Dark practices on night shift at death hospital

But an inquiry into Anne Grigg-Booth, published yesterday, paints a wider disturbing picture of night work on wards at Airedale Hospital, near Keighley, about which top management were either ignorant or did little or nothing to confront.

It found the night nurse practitioner was not alone in carrying out illegal prescribing at the hospital between the mid-1990s and her suspension in 2003. It said the conduct should have been "picked up and stopped six years earlier", well before any serious incidents took place.

But managers were quick to dismiss her as a "rogue" nurse and did not realise there were systemic failings at the organisation, wrongly believing that because it had won a string of accolades it was a successful NHS trust.

The report found Mrs Grigg-Booth was not a nurse in the mould of Grantham nurse Beverly Allitt or Colin Norris, who murdered four patients in Leeds during 2002, since her actions were "almost entirely" open.

She recorded what she was doing in clinical records and prescription charts.

Her role aimed to reduce the workload of junior doctors under arrangements in 1991 to cut their hours. It became unofficial policy for them to be allowed to stay in bed at night creating "the potential for patients to be put at risk", said the inquiry.

"Without realising it the trust board had a system in place which inadvertently put the needs of the organisation before that of patients."

It found that contrary to hospital policy, night nurse practitioners administered opiate painkillers straight into patients' bloodstreams.

They all believed they were permitted to do so and were competent to do it. Some managers knew about it but did nothing.

On some occasions Mrs Grigg-Booth went further and illegally prescribed opiates herself without permission from a doctor. Sometimes, but not always, she got a doctor to approve her actions retrospectively. Other practitioners may also have done the same but less often, the report found.