NHS England North (Cheshire & Merseyside)
Lampard Report (Savile Inquiry)
First Published: 24 March 2015 updated 27 November 2015 following DH publication (26 November 2015)
Prepared by: Lisa Cooper, Deputy Director Quality & Safeguarding
Contents
1. Report purpose 4
2. Background 4
3. Content of Lampard Report 4
4. Key recommendations from Lampard report (2015) 5
5. Update from Department of Health (26 November 2015) 8
6. Action taken by NHS England North (Cheshire & Merseyside) 8
7. Recommendation 9
1. Report purpose
The purpose of this report is to provide an update to Cheshire & Merseyside Safeguarding Boards (Children & Adult) regarding the publication of the Lampard final report relating to Jimmy Savile (February 2015) and Department of Health response update (26 November 2015).
2. Background
The Secretary of State appointed former barrister Kate Lampard to provide independent oversight of the NHS and Department of Health investigations into the role and activities of Jimmy Savile within health organisations.
An interim report published on 26 June 2014 provided assurance regarding the 28 NHS organisation reports including the independent investigations at Broadmoor Hospital and Leeds General infirmary and can be found at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/323488/Assurance_report.pdf
A final report was published on 26 February 2015 and can be found at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/407209/KL_lessons_learned_report_FINAL.pdf
As part of her final report Kate Lampard was asked to:
· Identify the common themes from all the NHS investigation reports into matters relating to Jimmy Savile
· Look at NHS-wide guidelines and procedures in the light of the findings and recommendations of all the NHS investigation reports
· Advise the Secretary of State for Health on whether and how any relevant guidelines or procedures need to be tightened or changed.
In addition, the Secretary of State for Health was interested in whether any inappropriate access that Savile was given, was because of his celebrity or his fundraising role. He has expressed concern about whether or not current systems sufficiently safeguard patients.
Further to the publication of the report Hilary Garratt, Director of Nursing, NHS England circulated a letter (21 July 2015) requesting that the role of NHS England is to work with the CCGs and regulators to ensure the relevant and appropriate recommendations are delivered. The letter suggested this becomes a standing item on regional/local QSGs for discussion with partners from Monitor; TDA and CQC.
3. Content of Lampard Report
Kate Lampard has commissioned expertise and considered the historical context; culture and issues that formed the background to Savile’s life and his offending in NHS Trusts. This included the changing sexual culture of the period in question; the shift in attitudes to celebrity and privacy; the legal status of and attitudes towards victims of child sex abuse; charitable fundraising and volunteering in the NHS; and NHS management structures and culture in the relevant period.
In addition, to producing the report Kate Lampard has used the oversight work as an opportunity to understand how the abuses were allowed to happen; identify the issues which are of relevance for today’s NHS; and how they may be addressed. This report focuses on the findings and conclusions of the NHS investigations with the intention of strengthening patient care and safety.
The findings of the separate NHS investigations regarding the cultures, behaviours and governance arrangements that allowed Savile to gain access and influence in the various NHS hospitals which gave him the opportunity to carry out abuses on their premises over many years are consistent. The common themes and issues that have emerged from the investigations findings which are seen as relevant to the wider NHS today are as follows:
· Security and access arrangements, including celebrity and VIP access
· The role and management of volunteers
· Safeguarding
· Raising complaints and concerns (by staff and patients)
· Fundraising and charity governance
· Observance of due process and good governance.
Social attitudes and public policy in relation to the protection of children and young people have changed and developed significantly since the time that Savile first started volunteering in NHS hospitals. In keeping with these wider societal developments, awareness among NHS staff of the issue of safeguarding and of their obligations to protect patients, especially children and young people, from abuse, harm, and inappropriate behaviour has increased markedly in recent years. There is some concern however that while staff may be aware of the issues raised by recent scandals, they may not necessarily recognise the implications of these issues for themselves and their own organisations.
4. Key recommendations from Lampard report (2015)
The recommendations of the report for NHS hospital trusts are also addressed to Monitor and the Trust Development Authority, under their duties to regulate NHS hospital trusts. Most of them are also addressed to:
· The Care Quality Commission under its duties and powers to regulate and assure the quality and safety of hospital services
· NHS England under its duties and powers to promote and improve the safeguarding of children and adults
The recommendations are listed below:
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Number / Recommendation1 / All NHS hospital trusts should develop a policy for agreeing to and managing visits by celebrities, VIPs and other official visitors. The policy should apply to all such visits without exception.
2 / All NHS trusts should review their voluntary services arrangements and ensure that:
· they are fit for purpose
· volunteers are properly recruited, selected and trained and are subject to appropriate management and supervision
· all voluntary services managers have development opportunities and are properly supported.
3 / The Department of Health and NHS England should facilitate the establishment of a properly resourced forum for voluntary services managers in the NHS through which they can receive peer support and learning opportunities and disseminate best practice.
4 / All NHS trusts should ensure that their staff and volunteers undergo formal refresher training in safeguarding at the appropriate level at least every three years.
5 / All NHS hospital trusts should undertake regular reviews of:
· their safeguarding resources, structures and processes (including their training programmes)
· the behaviours and responsiveness of management and staff in relation to safeguarding issues
· to ensure that their arrangements are robust and operate as effectively as possible.
6 / The Home Office should amend relevant legislation and regulations so as to ensure that all hospital staff and volunteers undertaking work or volunteering that brings them into contact with patients or their visitors are subject to enhanced DBS and barring list checks. Not accepted in principle by Secretary of State
7 / All NHS hospital trusts should undertake DBS checks (including, where applicable, enhanced DBS and barring list checks) on their staff and volunteers every three years. The implementation of this recommendation should be supported by NHS Employers
8 / The Department of Health and NHS England should devise and put in place an action plan for raising and maintaining NHS employers’ awareness of their obligations to make referrals to the local authority designated officer (LADO) and to the Disclosure and Barring Service.
9 / All NHS hospital trusts should devise a robust trust-wide policy setting out how access by patients and visitors to the internet, to social networks and other social media activities such as blogs and Twitter is managed and where necessary restricted. Such policy should be widely publicised to staff, patients and visitors and should be regularly reviewed and updated as necessary.
10 / All NHS hospital trusts should ensure that arrangements and processes for the recruitment, checking, general employment and training of contract and agency staff are consistent with their own internal HR processes and standards and are subject to monitoring and oversight by their own HR managers.
11 / NHS hospital trusts should review their recruitment, checking, training and general employment processes to ensure they operate in a consistent and robust manner across all departments and functions and that overall responsibility for these matters rests with a single executive director.
12 / NHS hospital trusts and their associated NHS charities should consider the adequacy of their policies and procedures in relation to the assessment and management of the risks to their brand and reputation, including as a result of their associations with celebrities and major donors, and whether their risk registers adequately reflect such risks.
13 / Monitor, the Trust Development Authority, the Care Quality Commission and NHS England should exercise their powers to ensure that NHS hospital trusts,(and where applicable, independent hospital and care organisations), comply with recommendations 1, 2, 4, 5, 7, 9, 10 and 11.
14 / Monitor and the Trust Development Authority should exercise their powers to ensure that NHS hospital trusts comply with recommendation 12.
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5. Update from Department of Health (26 November 2015)
The Department of Health provided an update report (26 November 2015) regarding progress against 13 of the 14 recommendations accepted by the Secretary of State within the final Lampard report. The report can be found here: https://www.gov.uk/government/publications/jimmy-savile-nhs-investigations response-to-lessons-learnt-report
Chief Executives of Monitor and NHS Trust Development Authority wrote to all NHS Foundation Trusts and NHS Trusts requesting they read the lessons learnt report and review their current practice against the recommendations. In particular, trusts were asked to:
· Develop an action plan to identify where additional action is needed against these recommendations
· Provide assurance that the necessary action has been taken – or where this is in progress, the date by which it will be completed
· Report back on their proposed actions within three months.
All NHS Foundation Trusts and Trusts responded, with the majority of responses being very detailed and considered. The responses have been collated by Monitor and TDA who have provided an update to the Secretary of State.
The Department of Health advise that they have confidence in the level of commitment across the sector to address the issues raised by the Savile investigations and the lessons learnt report.
6. Action taken by NHS England North (Cheshire & Merseyside)
The following actions have been taken by NHS England North (Cheshire & Merseyside) following publication of the final Lampard report and individual Trust reports:
· All reports shared with Designated Nurses for Safeguarding Children and Adults/Named GPs for Safeguarding Children for review and action with relevant Trusts.
· All reports shared with CCG Lead Nurses/Quality Leads for review and action with relevant Trusts.
· All reports shared with Director Nursing Specialised Commissioning (NHS England North) for review and action as required with relevant Trusts.
· Safeguarding Assurance Framework and Audit Tool (Children & Adults) has been updated to include review of relevant policies and proceedures relating to visitors/Trust membership schemes/volunteers/raising concerns.
· Summary report shared with all Children and Adult Safeguarding Boards.
In addition to the above and following publication of the Department of Health update (26 November 2015), NHS England Cheshire & Merseyside has ensured the following:
· Department of Health report (26 November 2015) is shared with all Designated Nurses (Children & Adults); Named GPs; CCG Safeguarding Leads; CCG Chief Nurses; Safeguarding Children & Adults Boards.
· CCGs seek assurance from NHS Foundation Trusts and NHS Trusts that all required actions in relation to the report have been taken.
· Local QSGs continue to receive assurance in relation to any actions taken.
7. Recommendation
Cheshire & Merseyside Safeguarding Boards (Children & Adult) are asked to note the contents of this report and consider any additional actions required from Health agencies in relation to this report and recommendations.
Lisa Cooper
Deputy Director Quality & Safeguarding
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