Norfolk and Suffolk mental health trust branded 'national scandal' over mis-recorded patient deaths

  • Watch a video report by ITV News Anglia's Rob Setchell


An embattled mental health trust has been branded a "national scandal" after a damning review revealed it had lost track of how many of its patients died.

An independent report into Norfolk and Suffolk Foundation Trust (NSFT)'s mortality data described it as unclear, inconsistent, and incomplete.

It identified thousands of unexpected deaths of patients in care or within six months of discharge - but recording processes were so "chaotic" that causes of death were often unconfirmed.

Norwich South MP Clive Lewis told ITV News Anglia: "It is a national scandal - you can't have thousands of deaths without knowing how and why.

"The trust fluctuates between awful and terrible.

"There must be a public inquiry to look at the whole trust, not just unexplained deaths. People need answers about how we have been failed so badly and for so long.

"I think all confidence in this organisation has now gone. The trust is not fit for purpose. I don't think anyone knows where the truth begins and the lies start."

The trust was rated as 'inadequate' and served it with a "warning notice" to improve in 2022. Credit: ITV News Anglia

The report by auditors Grant Thornton also found that senior clinicians were not confident in the data and therefore did not use it.

It said 278 patients were recorded as dying on the same day they were discharged.

But the trust itself now says there have been more than 11,000 deaths in the last five years. It insists most were not related to poor care - but was unable to say how many could have been avoided.

Campaigners want the trust's chief executive, chair and board all to be replaced.

Caroline Aldridge told ITV News Anglia that she was 'stunned' by the report Credit: ITV News Anglia

Caroline Aldridge, whose son Tim died in 2014, said the review was even worse than she first thought.

She added that she was stunned and "profoundly shocked" by the results, admitting she cried when she thought of all those who had been discharged and died.

"The data is meaningless, it's ambiguous, it conceals. What it conceals is these are our loved ones who are dying.

"These are our loved ones, who seem from these figures to be dying in ever larger numbers, and the system is focused on covering its backside, making itself look good and not on listening, learning, changing.

"If they don't know how many have died, then they can't know why they've died and they can't be truly learning from that.

"The message that bereaved families are telling me is that our loved ones don't count. They were invisible and they were failed in life and then their deaths aren't even counted.

"It says in the report they've lost sight of their mortality data but [it has happened] in plain sight because all of this has been going into board papers, to NHS England, and it's as if nobody cares."

The trust said it accepted the report and would implement the recommended changes. Credit: ITV News Anglia

For years the families of those who lost loved ones have also been campaigning for change. 

They have taken their fight to parliament to call for a public inquiry, and have made their case by hanging up the names of loved ones who died outside Hellesdon Hospital.

The trust said it accepted the findings of the report and would implement the recommended changes. But it also argued that more guidance was needed nationally to ensure that mortality data was collected accurately across the board.

Stuart Richardson, chief executive of the trust, said: "We welcome the independent Grant Thornton report published and accept its recommendations in full... We are very sorry that the trust has not previously had the systems and processes in place for the collection, processing and reporting of mortality data that would be rightly expected from a high performing organisation.

"I think it's very clear that the report shows it's a chaotic system we've been using to record data for people who passed away in the community.

He added: "Data quality, performance reporting, and governance all form vital elements of the improvement work that is well under way across the organisation – which was recognised by the Care Quality Commission with an overall improved rating in February 2023."


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