Improvements in patient safety made after the Mid Staffs scandal are being undone amid NHS-wide financial problems and chronic staff shortages, the TUC has warned in a report.
The report claimed that moves to make care in England safer, such as by placing greater numbers of nurses on wards, are under threat as services struggle to reconcile the need to provide high-quality care with growing financial pressures.
The report cites long waits for treatment, the greater rationing of care and patients trapped in hospitals despite being fit to leave. Temporary ward closures are also highlighted as a risk.
“The government’s relentless drive to find savings at a time of rising demand is unsustainable. Each month we are seeing patient safety put at risk by staff shortages, longer waiting times and cuts to services”, said Frances O’Grady, the TUC’s general secretary.
“Ministers need to re-read the Francis Review. You cannot deliver a world-class health service on the cheap,” she added, referring to Robert Francis QC’s warning that cuts in the nurse numbers at Stafford hospital contributed to the mistreatment of patients between 2004 and 2009. His mammoth report into care at the hospital, which followed a 30-month public inquiry, prompted hospitals across England to hire extra staff, especially nurses.
The TUC report, Patient safety: warnings from all sides, claims that what was meant to be a gradual rollout of safe staffing ratios across every area of hospital care was halted earlier this year. By then, the National Institute for Health and Clinical Excellence (Nice) had already recommended a 1:8 nurse to patient ratio in acute and maternity wards to ensure safety. However, equivalent standards for A&E units, which were due to be published late last year, have never appeared and critics say they have fallen victim to the NHS’s £22bn savings drive.
“It is worrying that our NHS still does not have the ability to apply safe levels on staffing. Even after the Francis inquiry, financial targets continue to have an overbearing influence over the approach to patient safety,” said Paul Evans, co-ordinator of the NHS Support Federation, a research and campaign group which drew up the report jointly with the TUC.
The report draws heavily on an unprecedented series of warnings about declining patient safety issued by a number of medical bodies representing doctors, health thinktanks, trade unions, NHS bodies and even the watchdog, the Care Quality Commission. The CQC recently stated in its annual review: “The safety of care is our biggest concern. Ensuring consistently safe care remains the biggest single challenge for hospital providers.”
Evidence in the TUC report reveals “a decline in the standards of care but also worrying concerns about the safety of patients”. Dr Louise Irvine, a GP and a member of the British Medical Association’s ruling council, said: “Staff are working flat out and mistakes are already happening. Care is declining in quality. Staff are overstretched – they make mistakes, there are delays in necessary care, and they don’t have the time to talk, listen or explain.” She cites an hour-long delay for an ambulance to come to her surgery to take a male patients with chest pains to hospital as evidence that key NHS services increasingly cannot cope with demand for care growing at 4% a year.
Claire Jones, a health visitor, said that she and her colleagues are now worried that a shortage of them doing the job means that they will miss problems such as developmental delay in children, as well as speech and language issues and poor diet in children, which may then become problematic.
