Tuesday, 27 November 2012

Care Before Targets Please

The MSP Keith Brown has been blowing the Scottish government's trumpet about the NHS.

Welcoming a newly published annual report into the 2100/2012 performance of the NHS in Scotland, which revealed the NHS has delivered some of its best ever performances against a range of key targets, Mr Brown said:

"These statistics clearly show that the improvements we have seen in the NHS in recent years have continued to grow and grow.

Despite the challenges that have been faced, the fact that NHS performance against key targets is so high is a fantastic achievement.

That achievement has only been made possible thanks to the hard work and determination of the dedicated NHS staff in Scotland, who consistently go the extra mile to care for their patients".

The statistics he refers to are the successful delivery of the 18-week referral to treatment waiting time target: reduced the time between decision to treat and treatment of cancer patients to 31 days; reduced incidents of C.difficile by 24% and MRSA/MSSA by 10% and carried out 272,000 alcohol Brief interventions in the past four years.

Derek Feeley, the NHS Chief Executive, described the progress as "the best ever performance".  While I welcome Mr Brown's enthusiasm for NHS targets being achieved, the latest FOI replies detail the care aspect of our health service is in need of improvement too. (You'll be able to check incidents which have occurred in your area).

It's about time politicians and health professionals realised that the public judge quality in the NHS by the standard of care their families and themselves receive and not by statistics. Care is fundamental to our health service and should never be sacrificed by target-driven managers.


Macheath said...

Well said! While statistics should always be taken with a pinch of salt, if the BBC has its calculations right, there is surely cause for urgent concern:

'Research suggests about one in ten hospital admissions result in an "adverse event".'

Amid the terse official descriptions of events that must, in some cases, have been deeply traumatic for those involved, this, somehow, seemed to sum it all up:

Slip/Trip/Fall - a patient tripped over staff member's foot and fell. The obstruction was removed.

Learning Points - none

subrosa said...

We used to have something called the Accident Book back in my day Macheath, for staff to record their stupid behaviour. :)

WitteringsfromWitney said...

It is not just in the NHS that meeting targets seems to be an important objective - it is prevalent in just about every sphere of 'providers', even housing associations. Targets are I believe also one of the main contributors why children's social services are in the mess it is.

pa_broon74 said...

I think it depends what target the is measuring, in terms of healthcare, if its financial performance I'd be suspicious about it but if its waiting times then I think that's probably ok although, I understand it would still be open to abuse (swapping people between lists/departments to off-load long term patients for example.)

Other than that, its down to the performance of the doctors managing the care, its been my experience they're either right into the care side of it (good) or right into the management side (bad) with very little in between.

I watched Newsnight last night, they were talking about the Liverpool Plan. It was a real swerve ball when the lady doctor being interviewed (who supports the Liverpool Plan) told us she was dying and was already on borrowed time, she also said she'd choose the LP.

It still needs looked at, the idea you can be admitted to hospital with dehydration (an example) and be put on a care regime that basically starves you to death because they didn't think you looked like you might make it.

Worrying indeed.

Crinkly & Ragged Arsed Philosophers said...

Quality of care and death are the real issues facing the NHS or any other care provider.

Waiting times come under the care issue but the essence isn't in the target of 18 or even 10 weeks it is in the time proactive care or treatments are introduced to either minimise the effects or cure the condition. In this respect statistics have a similar role to those of placebos.

As to the liverpool plan - as a pain management system it has a role to play. But not as a system which denies the fundamental sustenance of life.

For one reason if no other - nobody has yet been able to measure the inherent capacity of an individual to hang on and recover their life.

subrosa said...

I would't be surprised in the least WfW. That and Common Purpose.

subrosa said...

Good points pa_broon and what an retired medical pal said to me earlier in the year.

I didn't see Newsnight last night (bridge comes before TV!) but happy to hear a GP is able to plan her own LP. Pity the hoi polloi don't get the choice.

subrosa said...

Super contribution as always Crinkly. There have been some stories about people being removed and still going strong some time later, but I doubt if they are being officially recorded.

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