Health and Social Care Bill may compromise patient safety says Business School academic

Dr Williams is in an almost unique position to comment as he has both led various NHS organisations and most recently undertaken research into how hospitals can improve patient safety. Evidence from his research and the recent Inquiry into Mid Staffordshire NHS Foundation Trust, suggests that managers can lose sight of patient safety when faced with the need to save money and meet targets. He is concerned that the current reorganisation of the NHS and the need to save £20bn may compromise the NHS’ ability to keep patients safe. He explains:

“The first problem is that the NHS is being reorganised just at the same time it faces the need to make large savings. With uncertainty in the system it is harder to make strategic decisions to save money. The pressure is then on hospitals to do more with less. Part of my research shows evidence of the gradual deterioration of standards of care that can occur when hospitals are under continuous pressure to meet targets and save money. Patients are often looked after on the wrong wards by staff who are not experts in their illness. Research evidence from Australia and America shows a relationship between overcrowded hospitals and worse patient safety.

The second problem is the assumption that competition leads to an improved service for patients. Whilst that assumption may apply in large cities, what is necessary for patient safety is collaboration, particularly in more rural areas like the South West. Research shows that optimising parts of a system usually created problems for the whole system. Rather than hospitals and community services competing they need to work together to treat patients. Competition can create problems in communications. Accurate and timely communication is vital for patient safety. The Bill should be focusing on what works, such as combining health and social care budgets and organisations, which is proving successful in Torbay.

The third problem is that we are losing much of our commissioning expertise. Buying health services for a population is a complex task. There are many competing priorities such as keeping within budget, avoiding long waiting times, new cancer drugs, whilst also ensuring that patient safety is not compromised. Safety is not easy to define or measure so there is the danger that new commissioning organisations will concentrate on what can be counted, such as money and waiting times, and pay less attention to staff workloads and patient safety.”

Dr Williams concludes “With the state of the UK economy, the financial savings required across the NHS mean that there is a renewed emphasis on the ‘faster, better, cheaper’ approach. This is likely to put patient safety at further risk if the proposals under the Health and Social Care Bill are implemented.”

His full research paper can be viewed on this website.