almost identical packaging and that this constituted an unacceptable risk to patients.
Whilst the imposition of a significant fine therefore has established precedent, the Court will pay particular regard to the Sentencing Guidelines Council's guidelines on imposing appropriate sentences for health and safety offences causing death. These guidelines recommend that when considering the financial consequences of a fine against a public body such as an NHS Trust, the court should consider 'the effect upon the provision of services to the public'.
We note that the Trust is currently in administration (with a reported annual operating deficit of around £11m) and that the NHS Litigation Authority (which provides indemnity cover for legal claims against NHS Trusts) has claimed that the Trust's insurance would not cover a fine from the HSE. Given the obvious financial difficulties faced by the Trust, it will be interesting to see how the Court balances the need to impose a punitive sentence in recognition of the admitted failings, against the effect a fine will have on the continuing provision of services by the Trust.
Whilst this is the first criminal prosecution brought in relation to the broad Mid Staffordshire investigation, it is an acknowledgement of the corporate responsibility owed by NHS Trusts to the public under their care. It remains to be seen whether any further criminal action in relation to individual or corporate failings at Mid Staffordshire will be brought, and we await any formal announcement from the CPS at the conclusion of their investigations.