A major hospital trust at the centre of a police investigation allowed significant numbers of unregistered consultants to operate on patients, it has been claimed.
At least 105 cases of medical negligence and allegations of a cover-up at Royal Sussex University Hospitals NHS Foundation Trust are currently being probed.
The Telegraph has learnt that, as part of the investigation, officers are considering allegations that numerous surgeons in the troubled general surgery department in Brighton held the title of consultant without having qualified for the specialist register.
It can also be revealed that a weekly clinical safety meeting was scrapped in favour of a monthly meeting shortly before the period that saw many of the mishaps currently under review.
In order to qualify for the register, aspiring senior doctors must undergo a lengthy training under different mentors and pass multiple specialist exams.
Under NHS rules, only those who are on the register may take up any fixed-term, honorary or substantive consultant post in the NHS, subject to a few exceptions.
However, foundation trusts are not bound by this rule, in recognition of their greater legal autonomy compared to traditional hospitals.
Sources have claimed that, at its worst point, the proportion of unregistered consultant surgeons at the Royal Sussex County Hospital exceeded 40 per cent, although the trust is understood to dispute this figure.
There is currently a national shortage of consultants and concerns have begun to emerge from the medical establishment in recent years about a growing use of non-registered consultants to deal with rising patient demand.
A spokesman for the trust said: “Appointing experienced doctors not on the specialist register to consultant positions is common practice in the NHS, provided they can demonstrate the required training and expertise in their field.”
However, a source told The Telegraph: “The Royal Sussex County Hospital is a major trauma centre and supposed to be a teaching hospital.
“To claim it’s acceptable to have a high number of unregistered surgeons at a centre like this is entirely wrong and dangerous.”
A recently published review by the Royal College of Surgeons criticised “bullying” and a “culture of fear” at the trust.
Meanwhile, a damning Care Quality Commission report found a “wide disconnect in the relationship between staff and senior leaders”.
Governance drastically reduced
The Telegraph can disclose that in 2019 there was a major shake-up of clinical governance in general surgery which drastically reduced the frequency of morbidity and mortality meetings, where deaths and complications were discussed in order to learn lessons.
For several years up until that point, the reviews had taken place weekly on a Friday afternoon.
However, at a meeting of the department in the summer of 2019, new leadership scrapped the weekly meetings, with staff allegedly told their time could be put to better use.
The trust said the meetings became monthly, and that this was in line with Royal College of Surgeons guidelines.
The guidelines state that: “A frequency of one meeting each month is the most common arrangement.”
However, the guidelines add: “In large, busy units and for specialties in which complications are more prevalent it may be appropriate to meet more than once a month.”
Mr Peter Duffy, a consultant neurosurgeon who is now campaigning for better protection for whistleblowers in the NHS, said the decision to reduce the frequency of morbidity and mortality meetings “rings serious alarm bells”.
“If senior clinicians came to the conclusion that they needed weekly meetings and they were overruled, that raises serious alarm bells.
“At best it suggests a dysfunctional relationship there. Without these meetings, deaths can sometimes be brushed under the carpet.
“There are a range of clinical governance benefits.”
It is understood that at the 2019 meeting senior surgeons were also told that their offices would be moved away from the main department, a significant walk away.
Dr George Findlay, the trust chief executive, has promised improvements in the wake of the CQC report.
He previously served as deputy under Dame Mariane Griffiths, a close ally of former health secretary Jeremy Hunt, who retired in 2022.
At least two Employment Tribunals of former senior doctors at the trust are expected to go ahead in the coming weeks.
A spokesman said: “In 2019, a new Surgery leadership team changed case reviews to monthly which is in line with the Royal College of Surgeons guidance on frequency of M&M meetings.”
He added: “All surgeons employed by the Trust are licensed to practise by the General Medical Council.”
Northern Ireland saw the highest growth within the UK, where house prices increased by about 5.3% annually.
The outlook for the UK housing market seems to be a little brighter as house prices went up for a fourth consecutive month in January 2024, according to data from the Halifax House Price Index.
The Index revealed that the cost of an average house in the UK last month was estimated to set buyers back by about £291,029, which is £3,900 more expensive than in December. Good news for home owners but perhaps not for buyers.
The year-on-year Halifax House Price Index for January inched up 2.5% from 1.8% in December. This increase was also the most since January 2023. Meanwhile, month-on-month, house prices increased 1.3% in January, from 1.1% the previous month.
Northern Ireland leads the way in house prices
Northern Ireland saw the highest growth in the UK, with house prices jumping 5.3% annually. An average house in Northern Ireland is now valued at about £195,760, approximately £9,761 more than in January 2023.
Welsh and Scottish house prices also experienced robust growth, both inching up 4%, to £219,609 and £206,087 respectively. Yorkshire and Humber house prices grew by 2.8%, whereas houses in the North West became 3.2% costlier. East Midland houses only saw a 0.5% rise, but North East houses advanced 2%.
However, houses in the South East did not do as well as the rest of the UK, dropping about 2.3%, or £8,866 to an average of £379,220.
Kim Kinnaird, Halifax Mortgages director highlighted, as reported by Morningstar: “The recent reduction of mortgage rates from lenders as competition picks up, alongside fading inflationary pressures and a still-resilient labour market has contributed to increased confidence among buyers and sellers.
“However, while housing activity has increased over recent months, interest rates remain elevated compared to the historic lows seen in recent years, and demand continues to exceed supply. For those looking to buy a first home, the average deposit raised is now £53,414, around 19% of the purchase price. It’s not surprising that almost two thirds of new buyers getting a foot on the ladder are now buying in joint names.”
More likelihood of interest rate cuts in the next few months
Nationwide’s chief economist, Robert Gardner, said, as reported by The Guardian: “While a rapid rebound in activity or house prices in 2024 appears unlikely, the outlook is looking a little more positive.
“This follows a shift in view among investors around the future path of interest rates, with investors becoming more optimistic that the Bank of England will lower rates in the years ahead.”
On the other hand, the Bank of England (BoE) has maintained a more cautious stance, choosing to keep interest rates stable at 5.25% at its February meeting. Although independent economist and monetary policy committee (MPC) member Swati Dhingra suggested cutting interest rates immediately, the BoE chose to wait for more convincing data that inflation was taming.
However, the BoE also hinted at cutting interest rates in the next few months and revealed that it expects inflation to fall even more by summer.
UK house prices rose in annual terms in December for the first time in eight months, data from mortgage lender Halifax showed on Friday, adding to signs of a stabilisation in the property market after a hit from higher borrowing costs.
House prices were 1.7 per cent higher than in December 2022 – when the market was hammered by the “mini-budget” crisis of former prime minister Liz Truss.
In monthly terms, prices rose by 1.1 per cent from November, Halifax said.
Britain’s housing market boomed during the COVID-19 pandemic before demand fell as the Bank of England (BoE) pushed up interest rates to counter a surge in inflation across the economy.
However, a fall in mortgage rates in recent weeks has prompted some buyers to return to the market.
BoE data published on Thursday showed lenders approved the most mortgages in November since June.
Kim Kinnaird, director at Halifax Mortgages, said December’s price rise was probably driven mostly by a lack of properties on for sale but the fall in mortgage rates raised the possibility of increased confidence among buyers in early 2024.
“Our latest forecast suggests house prices could fall between -2 per cent and -4 per cent during the coming year, although, as with recent years, forecast uncertainty remains high given the current economic climate,” Kinnaird said.
Imogen Pattison, an economist with Capital Economics, said the full-year increase in prices was helped by a 1.4 per cent monthly fall in December 2022, shortly after the mini-budget crisis hit bond markets and market interest rates soared.
However, the recent fall in mortgage rates meant Capital now expected British house prices to rise by an annual 3 per cent in the fourth quarter of 2024, compared with a previous forecast of a 1.5 per cent fall, Pattison said.
Last week, rival mortgage lender Nationwide – which uses a different methodology to Halifax – said its data showed a fall of 1.8 per cent in house prices in the 12 months to December, the biggest drop over the course of a year since 2008. – Reuters