Saturday, 2 February 2013

Mr David Fillingham

David Fillingham is an interesting man. He is a typical NHS manager. No one has ever held him accountable for the issues below. He continues to sport his CBE and exist at the Kings Fund. He is contributor to the Health Service Journal. Here is the historical summary submitted to those responsible for Royal Bolton Foundation NHS Trust some years ago. No action was taken. 

Historical Summary

1. Mr David Fillingham currently holds the post of Chief Executive at Royal Bolton Foundation NHS Trust. He has held this position since September 2004. The Trust is currently in the top ten list of high HSMR [Mortality rates] according to Dr Foster. He also holds the post as Chair of the "Advancing Quality Alliance" (AQuA)

2. Before his current position, he was director of the NHS Modernisation Agency  from 2001-04. Between 1997-2001 he held the post of chief executive of University Hospital of North Staffordshire trust, Stoke on Trent. Chris Sherlaw-Johnson who is the Surveillance Manager at the Care Quality Commission stated as follows [ Email from him to Sarah Seaholme dated 9th December 2009] at 13.15 “"Earlier data from Dr Foster does suggest that they did have more concerning mortality in years before 2003/4".

3. He joined the NHS in 1989 after previously holding senior managerial positions in personnel and marketing at glass manufacturer Pilkington. After a short period at Mersey Regional Health Authority, David has occupied a number of Chief Executive positions – in Primary Care at Wirral FHSA from 1991 until 1993; in commissioning at St Helens & Knowsley HA from 1993 until 1997. His past history is notable because there has been no investigation into patient safety issues at these places. 

4. In the case of North Staffordshire NHS Trust, the litigation lag period and claims made in the years prior to 2005 resulted in payments made by the NHS Litigation Authority between 2004-2005. The table below shows the level of compensation paid out within claims filed during the reign of Mr David Fillingham between 1997-2004. 

Clinical negligence payments made by the NHSLA in 2004–05 for all claims against trusts in Shropshire and Staffordshire SHA
Member name Total paid
Burton Hospitals National Health Service Trust 335,088
Mid Staffordshire General Hospitals NHS Trust 652,418
North Staffordshire Combined Healthcare NHS Trust 106,764
Robert Jones and Agnes Hunt Orthopaedic and District
Hospital NHS Trust 81,258
Shrewsbury and Telford Hospital NHS Trust 951,905
South Staffordshire Healthcare NHS Trust 33,420
Staffordshire Ambulance Service NHS Trust 0
University Hospital of North Staffordshire NHS Trust 3,515,590

Source- Hansard [15 Mar 2006 : Column 2326W] 

In summary, the compensation paid out by North Staffordshire NHS Trust was approximately 3-4 times that of Mid Staffordshire NHS Trust [currently scrutinised by the Mid Staffordshire Inquiry 2010] 

 3. A March 2002 report by the Commission of Health Improvement of a Clinical Governance Review at North Staffordshire NHS Trust found serious shortcomings in the supervision of junior doctors, 

"CHI was informed that junior doctors working in medicine were often inadequately supervised and often left alone on wards, particularly on the medical assessment unit (MAU). During an evening visit we found only two junior doctors covering MAU, which was full to capacity, with a further junior doctor covering MAU and emergency admissions; one junior doctor covered the medical wards and one covered medical outliers but these patients could be on wards on either site. CHI felt this situation posed a potential clinical risk to patients.”

The 2002 report went on to say, in Paragraph 5.78: 

"There were a number of concerns raised regarding support and supervision for junior doctors working in medicine. We were told of a number of occasions when it was felt there was a lack of support both during the day and when problems arise whilst oncall. The Trust has acknowledged that medical staffing at all levels is under resourced in medicine".
[ Full CHI Report available on request or from the CQC] 

3. The above report found fault in the Trust’s supervision of junior doctors. This is despite concerns being raised in 1998 by Dr Rita Pal, a Pre Registration House Officer on Ward 87 North Staffordshire NHS Trust. Concerns were raised about patient safety being put at serious risk by the lack of equipment, lack of supervision, the lack of nursing staff etc. At the time, the Trust and its chief executive denied that there was a problem. Subsequent to this, internal documents were found stating as follows. A letter from Dr Colin Campbell to Dr John Green, Clinical Director at City General Hospital Stoke on Trent, read as follows: (CAC/ AR/LET 2nd December 1998) Point 2 (first page) 

"To summarise other discussions that we have had on the medical PRHOs, I think that the following should be addressed within the directorate as a matter of urgency - (2) They should have proper clinical supervision at all times and help from a more experienced colleague... should always be available (The New Doctor GMC), On discussion with several of them they are still working without immediate supervision for significant periods.”

4.Despite reports verifying significant problems on Ward 87, David Fillingham and his team released a statement to Stoke Radio on Dr Rita Pal. It stated [ amongst other things]  “"Where allegations were made about the treatment of specific patients, case-notes were reviewed and her claims could not be substantiated" [3rd April 2000]. 

In 1999, a internal memorandum noted as follows:- 

Medical Division Memorandum 
Ward 87
From Ms Teresa Fenech 
Directorate Manager for Infectious Diseases City General Hospital Stoke on Trent. 
Reference TF/CLS/005 
18th May 1999

Point 3

“I informed you that I had undertaken an audit of every single patient on the ward the previous week. I identified a serious lack of baseline and routine observations. In the case of some patients there was also clearly a breach of policy and there was an apparent lack of misunderstanding from the staff of the importance of such issues. I informed you that in my opinion the level of care demonstrated for some patients on the ward at the time of my audit was nothing short of negligent"

[Documents available on request] 

5.The Executive Summary of the Creamer Report in 2001 into minority data showed quite the opposite. This is what it stated :- 

(a) “Patient care was clearly affected by the failures identified”;
(b) “The Directorate failed to take appropriate action when the allegations were made in a statement by Dr Pal”;
(c) “Although medical and nursing staff were concerned about the range of one voiced their concerns except Dr Pal which either demonstrated a general acceptance of the issues or staff felt unable to raise concerns”.
[ Creamer Report 2001 and summary report 1999 available on request] 

6.Mr Fillingham subsequently engaged in a series of events that were effectively designed to silence the whistleblower. He discussed a referral to the General Medical Council with the then Director of Public Health when the negligence on the ward was made public. He instigated and supported an investigation by the Health and Safety Executive into Dr Pal between 1998-1999. The Executive dropped the investigation and corrected their records some years later. This culminated into the above where the Chief Executive released a dishonest press statement to the local media [ and possibly the national media]. Fillingham’s intention demonstrated by the above has always been to undermine the whistleblower. 

7.Mr David Fillingham’s negligent mismanagement has never been investigated nor has he been held accountable for his actions. The above are summaries of documents unearthed from North Staffordshire NHS Trust over the last decade or so. I have not investigated the other institutions he has managed. It should be noted that no wider data study was ever instigated on Ward 87 and David Fillingham did not wish to quantify the level of mismanagement that compromised patient care. No one [ medical staff or otherwise] was held accountable for the serious failures on the Ward. Mr Fillingham allowed the ward to remain open thereby seriously compromising patient safety. As detailed above, despite warnings on various issues that affected patient care, they were not corrected by him. To this day, because data was not kept, it is unknown how many patients’ lives were compromised by this negligent mismanagement of the ward and also the hospital. 

In conclusion, Mr David Fillingham is not fit to manage any NHS organisation. The direct reason for the increasing mortality rate of the Royal Bolton NHS Foundation Trust is his severe lack of management skills and the failure to respect patient safety. Fillingham has a reckless attitude to patient safety. It is crystal clear that Mr Fillingham allowed patient care to be compromised at North Staffordshire NHS Trust for many years.  It is imperative that he is not placed in a position of responsibility in the future. 


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