NHS: Doctors Blame Pen-Pushers for Failures

The Government and senior pen-pushers are to blame for the NHS missing several key targets in June according to the doctors’ union, the British Medical Association, suggesting a top-down management system that fails to meet its own standards.

Missed Targets

More than 4 million patients are now estimated to be waiting for surgery, which is the highest figure since records began 10 years ago. The NHS failed to meet its target of operating on 92% of them within 18 weeks.

The June performance report from NHS England said that almost twice the targetted number of patients had been waiting six weeks or longer from referral for one of 15 key diagnostic tests. It is now nearly four years since the operational standard was met.

The target of having A&E patients in and out in four times was also missed, as well as two out of eight cancer targets.

Government fails own targets

BMA council chair Chaand Nagpaul said the Government “is now routinely missing its own targets across the health system – it hasn’t met its emergency department target for two years and cancer care is being compromised.

The NHS is clearly at breaking point, yet the Government doesn’t appear to have an answer to this crisis. These figures are just one part of a much bigger picture, one of an NHS under unsustainable pressure, with patients and frontline staff paying the price.”

NHS Scotland

Earlier in the month the association warned that NHS Scotland fails to involve frontline staff in decision-making, a shortcoming that it said creates unrealistic expectations and destroys staff morale. “Invariably this results in time spent trying to negotiate a reinterpretation of what was meant and protracted efforts to find a workable solution,” it said. “All of which adds to a sense of frustration and confusion for those caught in the crossfire as well as time wasted.”

That one-way communication process is counterproductive and fails to draw upon the vast skills, experience and talent within the service. “The culture within the NHS in Scotland does not encourage staff at any level to challenge perceived wisdom or ways of doing things to establish if they continue to be effective or could be done differently,” said the BMA. “This can result in a lack of fresh ideas or willingness to address approaches which are not working well for fear of being seen as non-compliant.”

Staff Retention

The disconnect with health boards often leads staff to quit in frustration at being unable to deliver quality care because they are forced to place a higher priority on meeting targets. “The pressure for only good news to be escalated is worryingly prevalent and may mean that areas of concern are not always raised because of a perception they will not be well received by senior management,” the BMA warned.

That may be a pragmatic look at the managerial issues within the NHS but what about the emotional factor? It is the staff at the very forefront of care who are keeping the service going, and putting unnecessary long-term pressure on them is a destructive and self-defeating strategy. Worse still is it is the staff and the broader service that are constantly blamed while those responsible point the finger and tighten the screws.

by Stewart Vickers

 

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