Care Quality Commission chairman to visit Royal Sussex County Hospital after allegations of racism

A senior figure from a national watchdog is coming to Brighton to hear about how racism is affecting staff in our hospitals. Frank le Duc reports

The chairman of the national hospitals watchdog the Care Quality Commission (CQC) is due to visit the Royal Sussex County Hospital on Tuesday 28 January. David Prior has been invited by Vivienne Lyfar-Cissé, who chairs the Black and Minority Ethnic (BME) Network at the trust which runs the Royal Sussex. Dr Lyfar-Cissé also chairs the NHS BME Network at national level.

She has experienced racial discrimination and victimisation at work and as a result won her employment tribunal claim against the trust for racial discrimination in 2007. The Trust also accepted liability for further acts of racial discrimination and victimisation against her in 2008. To the credit of Duncan Selbie, the chief executive at the time, he seconded her to design and lead a change management project called the Commitment to Change (C2C) Agenda for Race Equality.

Last month Dr Lyfar-Cissé resigned as the project leader to return to her role as principal clinical biochemist. She also published a review of the C2C project in which she spoke about barriers to change. She wrote: “Unfortunately, the evidence shows that the current leadership of the organisation believes it is immune to racial prejudices and as such is reluctant to change.”

Trust chief executive Matthew Kershaw said in his reply to Dr Lyfar-Cissé’s resignation letter: “I know and accept that there is more work to do on race equality but I do not believe that the trust that has used C2C to ‘cover up’ racist conduct to the detriment of staff and patients.” He said that the C2C project was a priority for the trust.

The trust board is made up only of white men and women, according to its website, although some estimates suggest that about 15 per cent of the staff are from ethnic minorities. Many of those staff have critical medical jobs. They include nurses in accident and emergency, critical care and intensive care as well as leading surgeons. Others have key supporting positions such as ward cleaners whose low-paid jobs are crucial in infection control.

Dr Lyfar-Cissé’s resignation came in the same month that freedom of information data showed a rise in the number of racist attacks being reported in the NHS. The Brighton trust was in the top ten with 15 physical or verbal attacks reported in 2012-13.

“I know and accept that there is more work to do on race equality”

In her review Dr Lyfar-Cissé cited eight incidents in which patients or visitors had been racially abusive to staff. In one case the perpetrator, since banned, was a voluntary member of staff employed by the South East Coast Ambulance NHS Trust. There were shortcomings among staff too from failures to report incidents to more concerning behaviour. One manager, for example, had shown a black member of staff a picture of a monkey without any rational explanation and the outcome of the Trust’s investigation was that the manager’s behaviour was neither inappropriate or racist.

One 81-year-old patient wrote: “There are, I know, bad doctors, bad nurses and bad patients. Unfortunately there are also wicked patients. Racist and homophobic remarks about the people helping them and looking for faults were common. Some patients appeared to be trying to turn other patients against the nurses. I was amazed by the forbearance and dignity shown by the nurses at this time. What I saw and heard I thought depicted in cartoons only. Why the nurses did not walk out on us is a tribute to their goodness.”

Highlighting another area of concern, Dr Lyfar-Cissé also said in her review: “A number of BME doctors have raised serious patient safety concerns including patients allegedly being harmed by doctors on restricted practice. It is the position of these doctors that the trust in the main is failing to take appropriate action to safeguard patients because the doctors involved are white British. The Patient Safety Ombudsman for the trust has provided evidence to the CQC to support the allegations of the BME doctors.”

Prejudice could cost precious public money in legal fees and compensation when it could be spent on patient care. Discrimination may mean that the best clinician may not be in the best position to provide patients – whatever their race or colour – with the best treatment. It may mean that a dangerous or poorly performing doctor or nurse is treating patients when they should be supervised or struck off. It’s not just a question of equality and fairness. It could be a matter of life or death for any one of us.