The government’s focus on targets means that few NHS hospital trusts prioritise safety issues, one chief executive of a trust claimed last week.
As a result very few senior staff of trusts attend conferences like the one organised by the National Patient Safety Agency in Birmingham last week, said Stephen Ramsden, chief executive for Luton and Dunstable NHS Trust. Mr Ramsden was one of only five chief executives there.
During questions to Jane Kennedy, the health minister whose responsibilities include patient safety, Mr Ramsden said: “I’m not a big fan of the target culture. If half the attention had been given to patient safety as has been given to waiting times then more chief executives would be here and more would have been done.”
His remarks were greeted with widespread applause from around 900 delegates, but Ms Kennedy seemed to misunderstand Mr Ramsden’s remark, believing he was calling for a target on patient safety.
She said such a target was not on the government’s agenda but hoped that the systematic reforms on patient safety being applied across the health service would lead to improvements.
“There is the MRSA &;methicillin resistant Staphylococcus aureus &; target. That has begun to redress some of the changes in practice that had allowed sensible management of infection risk to slip down the agenda,” she said.
Mr Ramsden later explained his stance: “If we breach accident and emergency waiting times on a daily basis there is interest from the strategic health authority and they get pressure from the Department of Health,” he said. “That gives the impression that this is the highest priority. I have never once had a request to answer for patient safety from anybody.
“I wasn’t saying we should have a patient safety target. I was saying let’s have some more attention so that chief executives know that reducing our mortality rates is more important than accident and emergency waits.”
In his address to the conference Lord Hunt, parliamentary undersecretary at the Department of Work and Pensions, emphasised the importance of involving leaders in patient safety as a powerful means of engendering change.
“One of the things your organisations have to do is to get senior commitments to safety,” he said.
Ms Kennedy also praised Alder Hey Hospital in Liverpool for restoring public confidence in the medical profession’s practice regarding the storage of tissues and organs after its inquiry into the issue.
But Michael Carter, a consultant anaesthetist at Luton and Dunstable Hospital, said that he did not think that the inquiry had restored the public’s faith in doctors’ behaviour. His research on 250 patients who had died in 2002 and 2003 had shown that only about one to two per cent had had post mortem examinations. He said this was the legacy of Alder Hey.
“The families don’t want it to be done, and there is also a cost to an autopsy. Can hospitals afford to be doing them? It does appear that the population has turned totally against autopsy,” Dr Carter said.
The minister said she would look into the matter.
In her speech she reported that every acute trust in England had now moved to the same 2222 crash call number after an initiative by the National Patient Safety Agency to standardise the number.
The rising prevalence of obesity means that NHS trusts may have to rethink their management of morbidly obese patients, staff from one Kent hospital told the conference.
Staff at East Kent Hospitals NHS Trust had to tackle the issue head on after they found themselves unprepared for the arrival of a 299 kg patient one Friday evening.
The trust already had a policy in place to deal with obese patients but has reviewed and updated it in light of the incident.
A member of staff developed back pain and had to go on sick leave after trying—with colleagues—to push a bed containing the man along a 75 metre corridor with a steep gradient and sharp curve.