20 Dec 2013

Recently a report on a rapid review of acute care in hospitals in NHS Lanarkshire was published [1]. This review was triggered by reports of above average mortality rates and has found a number of systems failings within acute service provision.

Commenting on the review, Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh, said,

“The findings of this review make depressing, but not surprising reading. They are an indication of systems under severe pressure and prevalent in unscheduled care. Clinicians across Scotland will recognise the challenges facing colleagues in Lanarkshire. Doctors and nurses work under severe pressure with rising numbers of patients treated by a workforce with high locum levels and local recruitment difficulties. Insufficient senior review, particularly out of hours; an over-reliance on junior doctors and poorly resourced quality improvement systems contributed to a downward spiral of quality. Quite simply clinical teams in Lanarkshire were unable to provide the quality of care that patients have a right to expect and which are enshrined in national quality standards.

“Let us be clear that we must not rush to find quick fixes for the symptoms rather than the underlying causes of the problem. What is required is a system wide approach to the provision of emergency and unscheduled care. National quality standards must be delivered to all patients; and senior managers (clinical and non-clinical) must take responsibility for making change happen. We cannot ignore these problems and the College, through collaborative work with the Scottish Government Health Department is fully committed to improving patient experiences and outcomes. The NHS is one of our most important assets. We have a collective responsibility to ensure that it is sustainable, properly supported and that we provide the standards of care that patients deserve and doctors and nurses want to provide”.

[1] Rapid Review of the Safety and Quality of Care for Acute Adult Patients in NHS Lanarkshire, NHS Healthcare Improvement Scotland, December 2013

http://www.healthcareimprovementscotland.org/our_work/governance_and_assurance/programme_resources/nhs_lanarkshire__review.aspx

 

RCPE comment on this issue in the media –

BBC News

http://www.bbc.co.uk/news/uk-scotland-glasgow-west-25414691

 

Daily Telegraph, article

http://www.telegraph.co.uk/news/politics/10524124/Patients-may-have-died-at-Scottish-hospital-thanks-to-poor-care.html

 

The Herald, article

http://www.heraldscotland.com/news/health/monklands-hairmyres-and-wishaw-hospitals-nhs-board-told-to-make-21-improvements.1387284103

 

The Herald, editorial

http://www.heraldscotland.com/comment/herald-view/urgent-need-for-review-of-nhs-emergency-care.22971874

 

The Scotsman, article

http://www.scotsman.com/news/health/hospital-patients-wait-weeks-to-see-senior-doctor-1-3236076

 

The Scotsman, editorial

http://www.scotsman.com/news/leaders-budget-cuts-no-excuse-for-poor-healthcare-1-3236843

 

Daily Record, article

http://www.dailyrecord.co.uk/news/scottish-news/nhs-lanarkshire-told-improve-patient-2936338