Hospital fined £200k by court after children exposed to 'significant risk'

The Care Quality Commission (CQC) brought the prosecution against the trust at Sheffield Magistrates’ Court yesterday after the children attended the urgent and emergency care centre (UECC) and/or the children’s assessment unit (CAU) at Rotherham Hospital, on multiple occasions between January 2019 to February 2020 with different complaints.

Prosecuting, Mr Ryan Donoghue, said child three was 14 days old when they were admitted in December 2019 with breathing difficulties and bleeding from the nose and mouth. No safeguarding action was taken, and they returned, or were visited at home by healthcare staff, a further four times, before visiting the UECC in January where the hospital discovered several non-accidental injuries including three broken ribs which were healing. 

Child four attended UECC with a mouth injury in January 2019 but was discharged, despite being subject to a child protection plan which was not identified by nurses. 

Mr Donoghue said the trust failures were across five areas including policy, training, and governance. It did not have effective reporting systems and processes — including recording staff training — or up to date policies to keep people safe or make sure staff were fully aware of them. 

It had been ranked as “requires improvement” by the CQC inspectors in 2015 and subsequent inspections including March this year.  

In mitigation, Miss Eleanor Sanderson said the trust had been working with the CQC on improvements but accepted these were not all "fully embedded". A new management team was in place since 2020 including chief executive Dr Richard Jenkins and senior figures such as a new chief nurse and medical director. 

The trust expressed “its deep regret”, she said. "Since the matters came to light those now managing the hospital have worked hard to ensure these events would not be repeated.”

District Judge Naomi Redhouse acknowledged the trust had a “significant history of safeguarding and governance concerns” identified by the CQC but stressed the charge was “a risk of harm not the causation of actual harm”. 

She acknowledged the pressure the trust and others nationally were under and that the hospital would be paying the fine itself so it would impact on service users. 

The cases of all four children and other unnamed service users were considered together as part of a single charge and the trust was fined £200,000. The trust must also pay a £170 victim surcharge and £33,068 costs to the CQC.

Speaking after the case, Sarah Dronsfield, CQC head of hospital inspection, said: “These young children were let down by Rotherham NHS Foundation Trust’s lack of good policies and processes around safeguarding, which sadly in this case has had very real-world consequences for them.  

“Anyone using health and social care services should have the right to be seen by staff with the right training, who have the right processes in place, to keep them safe. This was not the case at Rotherham General Hospital.

“This lack of good systems or training meant vulnerable young children, all less than six weeks old, were let down by the trust, sometimes on several occasions, when they failed to identify safeguarding concerns which could have prevented them from coming to further harm.

“I hope everyone working in the health and care system can learn from this and do all they can to prevent this happening again.

“The vast majority of people receive good, safe care when they attend hospital, but if we find a provider has put people in its care at risk of harm, we take action to hold it to account and protect people.

“I hope this prosecution reminds care providers they must always take all reasonable steps to ensure people receive safe care and treatment.”

The trust’s chief executive Dr Richard Jenkins said: "On behalf of Rotherham NHS Foundation Trust, I unreservedly apologise for the deficiencies in how the trust safeguarded children from the risk of harm in 2019 and early 2020. 

“The court focussed on failures in our policies, training and oversight of safeguarding and we fully accept the findings of the court. It’s important to note that the court was clear that the failings were not the result of actions of clinical staff and that no child came to harm as a result of the failings.”

Chief nurse Helen Dobson said: “Since 2019, the trust has made extensive changes to our children’s safeguarding processes. Robust action has been taken to improve policies, training and oversight, with the introduction of a range of initiatives including safeguarding huddles, closer partnership working within our teams and with Rotherham partners.

“In order to assure ourselves and others, we recently invited NHS England to independently review our children’s safeguarding arrangements and, while we await the written report, the verbal feedback from the reviewing team was positive.”