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Hospital denied dying man 'opportunity to survive'

Carl Nolan, who was born with liver disease, died aged 30 after a hospital failed to inform him of his condition. Credit: Family Photograph

A man who was born with liver disease died at the age of 30 following a catalogue of errors by his local health board which - ultimately - prevented him from having a transplant.

Unbeknown to him Carl Nolan had cirrhosis - a life threatening condition - but when he became ill and visited Glan Clwyd Hospital in Bodelwddyn, Denbighshire, staff failed to tell him about his complaint and he went without any medical treatment for several years.

Eventually when his liver was failing Mr Nolan was admitted to hospital but died three days later.

In a report published today the Public Services Ombudsman for Wales says: "Had he been treated three days earlier, Mr Nolan should have recovered from the infection and had a chance of receiving a liver transplant. This opportunity to survive and flourish was denied to him."

Betsi Cadwaladr Health Board has agreed to write to Mr Nolan's family to acknowledge its failings and pay them £5,500.

North Wales health board: Low risk of transmission

The worker infected with Hepatitis C worked in the obstetric and gynaecology units at what was then Maelor General Hospital.

North Wales' health board says the healthcare professional infected with Hepatitis C worked briefly at Wrexham Maelor Hospital (known then as the Maelor General Hospital) in May and June 1978.

Betsi Cadwaladr University Health Board says the risk of passing on the virus during a healthcare procedure is low, and could only happen if the worker suffered an injury causing them to bleed while treating the patient.

It says it has been reviewing its records, and obstetric and gynaecology patients from that time have been offered advice a blood test as a precautionary measure. Specialist clinic sessions will be held at Wrexham Maelor Hospital.

Andrew Jones, Director of Public Health for the Betsi Cadwaladr University Health Board, said: “I know that this news will cause some concern for patients who were seen in Wrexham at around that time. However I want to stress that the risk of transmission is low."

"Even so, it is important that we contact patients who were treated by this person and offer them support and the opportunity of a blood test. This will allow us to give reassurance that all is well or, if we do identify a person who is carrying the virus, ensure they get advice and treatment."

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N.Wales health board admits failings over infections

by Rob Shelley

A hospital board which has had the highest MRSA and C.diff infection rates in Wales over the past year says it needs to improve the way it tackles the problem.

The admission by Betsi Cadwaladr University Health Board in North Wales comes after a critical report on an outbreak earlier this year.

Betsi Cadwaladr 'acting quickly' to improve

Betsi Cadwaladr University Health Board said Prof Duerden's report confirms that it "must do more to improve infection prevention and control".

It focuses on improved leadership and management, and also the way cases are reported to the board and to the Welsh Government.

First we must apologise to the people of North Wales that our infection control practices have not been as good as they should have been. This has again been made clear in Professor Duerden's important and helpful report and we are acting quickly to make sure that the shortcomings that he has identified are addressed.

We have made it clear that we have an attitude of 'zero-tolerance' to preventable infection across the organisation. As an immediate step I have brought in a leading expert in infection prevention to work with us in North Wales as we improve our wider infection control services.

We have also put in place a weekly monitoring system at board level and we now have infection control groups led by senior clinical staff in each acute hospital to make sure there are clear lines of reporting and accountability at a local level. We are also in the process of recruiting additional nurses to our infection control teams.

I hope that by commissioning and publishing this report, and acting on its findings, we will be able to demonstrate and assure patients of the Health Board's determination to make the necessary and urgent improvements.

– Angela Hopkins, Executive Director of Nursing, Midwifery and Patient Services

Infections must be 'significantly increased priority'

The report concludes: "the prevention and control of healthcare associated infections requires significantly increased attention and priority" throughout the health board, "from individual wards and units through to the Executive Team and the Board itself."

It makes a large number of recommendations, including:

  • The profile of Infection Prevention and Control needs to be enhanced across all clinical areas
  • Each ward should receive, each month, its own figures for key HCAI numbers with historical data over previous months for comparison
  • All clinical and non-clinical staff have a personal responsibility for their own standards and activities - all staff must be included in policies such as hand hygiene and be part of the audits

C.diff outbreak - what went wrong?

Today's report, commissioned by Betsi Cadwaladr and delivered by Prof Brian Duerden, says "many inter-related issues came together to make a C.diff outbreak a significant risk", particularly at Ysbyty Glan Clwyd.

96 cases of the virus were recorded at the hospital between January and May 2013.

The report identifies these weaknesses in the system:

  • There was a weak Infection Prevention & Control management structure, and a failure to recognise the risk indicated by the high background rate of C.diff infection
  • There was a lack of Infection Prevention & Control leadership
  • Infection Prevention & Control appears to have had a low priority
  • There was a failure to respond in a timely manner to concerns about isolation capacity and infection risks
  • There was a lack of single room isolation facilities and delays in isolating patients with diarrhoea that might be infectious, including potential C.diff cases

The number of specialist Infection Prevention & Control staff had been reduced, particularly at Ysbyty Glan Clwyd, resulting in:

  • Inadequate training for ward staff
  • Reduced support for ward Infection Prevention & Control activities
  • Withdrawal of Infection Prevention & Control support for community hospitals and primary care

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Health board apologises over infections failings

Wales' largest health board has admitted it needs to improve the way it deals with infection rates, as a highly critical report is published into an outbreak of Clostridium difficile (C.diff) earlier this year.

Betsi Cadwaladr University Health Board said "we must apologise to the people of North Wales that our infection control practices have not been as good as they should have been."

Today's report recommends all staff must be aware of their responsibilities when it comes to hand hygiene. Credit: PA

96 cases of the C.diff virus were recorded at Ysbyty Glan Clwyd, near Rhyl, between January and May 2013.

A report by Professor Brian Duerden from Cardiff University, commissioned by the health board and published today, said "significant" improvements need to be made in infection prevention and control.

Flint Hospital: Health board 'aware of strong feelings'

We are fully aware of the strong feelings being expressed today regarding the relocation of the clinics from Flint Community Hospital to Borough Grove Clinic.

The Minister confirmed last month that the decisions made by the Health Board in January of this year were to be implemented and we are very keen to work closely with local people to take forward the plans to develop new services and facilities in Flint.

The health board is working hard to make sure there is a smooth transition of all clinics with minimum disruption for patients.

– Betsi Cadwaladr University Health Board spokesperson

The spokesperson added: “We would like to reassure patients that the health clinic is a safe place to deliver our services. In the long term these services will be provided from a more modern Primary Healthcare Resource Centre.

"As of Monday, the phlebotomy, counselling and outpatient clinics previously provided from the hospital will be provided from the Borough Grove clinic building.

"On Monday 2nd September, GP Minor Surgery services will also transfer from the hospital to the clinic, following an upgrade of the current facilities.”

Health board 'accepts unequivocally' critical report

Members of the Betsi Cadwaladr University Health Board have "fully and unequivocally" accepted the findings of a highly critical report on the Health Board’s management and governance arrangements.

At a public meeting today the board apologised for the failings that had been identified in an auditor's report and vowed to move ahead quickly to address the recommendations made.

We know the Report has left staff with many questions and has damaged public confidence in the way the Health Board has been operating. However I have been encouraged to see that the Betsi Cadwaladr Board are not shying away from these difficult issues, and I have found a real determination to make sure that this marks a turning point

– Paul Roberts, Chief Executive, Abertawe Bro Morgannwg University Health Board

We now have a clear plan and structure to drive forward the improvements that are needed, and I am pleased that these are in place. As we move forward we must make sure that we talk and listen to staff in the Health Board, as well as colleagues in partner organisations, to understand their concerns and reflect their views in our work

– Geoff Lang, the Acting Chief Executive, Betsi Cadwaladr University Health Board.
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