Patient care is not a priority in NHS, say staff

23 May 13
Almost three-quarters of NHS staff do not believe that quality of care is given enough priority in the health service, according to a survey by the King’s Fund.

By Richard Johnstone | 23 May 2013

Almost three-quarters of NHS staff do not believe that quality of care is given enough priority in the health service, according to a survey by the King’s Fund.

Respondents to the think-tank poll also identified lack of appropriate resources and inadequate staffing levels as the major barriers to improving care.

The survey, which covered 900 doctors, nurses and managers, follows Robert Francis's public inquiry into care failures at the Mid Staffordshire hospital trust.

Overall, 73% of respondents said not enough priority was given to care across the health service, and the proportion rose to 80% among nurses.

In addition, only 14% believed the quality of leadership in the NHS was ‘good’ or ‘very good’, while 40% said it was ‘poor’ or ‘very poor’.

The think-tank report, Patient-centred leadership, concluded this showed the need to ‘transform’ the systems, leadership and culture of the NHS to ensure the lessons from the Francis report were acted on.

Management needed to focus on the needs of patients, and hospital trust boards should take a greater role in ensuring the quality and safety of care, the report added.

Although boards are formally responsible for care, which is a corporate responsibility for trusts, survey respondents ranked them only sixth out of eight institutions in terms of influence on care quality. They were rated behind clinicians, managers, government, regulators and patients.

The report said the boards needed therefore to give priority to quality and patient safety by actively seeking patient feedback, reviewing and learning from complaints and acting on the results of staff surveys. 

Nicola Hartley, director of leadership development at The King's Fund, said it was ‘the responsibility of all NHS organisations and professionals to make care patient-centred’.

However, the survey suggested there was ‘a long road to travel to achieve this’, she added.

‘Leaders throughout the NHS, especially at board level, need to ensure that patient-centred care is core to the organisational culture. These kinds of changes do not occur by good intention; they require time and commitment from ward to board to achieve sustainable change.’

Responding to the report, the NHS Confederation said the number one priority for NHS leaders was to change in their organisational culture to create a 'virtuous circle' of improving standards of care for patients.

Chief operating officer Matt Tee said: ‘The NHS is a huge and complex organisation, and changing its culture is not achievable overnight. ‘Nevertheless, it is very worrying that such a significant proportion of respondents to the King's Fund survey think the NHS does not sufficiently prioritise quality of care.’

Trade union Unison said that the survey suggested that the ‘worst fears’ for the NHS were coming true as the health service struggled to deliver quality patient care due to time and resource constraints.

‘Cuts mean trusts do not have enough money to pay for a growing and complex health service that relies on expensive equipment, high-tech treatment and costly drugs,’ said Unison head of health Christina McAnea.

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