Patient safety: Warnings from all sides

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By Paul Evans, Director, NHS Support Federation

Since the beginning of 2016 there has been an unprecedented series of warnings raising the alarm about the pressures on the NHS.

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Shocking accounts from the frontline of today’s NHS fill these reports. A dozen evidence-based warnings have been issued by Royal Colleges, trade unions and think tanks, all with a repeating theme - that care is not just under pressure, but is becoming unsafe. The NHS Support Federation summarises them in a new investigation which reveals how the government is gambling on the resilience of staff and patients in the face of a lack of resources.

The Royal College of Physicians identified that 20% of consultants felt that understaffing was frequently affecting patient safety. The Royal College of Midwives’ research revealed that 40% of maternity units are having to close temporarily because they cannot cope with demand.

A BMA survey found that many junior doctors with little specialist experience are having to take responsibility for entire wards of patients, such as in intensive care and on stroke and surgical units.

Only 3 years on from the Francis report the reality is that the government are gambling with patient care. They are relying on the resilience of staff and patients in the face of huge underfunding and cuts, which they themselves have instigated.

NHS funding rises have been the lowest since the 1950s. Government demands for £40bn of savings (2012-21) have left the NHS in a financial vice. No wonder then that survival is now based upon cuts, rationing and pushing services closer to the edge.

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In October 2016, the Royal College of Nursing survey of mental health nurses concluded that the rationing of care and the shortage of beds was so bad that young people risk harming or killing themselves.

Underinvestment is worsening the chronic shortage in staff. In the last few months The Royal College of Physicians, Royal College of Anaesthetists, Royal College of Paediatrics and Child Health and the BMA all reported widespread problems with rota gaps - where shifts start with too few staff.

UNISON, The Royal College of Midwives and the RCN have all reported on staff fears about understaffing and how they view these as “unsafe”.

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In community healthcare the number of district nurses and health visitors has been falling, whilst GP staffing levels are virtually static. Lack of staff is also causing temporary closures of maternity and A&E units.

The declining performance figures for the NHS through 2016 reflect the problems only too starkly, but worryingly the most vulnerable are just as exposed to the risk. More than 10,000 patients waited at least two hours before handover from an ambulance to a casualty unit in 2015/16 – a five-fold rise in just two years. The Royal College of Emergency Medicine warned “the risks to patients aren’t acceptable.”

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Reading these reports leaves no room for doubt about the scale and urgency of the problem. Unacceptable risks to patients are happening on a daily basis. Together they describe a situation that is worse than any previous crisis in the NHS. The only question they can’t answer is why is the government is not reacting.