Controversial consultancy 'should be blacklisted by the NHS'

Martin Shipton

Calls have been made for the NHS to stop using a controversial consultancy after it failed to identify critical failings in the treatment of a five-year old boy with asthma who died a week after he was sent home from hospital.

Niche Health and Social Care Consulting caused outrage in October 2024 after accusing parents whose families have been blighted by medical failings at Singleton Hospital’s maternity unit in Swansea of making false allegations about a review examining the scandal.

Now allegations that Niche produced a ‘whitewash’ report into the death of Yusuf Nazir eight days after he was seen at Rotherham Hospital in South Yorkshire and sent home with antibiotics have been vindicated after a further inquiry listed numerous failings that were not highlighted by Niche.

Niche’s 2023 report into Yusuf's case had concluded his care was appropriate and "an admission was not clinically required", but this was rejected by his family.

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'No beds'

Yusuf’s family has always maintained they were told there were "no beds and not enough doctors" in the emergency department, and that Yusuf should have been admitted and given intravenous antibiotics in Rotherham.

The new report, ordered after the UK Government’s Health Secretary Wes Streeting met Yusuf’s parents, concluded: “Our primary finding is that the parental concerns, particularly the mother’s instinct that her child was unwell, were repeatedly not addressed across services."

Haroon Rashid, a campaigner whose own five-year old son Ayaan died in Sheffield Children's Hospital in 2023, said of the Yusuf Nazir case: “The original Niche report was only 36 pages long and the second investigation report by Nurture Health and Care is 139 pages long which is concerning as that is a lot of detail missed by Niche. The new report adds 103 pages of detailed information into Yusuf’s care and many failings Niche did not cover in their report. What sheer incompetence from Niche that 103 pages of failings were missed by them, yet they will face no accountability for their failings.

"In the second investigation for Yusuf’s family in a nine-month period the investigators Nurture met the family 10 times yet in 21 months Niche met Ayaan’s family only once, so what does that tell you about Niche and how it treats bereaved families?

“This now brings things back to my son Ayaan’s tragic death and how Niche has covered up his death along with the same NHS executives who were involved in Yusuf’s tragic case. Twenty three chances to save Yusuf were missed that Niche did not highlight in their report and in Ayaan’s tragic case 17 chances to save his life in three days were dismissed and brushed under the carpet by Niche as their report does not highlight 17 ignored referrals to escalate his care being dismissed.

“The report from October 2023 into Yusuf’s care by Niche has disappeared from the NHS England website which is concerning as that report should remain in the public domain so people can see for themselves the sheer incompetence of Niche who missed so many failings in his care. It would seem NHS England has removed the original report to protect Niche from further reputational damage and the commercial interests of Niche who NHS England has handed over £14m of public funds to over the last 10 years.”

Mr Rashid called for NHS bodies to stop using Niche.

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Singleton Hospital

Concerns about Niche extend to Wales, with Swansea Bay University Health Board having commissioned the consultancy to advise a review into failings at the Singleton Hospital maternity unit.

A briefing document written by Kate Jury, the managing partner of Niche, suggested parents had created a distorted narrative in order to discredit efforts to understand what went wrong at the Singleton unit.

Parents at the forefront of what they see as a campaign for justice said they were upset and outraged by the Niche document.

In September 2023 a Healthcare Inspectorate Wales inspection report concluded that the safety and wellbeing of mothers and babies could not be guaranteed at the Singleton Hospital unit.

The Welsh Government refused to hold a public inquiry into concerns about the unit. Instead a review was commissioned by the health board.

Parents led by Rob and Sian Channon, whose six-year-old son Gethin suffered serious brain damage at birth because of medical negligence at the unit, walked away from the review, saying they had no confidence in it.

'Devastated'

Reacting to the new report into the death of Yusuf, Mr Channon said: “We are devastated to hear another story involving Niche Consulting and our thoughts are with the parents of Yusuf.

“After hearing of this story we have written to [Cabinet Secretary for Health] Jeremy Miles to ask him to ensure that Niche Consulting won’t be awarded any more work by NHS bodies in Wales. Investigations into incidents in the NHS in Wales must be undertaken with integrity, compassion and competence.”

A spokesperson for Niche responded: “Niche is contracted to carry out detailed reviews and investigations precisely because of our independent role. We do not work for, or on behalf of, a health board or NHS trust. Our investigations are robust, proportionate, evidence-based and supported by the most up to date examples of good practice.

“A hugely important part of work is listening to families and finding the answers that they need about the care they, or a loved one, has received.

“We have over 30 years of experience and the work we do makes a huge difference in helping ensure that lessons are learned and improvements made where change is necessary.”

On the care and treatment of Yusuf Nazir in 2023, the spokesperson said: “This has been a tragic case, and our thoughts remain with this family, who worked closely with us during our initial review over several meetings and conversations.

“The second review commissioned, following our review, had a different and specific scope to answer the remaining questions that the family had. Both the initial and subsequent reports are now known to have reached the same broad conclusions, and both are conscientious investigation reports which provide important recommendations for improvement.

“An inquest has now been opened into Yusuf’s death, and we will be on hand to help with any enquiries from HM Coroner. Most importantly, we hope this process gives the family the answers they did not feel they got from either the first or subsequent investigation.”

'Sincere condolences'

On the care and treatment of Ayaan Rashid, the spokesperson said: “We would like to offer our sincere condolences to Ayaan's family for their loss and we understand how difficult this has been to come to terms with.

“Niche was commissioned by Sheffield Children’s NHS Foundation Trust in June 2023 to undertake an investigation into Ayaan’s care. Our investigation included the consideration of over 3,000 points of concern highlighted by his family over the timeline of the care he received.

“Our draft report has recognised many aspects of care which fell below expected standards, and we have made 15 recommendations for improvement. Our work recognised that the bereavement care provided to the family was poor and the cultural sensitivity shown after Ayaan’s death was substantially inadequate, and this has undoubtedly added to the highly traumatic experience of this family.

“NHS South Yorkshire shared our draft report with Ayaan's family in January this year. Niche, NHS South Yorkshire and Sheffield Children's NHS Foundation Trust, have ensured that Ayaan's family have the support they need, as they provide comments on the draft report.”

On the Singleton Hospital review, the spokesperson said: “The Swansea Bay Independent Maternity and Neonatal Review has now been published and is available to view on the Swansea Bay University Health Board website.

“Niche was commissioned by Swansea Bay University Health Board in May 2024 to support the delivery of the review. This was following concerns raised by families, by regulators and via MBRRACE (mothers and babies reducing risks through audits and confidential enquiries).

“The underlying aim of the review was to identify opportunities to improve patient safety within Swansea Bay Maternity and Neonatal Services and make recommendations for organisational and system learning.

“The review process was a huge undertaking involving taking in the views of over 1,000 women and families, undertaking detailed clinical reviews of care of 138 women and 125 babies, detailed discussions with community groups, and the extensive analysis of data, evidence and other information. This review has examined the services from all aspects, in order to form a rounded, independent view.

“All families needing maternity and neonatal care deserve and have the right to expect safe, compassionate, and consistent care. We hope that this report provides the women and families of Swansea and Neath Port Talbot with reassurance that the facts are now known. And, where change is needed, the Health Board is now fully aware of this.

“Our work is now complete and the health board is taking forward the recommendations contained in the report having unanimously accepted all the independent review’s findings and recommendations. “