Is the NHS putting targets ahead of patients?

When you go into a NHS hospital, you expect to be receiving the best care possible, but according to a series of reports, the NHS could be putting targets ahead of the treatment of its patients.

NHS funding has nearly tripled from GBP£39.9 billion to GBP£102 billion in 11 years but there are concerns the cash has failed to raise standards.

Previous accounts from hospital workers have stated that increasingly, the medical needs of patients are being overshadowed by the need for hospital's to meet targets and balance the books. Patients are moved, services altered and waiting lists manipulated to ensure hospitals aren't penalised. Patients are even discharged too early, in the knowledge that they will have to be readmitted.

The three reports by international health think tanks were commissioned by the Department of Health in 2008 as it conducted a review of regulation of the health and social care.

The documents were obtained under the Freedom of Information Act by the think tank Policy Exchange which estimated that there are 43,000 deaths in the NHS each year which could be prevented with better treatment, the British paper The Telegraph reports.

Experts said the reports showed that hospital scandals such as Stafford, where up to 1200 people died needlessly, Basildon where around 400 more patients died than would have been expected and the superbug outbreaks at Stoke Mandeville and Maidstone and Tunbridge Wells, are not isolated incidents.

They warned that regulation needs to be tougher and patient safety should be given a higher priority.

Quality Oversight in England

The first report, Quality Oversight in England, by the Joint Commission International criticised the system of allowing hospitals to declare whether they were compliant with national standards as two thirds of the assessments made by regulators did not agree with the declarations.

The second report, Achieving the Vision of Excellence in Quality, was conducted by the Institute of Healthcare Improvement and found that the health service didn't have a clear idea of what good quality healthcare meant so resorted to the default position that "quality means meeting the targets."

It added: "The NHS has developed a widespread culture more of fear and compliance, than of learning, innovation and enthusiastic participation in improvement."

It said that staff in the NHS had to satisfy a manager or inspector instead of looking to satisfy patients and families.

The final document, by Rand, Developing, Disseminating and Assessing Standards in the National Health Service, said that there was a concern that the Department of Health was more interested in costs than clinical quality and that assessments of healthcare seemed to be motivated by political rather than health concerns.

Denial

Katherine Murphy, Director of the Patients Association, said: "Despite denial after denial surely now the Department of Health must accept that these reports get to the heart of the problems that have been plaguing the NHS for the last decade.

"Obsession with targets and not care, flawed systems of self assessment, a culture of blame and fear and most of all patients at the bottom of the pile of priorities. Together these reports paint a damning picture. Their findings should've been released at the time. You can't just bury bad news."

A Department of Health spokesman said: "England is one of the world leaders in the international drive to improve the safety of healthcare.

"We have set up and work alongside the National Patient Safety Agency to encourage medical staff to report and learn from incidents even when no harm was caused to the patient.

"Every death or serious injury due to mistakes in medical care must be investigated and the lessons must be learned and acted upon."

Visiting a hospital strikes fear in many, and these latest reports are going to do nothing to quash those fears. Do we have to worry that theNHS is falling around our feet? There appears to be more and more reports of things going wrong in the NHS and patients suffering as a consequence.

 

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